EFFICIENCY OF TEMPOROMANDIBULAR JOINT ARTHROCENTESIS WITH OZONATED WATER IN MANAGEMENT OF ANTERIOR DISC DISPLACEMENT WITHOUT REDUCTION: A RANDOMIZED CLINICAL TRIAL

Objective: The aim of the study was to evaluate the efficiency of temporomandibular joint arthrocentesis with ozonated water versus ringer lactate in treatment of anterior disc displacement without reduction (closed lock) and to evaluate the effect of both procedures on the level of interleukin-6 (IL-6) in the joint space.
Patients and methods: Forty patients with bilateral anterior disc displacement without reduction were included in the study. Patients were randomly allocated into 2 groups. Group I performed arthrocentesis using ozonated water while group II underwent the same procedure using sodium ringer lactate. Clinical evaluation of the patients was done preoperative, immediately ostoperative, at 1 week and 1, 3 and 6 months postoperatively. The pain was assessed using visual analog scales. Maximal mouth opening (MMO) was recorded at each follow-up visit. Synovial fluid sample was collected to detect the level of IL-6, preoperative, immediately postoperative and at six months postoperative
Results: Both groups showed improvement in clinical parameters. Concerning maximal mouth opening, there was no statistically significant difference between the two groups pre-operatively, after 1 week as well as after 1 month. After 3 months and 6 months, Group I showed statistically significant higher mean MMO than Group II. the pain score assessment showed no statistical significant difference between the two groups pre-operatively. Through all other periods, Group I showed statistically significantly lower mean VAS scores than Group II. The interleukin-6 levels showed no statistically significant difference between the two groups pre-operatively. Immediately post-operative as well as after 6 months, Group I showed statistically significantly lower mean IL-6 level than Group II.
Conclusion: Arthrocentesis using ozonated water proved to have superior results in treatment of TMJ anterior disc displacement without reduction. Interleukin-6 level in the TMJ synovial fluid has direct correlation with the dysfunction symptoms.