Evaluation of computer-guided visco-supplementation in the management of internal derangement of temporomandibular joint: a randomized controlled clinical trial.

OBJECTIVE

To evaluate the feasibility and clinical outcomes of computer-guided injection of sodium hyaluronate visco-supplementation and arthrocentesis in the treatment of temporomandibular joint disorder compared with conventional injection.

STUDY

DESIGN

Twenty patients with Wilkes stage I & II internal derangement were selected and randomly allocated into the intervention group, managed with computer-guided intra-articular visco-supplementation, and the control group, managed with conventional technique. The efficacy of the computer-guided procedure was appraised by the assessment of the need for needle relocation and the duration of the procedure in both groups. Clinical evaluation was performed for the assessment of pain intensity, maximum unassisted vertical mouth opening, and maximum lateral mandibular deviation during opening in both groups.

RESULTS

Computer-guided group demonstrated a statistically significant difference from the free-hand group regarding the total procedural time and number of needle relocations. The guided group didn't require any needle relocation with a mean procedural time of 8.35 ± 0.47 minutes. All patients in both groups reported immense improvement in all clinical parameters, with no statistically significant difference between the two groups.

CONCLUSIONS

The use of computer-guided visco-supplementation for the treatment of internal derangement is a promising practice with improvement in the procedural accuracy and effectiveness of the injectable material. Additionally, it makes the procedure more reproducible and simpler for both clinicians and patients.