[Intraarticular injection-dilatation and later lavage plus viscosupplementation of TMJ for the treatment of anterior disc displacement without reduction].

Purpose: To evaluate the clinical efficacy of the TMJ intraarticular injection-dilatation and later lavage plus viscosupplementation as a treatment for anterior disc displacement without reduction of the TMJ.

Methods: 29 patients with anterior disc displacement without reduction of the TMJ were treated by using intraarticular injection-dilatation. Arthrocentesis and lavage was conducted after 3-5 days, a volume of 1ml of sodium hyaluronate was injected into the super cavity at the end of lavage. The passive exercise mouth opening was done twice every day. Paired t test was used for statistical analysis.

Results: The maximum mouth opening was increased from (23.66+/-4.39)mm before treatment to (34.93+/-4.50)mm after intraarticular injection-dilatation(P<0.01), (39.17+/-4.38) mm after lavage plus viscosupplementation(P<0.01). The mandibular healthy side direction motion increased significantly (P<0.01) at different periods. 2 patients had mandibular motion pain after a series of treatments. 5 cases had pain on the opposite joints during treatment.

Conclusion: (1) The TMJ intraarticular injection-dilatation and later lavage plus viscosupplementation is useful for patients with anterior disc displacement without reduction of the TMJ. The new therapy can increase mandibular motion and reduce pain. (2) The TMJ intraarticular injection-dilatation and lavage plus viscosupplementation are complementary and accumulated. (3) The opposite joint's pathological changes that is found and treated can increase the overall effect.