Tenoxicam Injection Efficacy for TMJ Arthrocentesis

The patients were randomly separated into two groups by simple randomization method by computer. No conservative treatment was applied before arthrocentesis. Only arthrocentesis was given to patients in the control group (n:14), while the TX group (n:16) received both arthrocentesis and a 2-ml injection of tenoxicam (Oksamen-L, Mustafa Nevzat İlaç Sanayi, Istanbul, Turkey) to the temporomandibular joint (Fig. 1) The preauricular area was cleaned with 10% povidone-iodine solution. Ultracaine D-S Forte® (Sanofi-Aventis, İstanbul, Turkey) was used as a local anesthetic. The entry point was along the lateral canthus-tragus line (Holmlund-Hellsing line), 10 mm away from the anterior tragal midline and 2 mm under it. The second point was along the lateral canthus-tragus line, 20 mm away from the anterior tragal midline and 10 mm under it [22 ].Fig. 1

Arthrocentesis procedure

Preoperative measurements and arthrocentesis procedures were performed by the same surgeon (GYY). All patients were irrigated with approximately 100 ml of Ringer’s lactate. In the control group, no additional injections were given, but in the TX group, 2 ml(20 mg) of tenoxicam was injected intraarticularly following arthrocentesis. A drug containing paracetamol was prescribed to relieve post-procedure pain. A soft diet was recommended to the patients. Physical therapy, occlusal splint or other preventive treatments were not applied during the follow-up period. The form in which the data of the patients is processed is given in Fig. 2.Fig. 2

A patient form sample

Patients were followed for 6 months. The outcome variables were pain scores on a visual analog scale (VAS), VAS joint sounds (crepitus sounds), and maximum mouth opening (MMO), which were measured at baseline, one week, one month, three months, and six months after the arthrocentesis. To measure the VAS value, a 10-cm-long numbered line was created. The patient chose a point on the line, the corresponding value was measured with a ruler, and a score was given. MMO was gauged between the incisal edges of the maxillar and mandibular central incisors. Outcome variables were evaluated postoperatively by the surgeon (AK), who was unaware of the treatment procedures for all patients.