Temporomandibular joint injection with corticosteroid and local anesthetic for limited mouth opening

Abstract

It is unclear whether temporomandibular joint (TMJ) injections with local anesthetic and corticosteroid are an effective first-line management modality for patients with limited mouth opening. The purpose of this study was to determine the effectiveness of TMJ injections in patients with disc displacement without reduction (DDWOR), i.e. closed lock, at the University of Southern California Orofacial Pain and Oral Medicine Center. A retrospective chart review was conducted using a database of over 4000 patient records from 2003-2010. We identified 17 patients (16 female; 1 male) between the ages of 16 and 70 years who had been diagnosed with DDWOR and received a TMJ injection. Active mouth opening before injection ranged between 15 and 40 mm (average 29 mm), and active mouth opening after injection and manual mobilization ranged between 25 and 50 mm (average 39 mm). The average increase in mouth opening after injection and manual mobilization was 10 mm (P = 0.0004). TMJ injection with corticosteroid and local anesthetic is suitable as an alternative first-line management modality for DDWOR.