[Treatment of temporomandibular joint disc perforation with injection of hyaluronic acid or disc repair].

OBJECTIVE: To assess the efficacy of injection of sodium hyaluronate in the treatment of patients with disc perforation by using cone- beam computed tomography (CBCT) and temporomandibular joint (TMJ) function.

METHODS: Twenty- eight patients (38 joints) with disc perforation observed through arthrography who received injection of sodium hyaluronate and other 20 patients (29 joints) who received disc repair were included in this study. Pain (visual analog scale, scores 0 to 100), maximal mouth opening, modified Helkimo's clinical dysfunction index and TMJ examinations with CBCT were obtained before and 3, 9 months after treatment.

RESULTS: A statistically significant increase (P < 0.05) in TMJ clinical outcome was observed at each follow-up. The maximal mouth opening (MMO) increased 5.89 mm and 7.64 mm at 3 and 9 months follow-up in the hyaluronic acid (HA) group, and the MMO increased 2.75 mm and 6.10 mm at 3 and 9 months follow-up in the operation group. Osseous remodeling occurred in 66% (25 of 38 joints) of patients after HA injection and 55% (16 of 29 joints) of patients appeared bone remodeling after disc repair.

CONCLUSIONS: Both injection of hyaluronic acid and disc repair are effective for treatment of temporomandibular joint disc perforation.