Is arthrocentesis plus hyaluronic acid superior to arthrocentesis alone in the treatment of disc displacement without reduction in patients with bruxism?

Purpose: This study was designed to investigate the efficacy of arthrocentesis with and without intra-articular injection of hyaluronic acid (HA) in the treatment of disc displacement without reduction (DDwoR) in patients with bruxism. Materials and methods: A retrospective cohort study was conducted using the files of patients with DDwoR, limited mouth opening, and bruxism. Patients were divided into two groups according to the treatment method: arthrocentesis alone (group 1) and arthrocentesis plus intra-articular HA injection (group 2). To evaluate the clinical outcomes for the groups, maximum mouth opening (MMO) and visual analog scale (VAS) values before treatment, immediately after the operation, and at 1, 3, 6, 9, and 12 months postoperatively were analyzed. Results: The study consisted of 40 patients (34 female and 6 male, mean age 36.0 +/- 11.95 years). MMO values increased and VAS scores decreased in both groups at all follow-ups after the treatment compared with pretreatment values (p < 0.001). The increase in MMO in group 2 was greater than in group 1 only at 3 and 6 months postoperatively (p = 0.013 and 0.009, respectively). Conclusions: Intra-articular HA injection is not a relevant addition when arthrocentesis is performed and a stabilizing splint is used. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.