Repeated sodium hyaluronate injections following multiple arthrocenteses in the treatment of early stage reducing disc displacement of the temporomandibular joint: A preliminary report

Purpose: The aim of this study was to assess the safety and clinical utility of intraarticular injection of sodium hyaluronate for the treatment of symptoms associated with internal derangement of the temporomandibular joint (TMJ). Patients and methods: Twenty patients, who have early stage temporomandibular dysfunction (TMD). were treated with intraarticular sodium hyaluronate injection and arthrocentesis. The patients received sodium hyaluronate (15 mg/ml) (1 ml) injections two times a week first following arthrocentesis with 200 ml Ringer's Lactate and the second without. The procedure was repeated for three times at weekly intervals for 3 weeks. Pre- and postinjection pain intensity, the presence of joint sounds, and interincisial distance were recorded. These data were evaluated by visual analog scale (VAS). Results: The follow-up period was 6 months. There was a statistically significant reduction of pain intensity (p < 0.001) and joint sound (p < 0.001) in all patients. Initial measurement of maximal mouth opening (MMO) was 33.40 +/- 3.75 mm. At the end of the follow-up period, the same measurements were repeated and interincisal distance was 49.3 +/- 3.74 mm. The difference between these measurements was statistically significant (p < 0.001). Conclusion: We suggest that repeated sodium hyaluronate injections following multiple arthrocenteses with Ringer's Lactate is an effective and safe method for the treatment of early stage reducing disc displacement of TMJ. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.