Study on the Combined Application of Occlusal Splint and Intra-Articular Injection of Hyaluronic Acid in the Treatment of Non-Reducible Anterior Disc Displacement of the Temporomandibular Joint

Ke Bi, Gang Cheng, Xiuyin Wu, Zhijun Lv Department of Stomatology, Affiliated People’s Hospital of Shandong First Medical University, Jinan, People’s Republic of ChinaCorrespondence: Zhijun Lv, Email [email protected]: To investigate the effect of combining intra-articular injection of hyaluronic acid (HA) with occlusal splint therapy in the treatment of non-reducible anterior disc displacement of the temporomandibular joint (ADDWoR).Methods: A retrospective analysis was conducted on the clinical data of 62 patients with ADDWoR admitted to our hospital from April 2023 to June 2024. According to the treatment method received, patients were divided into a control group (n=31, treated with occlusal splints) and an observation group (n=31, treated with occlusal splints combined with intra-articular injection of HA). The clinical treatment effects, pain levels (Visual Analog Scale [VAS]), temporomandibular joint dysfunction (Friction Temporomandibular Joint Dysfunction Index [CMI]), mandibular movement function (maximum mouth opening [MMO], left lateral excursion [LLE], right lateral excursion [RLE], protrusive movement [PM]), clinical aesthetic indicators (condylar height, joint space width), and adverse reactions were compared between the two groups.Results: (1) Clinical Efficacy: The observation group had a higher total effective rate (90.32% vs 67.74%, P < 0.05). (2) Pain & Dysfunction: Both groups showed significant improvement in VAS and CMI scores over time, with the observation group exhibiting greater reductions (P < 0.05). (3) Mandibular Function & Aesthetic Indicators: The observation group had greater improvements in MMO, LLE, RLE, PM, condylar height, and joint space width (P < 0.05). (4) Adverse Reactions: No significant difference in adverse reaction rates (P > 0.05).Conclusion: The combination of intra-articular injection of HA with occlusal splint therapy can further improve the treatment outcomes for ADDWoR patients, alleviate pain, improve temporomandibular joint dysfunction and mandibular movement function, promote aesthetic recovery, and does not increase the risk of adverse reactions.Keywords: occlusal splint, intra-articular injection of HA, non-reducible anterior disc displacement of the temporomandibular joint, ADDWoR, treatment efficacy