Abstract
Internal joint derangements (IJD) of the temporomandibular joint (TMJ) encompass a multifaceted array of conditions that have the potential to induce a gradual decline in joint health, ultimately resulting in persistent pain and disruptions in daily living. The management of these conditions poses significant hurdles to achieving effective pain management and restoration of normal TMJ functionality, presenting ongoing challenges in the medical field. At present, the approach of utilizing arthrocentesis in conjunction with intra-articular injections containing corticosteroids (CSs) and hyaluronic acid (HA) is a commonly employed method aimed at addressing chronic pain, surpassing the outcomes of more conservative treatment modalities. Nevertheless, further advancements in treatment strategies are warranted to enhance outcomes and provide holistic relief for individuals with TMJ-related concerns. The effectiveness of arthrocentesis in combination with intra-articular injections of HA and CSs has been demonstrated with the help of five case reports of elderly patients with IJD. All were chronic patients who were unresponsive to conservative management and presented with chronic pain and reduced mouth opening. Open- and closed-mouth magnetic resonance imaging (MRI) provided the diagnosis of IJD, and the patients were treated with arthrocentesis using a two-needle approach that involved flushing the joint space with Ringer's lactate solution followed by intra-articular injections of 0.5 ml HA and 0.5 ml prednisolone at a concentration of 40 mg/ml into the joint space. All patients showed a significant reduction in pain and improvement in mouth opening at the follow-up visits.