TMJ Disorders Treated with Conservative Treatment (Medicines and Physiotherapy) and Arthrocentesis: A Comparative Study

Joints are covered with ligaments and muscles, which give the joint its strength, and its range of motion, with no pain during its normal activity. The tempomandibular joint (TMJ) connects the mandible with the rest of the head parts. The TMJ plays an important role in the opening and the closure of the oral cavity. Any decrease in the maximal opening of mouth (MMO) may interfere with its basic life activities like eating, drinking, breathing, and speech. The patient who has a tempomandibular disorder (TMD) may exhibit some manifestations like pain and swelling around the joint. He may also hear some clicks during the joint movement, either unilateral or bilateral. To help the patient to overcome these complaints, the treatment protocol starts through the clinical assessment of the joint to determine what the severity and the extent of the problem, and the expectedcauses. The treatment protocol starts with the conservative treatment (a combination of nonsurgical interventions like medicines and physiotherapy), and may end with arthrocentesis and surgery if needed. In the conservative treatment, medicines like analgesia are prescribed to relax the joint, and antibiotics are to treat infections if needed. Life styleinstructions to the patient are very important like how to act with daily activities, and how to decrease any strong activities around the joint muscles. Arthrocentesis can be performed after two weeks if the conservative treatment was not helpful. Arthrocentesis is a simple procedure that can be performed in the clinic in order to decompress the affected TMJ. It is called the "lavage" of the joint, which involves 1 or two needle insertions in the joint, a washing fluid is administered, and then the fluid is aspirated. The irrigated fluid is to wash out the inflammatory mediators will be washed out, and the pain is expected to decrease. Methodology: In this research, we followed a Cross-sectional design, quazi experimental a time series with withdrawn and reinstituted treatment. A random selection of 100 patients who had visited the maxillofacial clinic and their chief complaint was the decrease in MMO and pain in TMJ. Results: The follow of the conservative treatment was helpful with (67%) success (n=100, (p=0.05)), and (33%) needed to perform arthrocentesis with 85% success (n=33, (p=0.05)). Only (5%) of the patients (n=100, (p=0.05)) didn't respond to both treatments; the conservative and arthrocentesis, and they needed further investigations.