TO STUDY THE EFFICACY OF LOW-MOLECULAR WEIGHT SODIUM HYALURONIDASE AND BETAMETHASONE IN TEMPOROMANDIBULAR JOINT ARTHROCENTESIS.: A COMPARATIVE STUDY

Abstract

Introduction: Dysfunction of the temporomandibular joint (TMJ) is a therapeutic challenge for oral and maxillofacial surgeons. Temporomandibular joint disorders (TMD) refer to a group of heterogeneous dysfunction conditions involving the masticatory system, reducing life quality of the sufferers. One of the most common forms of Temporomandibular disorder (TMD) is Internal derangement (ID). Arthrocentesis was considered as an intervening treatment modality between nonsurgical treatment and arthroscopic surgery.

Aim of study: This comparative study was designed to investigate the efficacy of low-molecular weight sodium hyaluronidase and betamethasone in the treatment of temporomandibular joint disorders through Arthrocentesis procedure.

Material and Methods: A total of 100 patients visiting to the outpatient department of Oral and Maxillofacial Surgery Pacific Institute of Dental College, age group 18 -60 years included in the study based on inclusion criteria. The patients’ complaints were limited mouth opening, TMJ pain, and joint noises during function. Patients were randomly divided into two groups.

Group A patients will receive 1 ml of 10mg Sodium hyaluronate and Group B patients will receive 1 ml of 0.05mg of Betamethasone in  joint space ,in single puncture. Parameters such as temporomandibular joint pain intensity, clicking sounds (opening and closing click sounds) maximum incisal mouth opening, protrusive and Right & Left lateral excursions will be recorded. Patients were followed at regular interval of one week, 1, 3, and 6 (follow up) after last injection.

Results: According to the visual analogue scale for pain intra articular injection low molecular weight Hyaluronic acid proved to be better compared to injection betamethasone. Preoperative maximum mouth opening in group A patients with a mean of 23.2, while postoperative maximum mouth opening with a mean of 35.5 at 6months follow up The preoperative maximum mouth opening in Group B patients opening with a mean of 24.7, while postoperative maximum mouth opening with a mean of 34.2 at 6months follow up

Conclusion: Both techniques increased maximal mouth opening, lateral movements, and function, while reducing TMJ pain and noise. Although patients benefitted from both techniques. It is observed that arthrocentesis followed by intra articular injection of low molecular weight hyaluronic acid was better than betamethasone.