West China Journal of Stomatology

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Influence of intra-articular corticosteroid on the efficacy of arthrocentesis in treatment of temporomandibular joint anterior disc displacement without reduction

HAN Yang, FU Kai -yuan, CHEN Hui -min, LI Jing   

  1. Center for Tempormandibular Disorders and Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing 100081, China
  • Received:2010-12-25 Revised:2010-12-25 Online:2010-12-20 Published:2010-12-20
  • Contact: FU Kai -yuan,Tel: 010-62179977-5342

Abstract:

Objective To compare the efficacy and radiographic changes after arthrocentesis followed or not followed by intra -articular corticosteroid injection in patients with temporomandibular disc displacement without reduction  Methods Ninty patients were enrolled in the randomized clinical trial. After receiving arthrocentesis, either 0.5 mL triamcinolone acetonide plus 0.5 mL saline(experimental group,n=46) or 1 mL saline solution as control(control group, n=44) was injected. Patients were assessed by visual analogue scale(VAS) pain scores and Fricton temporomandibular joint(TMJ) index at first visit before treatment, 3-4 weeks and 6 months after treatment respectively. Transpharyngeal and lateral transcranial projections for temporomandibular joints were taken for imaging evaluation. The pain score of patients with pain complaint were recorded everyday for 1 week after treatment. Results Glucocorticoid injection showed more effective pain control over the first week(P<0.05), and both groups reported symptom and clinical sign relief significantly after treatment(P<0.001). However, quantitative evaluation for pain reduction, maximal mouth opening improvement and Friction TMJ index showed no significant difference between two groups at 3-4 weeks and 6 months after the treatment. Also there was no significant difference for condylar bone changes radiographically between the two groups. Conclusion Arthrocentesis is an effective treatment for temporomandibular joint disc displacement without reduction, but it is not necessary to inject corticosteroid after arthrocentesis. Intra -articular corticosteroid injection after arthrocentesis is indicated for only those patients with severe pain.

Key words: temporomandibular disorders, anterior disc displacement without reduction, arthrocentesis, corticosteroid