Evaluation of different doses of hyaluronic acidadministration after arthrocentesis in patients withunreduced disc displacement: A randomised clinicaltrial

Objective: In our study, we aimed to compare the clinical efficacy of different doses of hyaluronic acid after arthrocentesis in patients with disc displacement without reduction. Materials and Methods: The study was conducted in a total of 36 patients who met the inclusion criteria, were older than 18 years of age, had at stage 3 and stage 4 in the Wilkes classification and were diagnosed with disc displacement without reduction. Patients were randomly assigned to Group 1 (Ostenil®, TRB Chemedica SA, Vouvry, Switzerland) and Group 2 (OSTENIL® PLUS, TRB Chemedica SA, Vouvry, Switzerland) injections containing different doses of hyaluronic acid before the operation. Patients completed the TMD Pain Questionnaire, Generalized Anxiety Disorder Test-7, Chronic Graded Pain Scale Version 2.0, Fonseca Anamnestic Questionnaire, Jaw Functional Limitation Scale, SF-36 Quality of Life Scale, Beck Depression Scale, maximum mouth opening, contralateral movements, Visual Analog Scale (VAS) pain scores, temporomandibular joint sounds and masticatory muscle palpation findings before, 1 month and 3 months after treatment were compared. Results: Increased maximum mouth opening and contralateral movements, decreased pain, decreased TMJ sounds, and increased lateral and protrusive movements were observed in both groups after the procedure. No statistically significant difference was observed in the improvement of symptoms in the groups treated with different doses of hyaluronic acid after arthrocentesis. Conclusion: In the treatment of disc displacement without reduction, hyaluronic acid application in combination with arthrocentesis was found to be very successful in reducing the pain of the patients and increasing the maximum mouth opening. In addition, it was concluded that there was no statistically significant difference between the groups treated with different doses of hyaluronic acid application after arthrocentesis. Keywords: TMJ, maximum mouth opening, arthrocentesis, hyaluronic acid, VAS, dose