Short-term effects of arthrocentesis plus viscosupplementation in the management of signs and symptoms of painful TMJ disc displacement with reduction. A pilot study.
OBJECTIVE
To provide data on the short-term effect of a cycle of five weekly arthrocenteses plus hyaluronic acid injections in the management of signs and symptoms of painful disc displacements.


METHODS
Thirty-one consecutive patients (25 females, six males; mean age 42.4) with a combined diagnosis of disc displacement with reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders underwent a cycle of five arthrocenteses with injections (one per week) of 1 ml hyaluronic acid. A number of subjective and objective clinical parameters were assessed at the time of the diagnosis (baseline), at each appointment during the treatment, at the end of the treatment, and three follow-up appointments (1 week, 1 month, and 3 months).


RESULTS
At the end of the treatment period, marked improvements with respect to baseline values were recorded in all the outcomes variables, and they were maintained over the 3-month follow-up span. Significant changes were shown in subjective outcome variables, viz., masticatory efficiency, maximum pain levels, functional limitation, perceived efficacy, and objective clinical parameters, viz., jaw range of motion on different movements. Tolerability of treatment was acceptable since the first intervention and was moderately improved over time.


CONCLUSIONS
A cycle of five weekly hyaluronic acid injections performed immediately following arthrocentesis is effective to improve signs and symptoms in patients with painful temporomandibular joint disc displacement with reduction and to maintain them over a 3-month follow-up.
Guarda-Nardini
Luca
L
TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
Manfredini
Daniele
D
Ferronato
Giuseppe
G
D000328:Adult; D018771:Arthralgia / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D004204:Joint Dislocations / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019152:Paracentesis; D013704:Temporomandibular Joint; D019224:Temporomandibular Joint Disc
D006820:Hyaluronic Acid