Study Of Sodium Hyaluronate Injection On Treating Temporomandibular Joint Disc Displacement

Purpose To investigate the clinical curative effects of sodium hyaluronate injection on temporomandibular joint disc displacementand the changes of the articular disc positionin pretherapy and post-treatment and provide corresponding basis of the changes in the internal structure of the temporomandibular joint after sodium hyaluronate injection.Materials and Methods1 Research objects We selected 100 patients who were diagnosed with temporomandibular joint disk displacement.The subjects are all from the Dental hosptial of Henan province 2014 and 2015,35 males and 65 females, 14~56 years old(average of 28.40±8.29);The shortest course of the disease was 1 month,the longest was 60 months,the average duration was 10.40 ± 6.36(mean ± standard deviation) months. Among them,50 cases of patients was anterior disc displacement with reducation;50 cases of patients was anterior disc displacement without reducation.MRI and clinical routine inspection of the temporomandibular joint was carried out among all patients. All patients must be diagnosed with the temporomandibular joint disc displacement. The patients of articular disc perforation and temporomandibular joint organic disease must be excluded.Patients with any other treatment methodsin the last three months was excluded too.2 Method Routine inspection(snapping,pain and aperture width) of temporomandibular joints was carried out during the first visitand Fricton TMJ disorders index was used to evaluate function of the temporomandibular joint.Germany Siemens 3.0 T Siemens MAGNETOM Skyra magnetic resonance imaging was used to scan all of the patients in the area of temporomandibular joint includeing silent oblique sagittal T1 WI, T2 WI,coronal T2 WI and mouth oblique sagittal T2 WI.one treatment course(including 3 injections, every 2 weeks a time) on affected side was carried out, after 3 months,routine inspection of temporomandibular joints,Fricton TMJ disorders index evaluating and MRI scans of temporomandibular joint was carried out again.Clinical effects of sodium hyaluronate injection was evaluated by routine inspection and Fricton TMJ disorders index;MRI image was used to evaluate effect of the treatmenton the joint plate location changes.3 Data processing Repetitive measure 3 times, all the experiment data are averaged.Statistical description using the mean(`x)or the mean±standard deviation(`x±s),using SPSS17.0 software for statistical analysis.When comparing the effect of sodium hyaluronate before and after treatment, using two sample mean t test, when P < 0.05 for the difference was statistically significant.Results1 Sodium hyaluronate in the treatment of articular disc displacement the rapeutic effect evaluation. Compared with prior treatment,the difference of clicking of joint,VAS index and aperture width was statistically significantin reversible joint disc displacement patients and an irreversible articular disc displacement patients(P< 0.05).Fricton index value of prior treatment is less than that of post treatment(P< 0.05). 2 MRI analysis of the position change of the temporomandibular joint disc. By adopting Drace standard, 3 mouth after treatment,MRI show that 52% of reversible articular disc displacement was reseted and 10% of irreversible articular disc displacement was reseted. ResultsConclusions 1、Articular cavity sodium hyaluronate in jection can be a effective treatments for temporomandibular joint disc displacement; 2、The patient’s clinical symptoms can be improved by sodium hyaluronate in jection.But influence on changes of the articular disc position still need further study; 3、MRI can only act as a kind of auxiliary examination means in the diagnosis and treatment of temporomandibular joint disk displacement.More factors should be considered to evaluation of therapeutic effect of sodium hyaluronate.