Influence of intra-articular corticosteroid on the efficacy of arthrocentesis in treatment of temporomandibular joint anterior disc displacement without reduction / 华西口腔医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the efficacy and radiographic changes after arthrocentesis followed or not followed by intra-articular corticosteroid injection in patients with temporomandibular disc displacement without reduction.</p><p><b>METHODS</b>Ninty patients were enrolled in the randomized clinical trial. After receiving arthrocentesis, either 0.5 mL triamcinolone acetonide plus 0.5 mL saline (experimental group, n = 46) or 1 mL saline solution as control (control group, n = 44) was injected. Patients were assessed by visual analogue scale (VAS) pain scores and Fricton temporomandihular joint (TMJ) index at first visit before treatment, 3-4 weeks and 6 months after treatment respectively. Transpharyngeal and lateral transcranial projections for temporomandibular joints were taken for imaging evaluation. The pain score of patients with pain complaint were recorded everyday for 1 week after treatment.</p><p><b>RESULTS</b>Glucocorticoid injection showed more effective pain control over the first week (P < 0.05), and both groups reported symptom and clinical sign relief significantly after treatment (P< 0.001). However, quantitative evaluation for pain reduction, maximal mouth opening improvement and Friction TMJ index showed no significant difference between two groups at 3-4 weeks and 6 months after the treatment. Also there was no significant difference for condylar bone changes radiographically between the two groups.</p><p><b>CONCLUSION</b>Arthrocentesis is an effective treatment for temporomandibular joint disc displacement without reduction, but it is not necessary to inject corticosteroid after arthrocentesis. Intra-articular corticosteroid injection after arthrocentesis is indicated for only those patients with severe pain.</p>