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Background <p>Temporomandibular joint (TMJ) disorders cause pain, restricted mouth opening, jaw deviation, and joint sounds. When conservative treatments fail, arthrocentesis is performed, often followed by intra-articular injection of sodium hyaluronate (SH) to enhance joint function. This study evaluates inflammatory mediator levels in synovial fluid and their correlation with disease severity. It also assesses the efficacy of arthrocentesis with Ringer’s lactate and examines post-operative clinical outcomes.</p> Methodology <p>Twenty-seven patients with Wilkes stage II or III internal derangement underwent single-puncture arthrocentesis with Ringer’s lactate followed by intra-articular sodium SH injection. The first and last 5&#xa0;ml of lavage fluid were analyzed for inflammatory mediators, including prostaglandins, serotonin, IL-1, IL-6, and total protein. Pre-treatment levels were correlated with clinical parameters such as pain, mouth opening, and mandibular lateral movements. Changes in inflammatory mediator levels between lavage samples assessed arthrocentesis efficacy, while post-operative pain and jaw function evaluated treatment outcomes.</p> Results <p>Median pain at rest and on movement significantly decreased (<i>p</i> &lt; 0.0001) at all follow-ups. Mouth opening and lateral excursive movements improved significantly over time (<i>p</i> &lt; 0.0001). Pre-operative pain scores and restricted jaw movements correlated with elevated inflammatory mediators and total protein in the initial lavage sample, though no significant association was found. Similarly, post-operative inflammatory mediator levels did not significantly correlate with pain at six months.</p> Conclusion <p>This study highlights the effectiveness of TMJ arthrocentesis with Ringer’s lactate and sodium hyaluronate in reducing pain and inflammatory markers over six months. While no significant correlation was found between mediator levels and pain scores, clinical improvement supports its therapeutic value. The findings suggest pain may be influenced by individual thresholds, chronicity, or psychosocial factors.</p>

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Correlation Between Inflammatory Mediator Levels and Clinical Symptoms in Temporomandibular Joint Disorders: Biochemical Analysis and Treatment Outcomes Following Arthrocentesis and Sodium Hyaluronate Injection

  • 期刊论文

  • 发表日期：

    2025年9月12日

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  • Joyce Pascalia Sequeira,
  • Varsha Haridas Upadya,
  • Punchappady Devasya Rekha

摘要

Background

Temporomandibular joint (TMJ) disorders cause pain, restricted mouth opening, jaw deviation, and joint sounds. When conservative treatments fail, arthrocentesis is performed, often followed by intra-articular injection of sodium hyaluronate (SH) to enhance joint function. This study evaluates inflammatory mediator levels in synovial fluid and their correlation with disease severity. It also assesses the efficacy of arthrocentesis with Ringer’s lactate and examines post-operative clinical outcomes.

Methodology

Twenty-seven patients with Wilkes stage II or III internal derangement underwent single-puncture arthrocentesis with Ringer’s lactate followed by intra-articular sodium SH injection. The first and last 5 ml of lavage fluid were analyzed for inflammatory mediators, including prostaglandins, serotonin, IL-1, IL-6, and total protein. Pre-treatment levels were correlated with clinical parameters such as pain, mouth opening, and mandibular lateral movements. Changes in inflammatory mediator levels between lavage samples assessed arthrocentesis efficacy, while post-operative pain and jaw function evaluated treatment outcomes.

Results

Median pain at rest and on movement significantly decreased (p < 0.0001) at all follow-ups. Mouth opening and lateral excursive movements improved significantly over time (p < 0.0001). Pre-operative pain scores and restricted jaw movements correlated with elevated inflammatory mediators and total protein in the initial lavage sample, though no significant association was found. Similarly, post-operative inflammatory mediator levels did not significantly correlate with pain at six months.

Conclusion

This study highlights the effectiveness of TMJ arthrocentesis with Ringer’s lactate and sodium hyaluronate in reducing pain and inflammatory markers over six months. While no significant correlation was found between mediator levels and pain scores, clinical improvement supports its therapeutic value. The findings suggest pain may be influenced by individual thresholds, chronicity, or psychosocial factors.