Department of Plastic Reconstructive and Aesthetic Surgery, Gaziosmanpasa University, Faculty of Medicine, 60100 Tokat, Turkey.
J Craniomaxillofac Surg. 2012 Dec;40(8):685-9. doi: 10.1016/j.jcms.2011.12.003. Epub 2012 Jan 14.
The aim of this study was to assess the safety and clinical utility of intraarticular injection of sodium hyaluronate for the treatment of symptoms associated with internal derangement of the temporomandibular joint (TMJ).
Twenty patients, who have early stage temporomandibular dysfunction (TMD), were treated with intraarticular sodium hyaluronate injection and arthrocentesis. The patients received sodium hyaluronate (15 mg/ml) (1 ml) injections two times a week first following arthrocentesis with 200 ml Ringer's Lactate and the second without. The procedure was repeated for three times at weekly intervals for 3 weeks. Pre- and postinjection pain intensity, the presence of joint sounds, and interincisial distance were recorded. These data were evaluated by visual analog scale (VAS).
The follow-up period was 6 months. There was a statistically significant reduction of pain intensity (p < 0.001) and joint sound (p < 0.001) in all patients. Initial measurement of maximal mouth opening (MMO) was 33.40 ± 3.75 mm. At the end of the follow-up period, the same measurements were repeated and interincisal distance was 49.3 ± 3.74 mm. The difference between these measurements was statistically significant (p < 0.001).
We suggest that repeated sodium hyaluronate injections following multiple arthrocenteses with Ringer's Lactate is an effective and safe method for the treatment of early stage reducing disc displacement of TMJ.
本研究旨在评估关节内注射透明质酸钠治疗颞下颌关节(TMJ)内部紊乱相关症状的安全性和临床实用性。
20 名早期颞下颌功能障碍(TMD)患者接受了关节内透明质酸钠注射和关节穿刺术治疗。患者在关节穿刺后首先接受两次每周 15mg/ml(1ml)透明质酸钠注射,每次注射后再用 200ml 林格氏乳酸冲洗关节腔,第二次则不冲洗。每周重复三次,共 3 周。记录注射前后的疼痛强度、关节声响和切牙间距离。这些数据通过视觉模拟评分(VAS)进行评估。
随访期为 6 个月。所有患者的疼痛强度(p < 0.001)和关节声响(p < 0.001)均有统计学显著降低。最大张口度(MMO)的初始测量值为 33.40 ± 3.75mm。在随访期末,重复相同的测量,切牙间距离为 49.3 ± 3.74mm。这些测量值之间的差异具有统计学意义(p < 0.001)。
我们认为,在林格氏乳酸多次关节穿刺后重复透明质酸钠注射是治疗早期 TMJ 盘前移位的有效且安全的方法。