Background and objectives: Conservative treatment has been traditionally considered as the primary treatment for the tempromandibular disorders (TMD). We aimed to assess the effectiveness of single needle tempromandibular joint (TMJ) arthrocentesis and injection of Hyaluronic acid given once under local anaesthesia for patients with the arthrogenic subdivisions of tempromandibular joint disorders (TMD) as the primary treatment modality.
Method: Patients with TMD seen between august 2008 till March 2013 were sub classified into myogenic or arthrogenic based on the research diagnostic criteria for TMD (RDC/TMD). Only the arthrogenic TMD subdivisions patients were included. Patient’s with sever pain (as assessed by VAS (Visual Analogue of Pain)) and sever jaw dysfunction (as assessed by Helkimo index) were offered TMJ arthrocentesis using single needle done under local anesthesia with the injection of 1 ml of hyaluronic acid. This treatment provided primarily without prior conservative treatment. None of the patients received occlussal splint and all procedures perfumed by the same surgeon. Improvement was considered to be good if pain and jaw dysfunction improved from being severe to be mild or none. Minimal review was 6 months.
Results: Ninety-three patients fitted the inclusion criteria and included in the study. The vast majority of the patients were female (90%) with an age range of 20–58 years old. Seventy patients (75%) had improved symptoms of pain and jaw dysfunction without the need of further treatment. None of the patients had significant complication.
Conclusion : Single-needle TMJ arthrocentesis under LA with HA injection given only once is effective and safe primary treatment modality for patients with sever pain and sever jaw dysfunction of the arthrogenic TMD subdivision.
Key words: single needle TMJ arthrocentesis; primary treatment; TMD