Susumu Mizuno

Primary Treatment for Osteoarthritis of the Temporomandibular Joint by Combination Therapy of Arthrocentesis, Mouth Opening Exercises, and a Non-steroidal Anti-inflammatory Drug Regimen

Abstract Purpose: To analyse the effect of primary treatment of osteoarthritis of the temporomandibular joint by a combination of arthrocentesis, range of motion exercises, and non-steroidal anti-inflammatory drugs for 12 weeks. Patients and Methods: Fifty patients with osteoarthritis of the temporomandibular joint and unilateral moderate or severe temporomandibular joint dysfunction underwent arthrocentesis and steroid injection followed by mouth opening exercises and oral administration of non-steroidal anti-inflammatory drugs. Therapy continued for 12 weeks, or was stopped earlier if symptoms improved. Patients were evaluated every 2 weeks by visual analogue scales for pain at rest, pain with mandibular motion, pain on chewing and interference with daily life, and measurement of maximal mouth opening. Results: All visual analogue scale values were statistically reduced and maximal mouth opening statistically increased from 32 to 40 mm with this combination therapy. The improvement rates at 2, 4, 6, and 8 weeks after the start of therapy were 46%, 62%, 70%, and 72%, respectively. However, there was no difference between the 10th and 12th weeks, which both showed 76% improvement. Conclusion: This combination therapy is an effective primary treatment for osteoarthritis of the temporomandibular joint. The follow-up period should be 10 to 12 weeks to reach maximum improvement.