The effect of intra-articular injection of ultracain in the temporomandibular joint in patients with preauricular pain: a randomized prospective double-blind placebo-controlled crossover study.
OBJECTIVE
To evaluate the distinguishing ability of intra-articular anesthesia from placebo in orofacial pain patients with pain located in the temporomandibular joint (TMJ) region, aiming at a validation of intra-articular anesthesia injection as a diagnostic test of pain in the TMJ region.


METHODS
A randomized prospective double-blind, placebo-controlled crossover study was conducted among 19 patients (18 females, 1 male) with pain in the TMJ region. The short-term effects of intra-articular ultracain and saline injections on pain and maximum mouth opening were measured and analyzed.


RESULTS
Compared with placebo injections, a statistically significant difference in pain scores was found after intra-articular injection of a local anesthetic on Visual Analog Scale values. The maximum mouth opening scores did, however, not differ between the 2 groups.


CONCLUSIONS
TMJ injection with local anesthesia leads to the decrease of pain in patients with preauricular pain. To establish the source of pain, injection of a local anesthetic in the TMJ may be used as a diagnostic tool. However, the results of diagnostic injections should still be interpreted cautiously.
Tjakkes
Geerten-Has E
GH
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, The Netherlands. g.h.e.tjakkes@kchir.umcg.nl
Tenvergert
Elisabeth M
EM
de Bont
Lambert G M
LG
Stegenga
Boudewijn
B
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002355:Carticaine / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005157:Facial Pain / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D013704:Temporomandibular Joint / Q000187:drug effects*
D000779:Anesthetics, Local; D002355:Carticaine