Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction.

The long-term effect (2 years) of occlusal treatment and intra-articular injections of a mixture of corticosteroid and local anaesthetic was investigated in two groups of patients with pain and dysfunction in the temporomandibular joint (TMJ). Fifteen patients were treated with injections and eighteen patients with occlusal adjustment. The TMJ was tender to palpation in all patients. The intra-articular injections were given once a week for three weeks. The occlusal treatment included splints, grinding on natural teeth and occlusal correction of complete dentures. The severity of the subjective symptoms and clinical signs was estimated before and after treatment. Both sorts of treatment reduced the subjective symptoms and the clinical signs significantly, but the reduction was significantly greater after the intra-articular injections. The effect of the injections was less efficient in patients with radiographic signs of remodelling of the TMJ and general joint symptoms. It was concluded that both intra-articular injections of corticosteroid combined with local anaesthetic and occlusal treatment have a long palliative effect on TMJ pain and dysfunction. The intraarticular treatment, however, had a greater effect on the clinical signs.