Enhanced Management of TMJ Internal Derangement: A Focus on Sodium Hyaluronate in Arthrocentesis

Enhanced Arthrocentesis with Sodium Hyaluronate

Abstract

Background: Internal derangement (ID) of the temporomandibular joint (TMJ), often leading to pain and impaired jaw function. Traditional non-surgical treatments include diet modification, splint therapy, physiotherapy, and medications, while invasive surgical options are considered when this fails. Arthrocentesis is a minimally invasive procedure, and adding sodium hyaluronate (SH) has shown the potential to enhance outcomes. Objective: This study explores the impact of adding sodium hyaluronate to arthrocentesis to enhance pain relief and joint function in TMJ internal derangement. Study Design: Randomized controlled experiment. Settings: This research was performed at the Departments of Oral Medicine and Oral & Maxillofacial Surgery at Lahore Medical & Dental College, Lahore Pakistan. Duration: The study lasted for one year and eight months. Methods: Fifty patients with Wilkes stage III, TMJ ID, unresponsive to conservative treatment, were enrolled and randomized into two groups. Group A received arthrocentesis with regular saline, while Group B received arthrocentesis followed by an intra-articular injection of SH. Pain and maximum mouth opening (MMO) were evaluated preoperatively and during the six months postoperatively. Results: Group B exhibited significantly greater pain reduction (VAS score: 1.95 vs. 6.85) and improved MMO (16.75 mm vs. 10.65 mm) compared to Group A. SH showed superior outcomes in both pain relief and MMO. Conclusion: Arthrocentesis combined with sodium hyaluronate significantly enhances pain reduction and joint function in TMJ internal derangement compared to arthrocentesis alone.