Efficiency of Ozonated Water Arthrocentesis Versus Conventional Arthrocentesis in the Treatment of Anterior Disc Displacement With Reduction of the TMJ

A large number of people worldwide suffer from temporomandibular joint internal derangement (TMJ ID), with women accounting for the majority of affected individuals.

Various treatment modalities have been proposed to restore functional equilibrium of the TMJ system. Management typically begins with conservative approaches, such as dietary modifications, antidepressant medications, non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and occlusal splints. When conservative measures fail to provide adequate symptom relief, minimally invasive interventions may be considered, including acupuncture, intra-articular injections of morphine or corticosteroids, botulinum toxin injection, and arthrocentesis. More advanced cases may require invasive surgical procedures such as arthroscopy or open joint surgery.

• Arthrocentesis using ozonized water (Procedure): Patients were treated by Arthrocentesis using ozonized water.
• Arthrocentesis using ringer's solution (Procedure): Patients were treated using conventional arthrocentesis with ringer's solution.

Primary outcomes

• Degree of pain [One week after surgery]: Each patient was instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable")

Secondary outcomes

• Measurement of maximum mouth opening [One week after surgery]: Maximal mouth opening which is the separation distance between the incisal edges of the mandibular and maxillary incisors was measured in millimeters

Sex: All, ages: 18 Years to 65 Years

Inclusion Criteria:

* Age: 18-65 years, with no gender preference.
* A main temporomandibular joint (TMJ) complaint that is diagnosed as disc displacement with reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).
* Presence of unilateral or bilateral temporomandibular disorder.
* American Society of Anesthesiologists (ASA) class I and II patients who are fit for general anesthesia.
* No improvement with conservative treatment for 3 months.
* Free of magnetic resonance imaging (MRI) contraindications.
* No previous surgeries to the TMJ.

Exclusion Criteria:

* History of systemic diseases that affect the TMJ such as rheumatoid arthritis and osteoarthritis.
* Restricted mouth opening due to muscle spasm.
* Developmental or congenital TMJ disorders.
* Benign or malignant TMJ lesions.