Comparative Study of Arthrocentesis with or without Using Piroxicam in the Management of Temporomandibular Joint Disorders

Introduction: Temporomandibular joint dysfunction (TMD) is a clinically significant condition which can be a source of acute or chronic orofacial pain and dysfunction including limitation of mandibular movement. Arthrocentesis is joint lavage which washes out these inflammatory mediators, thereby, relieving pain. Objective: To evaluate the efficacy of arthrocentesis with and without the injection of piroxicam on TMD. Materials and methods: This study was conducted on twenty patients with clinical and radiological diagnosis of TMD included in the study divided into equal groups. Ten patients were subjected to conventional arthrocentesis with saline solution alone, other ten patients underwent arthrocentesis by injection of piroxicam. Patient's evaluation will be preoperatively and postoperatively following the procedure and after 1st, 2nd week, 1 and 6 months. Magnetic resonance imaging (MRI) was performed in both groups before starting the treatment. Results: Evaluation of assisted and unassisted mouth opening showed increase at all time intervals. There was significant improvement in pain, range of motion, joint effusion and joint sounds. Conclusion: Arthrocentesis combined with piroxicam injections is superior to arthrocentesis alone in reducing impairment in patients with TMD on its clinical outcome.