An effect of hyaluronic acid on the temporomandibular joint arthrocentesis

Yeo, Hwan Ho; Kwon, Byong gon; kim, Jae Seung

Abstract

To compare the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis the author investigated 22 temporomandiular joint disorder(TMD) patients with pain and limitation of mouth opening who visited at the Department of Oral and Maxillofacial Surgery, Chosun Dental Hospital and were made a diagnosis as Wilkes stage III or IV of TMJ internal derangement clinically and radiographically. The two groups consisted of 10 patients with injection of sodium hyaluronate 10mg(Artz(R))(hyaluronate group) on the upper joint space of the affected temporomandibular joint 5 times at intervals of a week after arthrocentesis, and 12 patients with injection of dexamethasone(Oradexon(R)) at a time(dexamethasone group). Maximum mouth opening, pain value and satisfaction value during mastication were assessed on a visual analog scale before arthrocentesis and after 6 months. Then the within-group and between-group differences were evaluated in the obtained data and the clinical success rate of each group was calculated according to our success criteria. The results were as follows. 1. The mean of maximum mouth opening before arthrocentesis and after 6 months in the hyaluronate group were 24.9 mm and 39.0 mm respectively, and those before arthrocentesis and after 6 months in the dexamethasone group were 25.7 mm and 41.3 mm respectively. 2. The mean of pain value on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 6.7 and 1.8 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 7.0 and 1.8 respectively. 3. The mean of satisfaction value during mastication on a visual analog scale in the hyaluronate group before arthrocentesis and after 6 months were 2.8 and 7.7 respectively, and those in the dexamethasone group before arthrocentesis and after 6 months were 3.1 and 7.8 respectively. 4. There were statistically significant differences between all measurements before arthrocentesis and after 6 months(P<0.001), but no difference between all measurements in the hyaluronate group and those in the dexamethasone group. 5. The over all success rate of the hyaluronate group and the dexamethasone group were 60.0% and 63.6% respectively. In summary, there was significant difference between the effect of hyaluronate and dexamethasone on the temporomandibular joint arthrocentesis but hyaluronate is better than corticosteroid as the injection drug in consideration of the side effect related with repeated injection.