Intra-articular injection of a mixture of hyaluronic acid and corticosteroid versus arthrocentesis in TMJ internal derangement

Background: Internal derangements are the commonest disorders of temporomandibular joint (TMJ). Different treatment modalities have been proposed to treat this disorder. Arthrocentesis and intra-articular injection are gaining popularity in the treatment of internal derangement of TMJ. Purpose: The aim of this study was to compare between the effect of arthrocentesis and intra-articular injection using a mixture of hyaluronic acid and corticosteroid in the management of TMJ internal derangement. Materials and methods: Sixteen patients with TMJ internal derangement were selected and divided into 2 equal groups. In group I, arthrocentesis was performed with Ringer solution. In group II, intra-articular injection was performed with a mixture of 0.5 ml hyaluronic acid and 0.5 ml corticosteroid. Assessment of pain, maximum mouth opening, lateral movement and clicking was done before the treatment, one week, one month and three months after the treatment. All parameters were subjected to statistical analysis. Results: All studied parameters showed improvements. There was no statistically significant difference between the two groups regarding intensity of pain, maximum mouth opening, lateral movement and joint sound. Conclusions: TMJ arthrocentesis and intra-articular injection of a mixture of hyaluronic acid and corticosteroid have been found to be effective for treatment of TMJ internal derangement with reduction. Nevertheless, the simplicity of intra articular injection makes it the treatment of choice.