Comparison of the Clinical Outcome of Hegab Splint, Arthrocentesis, and Arthroscopy in Treatment of TMJ Closed Lock: Randomized Controlled Clinical Trial

Hegab AF, Abd Al Hameed HI and Ali Hasan AA

Department of Oral & Maxillofacial Surgery, Al-Azhar University in Cairo, Egypt Department of Diagnostic Radiology, Al-Azher University, Cairo, Egypt

^*Correspondance to: Ayman F Hegab 

 PDF  Full Text DOI: 10.25107/2474-1647.3720

Abstract

Background: Temporomandibular joint closed lock represents a clinical challenge that is mostly attributed to disc displacement without reduction. Objective: This prospective, randomized control study aimed to compare the clinical outcome of Hegab splint, arthrocentesis, and arthroscopy in treatment of TMJ closed lock. The study sample was derived from the population of patients who presented for evaluation and treatment of TMJ disorders. The patients were randomly assigned to one of the following three groups: Group I (Control): Patients treated by Hegab splint. Group II: Patients treated by arthrocentesis with injection of HA/PRP mix plus Hegab splint. Group III: Arthroscopy with injection of HA/PRP mix plus Hegab splint. The primary outcome variable was the change in pain using a visual analog scale, and improvement of maximum voluntary mouth opening. The secondary outcome variable was the change in joint sound. The third category of variables (age and sex) was evaluated in relation to the outcomes. Results: Group II and Group III exhibited significantly higher MVMOs than Groups I throughout the study period at 1, 3, 6, and 12 months (P=0.02). While statistical analysis between group II and III showed that Group III exhibited higher MVMO than Group II throughout the study periods (P=0.0002). Conclusion: With the limitation of the current study, the current study suggests that the use of arthroscopy with injection of HA/PRP mix plus Hegab splint showed higher performance results with statistically significant difference in relation to other groups. The use of arthrocentesis with injection of HA/PRP mix plus Hegab splint showed comparable results to the use of arthroscopy and should be used as the first treatment modality in closed lock cases before using arthroscopy.

Keywords

Hegab splint; Arthrocentesis; Arthroscopy; HA/PRP mix; TMJ closed lock

Cite the article

Hegab AF, Abd Al Hameed HI, Ali Hasan AA. Comparison of the Clinical Outcome of Hegab Splint, Arthrocentesis, and Arthroscopy in Treatment of TMJ Closed Lock: Randomized Controlled Clinical Trial. Clin Surg. 2024; 9: 3720..