Visco-supplementation therapy in internal derangement of temporomandibular joint.
OBJECTIVE
To study if visco-supplementation therapy is useful to the internal derangement (ID) of temporomandibular joint (TMJ).


METHODS
Sixty-three ID cases (69 TMJs) were studied by visco-supplementation therapy. The upper and/or lower articular cavities were irrigated with 5 ml normal saline and injected 0.3-1.0 ml 1% hyaluronate (HA) into articular cavity. If the symptoms of the disease still existed one week later, the therapy should be repeated for 1-2 times, once a week. The control group cases were injected 1 ml 2% lidocaine instead of HA. 8 other TMJs of 6 ID cases and 2 normal cadavers were studied with scanning electron microscopy (SEM) and light microscopy (LM).


RESULTS
The visco-supplement therapy was useful to ID patients. The difference between the test group and control group had statistical significance (chi 2 = 6.6535, P < 0.01). SEM and LM showed that the condyle, disc and bilaminar region in ID were degenerated or destroyed.


CONCLUSIONS
The friction between the articular surfaces in ID was increased and the bilaminar region could not retract the disc as in healthy TMJ. The visco-supplementation therapy can decrease the friction and resume the normal rheology of the diseased TMJs.
Department of Stomatology, First Teaching Hospital, Zhejiang Medical University, Hangzhou 310003, China.
Z
Z
Gu
Q
Q
Wu
Y
Y
Zhang
Z
Z
Zhang
K
K
Sun
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D013704:Temporomandibular Joint / Q000648:ultrastructure; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000188:drug therapy* / Q000473:pathology
D006820:Hyaluronic Acid