Abstract:

Objective

To compare clinical effects of arthrocentesis and sodium hyaluronate in treatment of TMD disc displacement without reduction of different stages.

Methods

126 cases （138 joints） with TMD disc displacement without reduction underwent arthrocentesis and sodium hyaluronate injection.These cases were distributed to three groups according to course of diseases： less than 6 months； 6 to 12 months； and over 12 months.The follow-up period was 12 to 36 months （average 26 months）.The clinical effects of each group were compared.

Results

The total success rate of three groups was 88.9%（112/126）.In less 6 months group， postoperative MIO（maximum interincisal opening） increased （8.2±3.4）mm and lateral excursions increased （4.8± 1.4）mm in average.91.7%（33/36） out of all patients who complaining pain as main symptom released.The success rate was 94.4%（34/36）.In the group 6 ～12 months， postoperative MIO increased （8.0±3.2）mm and lateral excursions increased （4.4±1.5）mm.90.5%（38/42） of patients who had pain felt the symptoms reduced.The success rate was 92.9%（38/42）.In the group over 12 months， postoperative MIO increased （7.1±4.1）mm and lateral excursions increased （3.5±2.4）mm in average.81.3%（39/48） of patients had pain released.The success rate was 83.3%（40/48）.Comparing with MIO， lateral excursions， pain release and success rate， the group less 6 months and the group 6 ～12 months were better than that of the group over 12 months （P ＜0.05）， however no significant differences were found between the group less 6 months and the group 6 ～12 months （P ＞0.05）.

Conclusions

Arthrocentesis and sodium hyaluronate injection are the effective procedures in treatment of TMD disc displacement without reduction.However，the clinical effects were better in cases treated within 12 months than those over 12 months.Earlier treatment is better.

Key words: Temporomandibular disorders, Disc displacement without reduction, Arthrocentesis, Sodium hyaluronate