Evaluation of Effect of Intraarticular Injection of Chitosan-Hyaluronate Gel Mixture Vs Hyaluronic Acid in Management of TMJ Internal Derangement

Temporomandibular joint ID treatment aims to reduce pain, promote mouth opening, and alleviate the inflammatory status of the joint cavity. Aim of work: To evaluate the effect of sodium hyaluronic acid Vs chitosan-hyaluronate hybrid gel injection into the upper cavity of the temporomandibular joint for management of anterior disk displacement without reduction. Methods: This study was conducted on 20 patients with 20 joints had anterior disc displacement without reduction. Patients were selected from the outpatient of Oral Maxillofacial Surgery at Faculty of Dental Medicine, Al - Azhar University, Cairo, boys. The patients were divided into two groups. Group one (control group) included 10 patients receiving Sodium Hyaluronic acid (HA) injected into the upper compartment of the TMJ cavity while Group two involved 10 patients receiving Chitosan-Hyaluronate Hybrid Gel (CH) injected into the upper compartment of the TMJ cavity. T-test was used for comparison before treatment and at 1 and 3 months after treatment. Results: Before treatment, there was a statistically non-significant difference in mean MMO in the two groups. At 1 and 3 month there was a statistically a significant difference in mean MMO in the two groups. HA/Chitosan group showed a higher MMO than HA group. Both groups showed a statistically significant increase in mean Pain measurements at 1 and 3 months. Conclusion: Chitosan-hyaluronate and HA are safe substances that can be injected into the TMJ cavity without any problems. In individuals with anterior disc displacement without reduction, chitosan-hyaluronate injection with arthrocentesis is more successful and predictable than HA.