Does Piroxicam have an Added Benefit on Arthrocentesis in the Management of Internal Derangement in Female Patients?: A Randomized Clinical Trial

Abstract

Background: Arthrocentesis is an accepted treatment modality for internal derangement. Piroxicam is an NSAID that can be injected into the TMJ. Purpose: The primary objective of this study was to improve mouth opening, and the secondary objective was to decrease TMD-associated pain. Methods: A randomized controlled trial (RCT) was performed on patients suffering from anterior disk displacement with reduction. Patients were divided into 2 groups: a study in which patients underwent arthrocentesis followed by an injection of 20 mg of piroxicam. Independent and paired sample t-tests were used to assess mouth opening. The χ2 test was used to assess the pain data; the P value was fixed at 0.05. Results: Twenty female patients were included in the current study. To ensure that covariables did not affect the study results, an intergroup assessment using Student’s t-test for unassisted mouth opening without pain preoperatively showed that the maximum unassisted opening without pain was 20.8±3.9 mm in the control group, and the average maximum unassisted opening without pain was 19.7±1.1 mm in the case study group. The unassisted mouth opening in the control group was 30.9±3.4 mm and 31.8±3.6 mm, respectively, and there was no significant difference (P=0.6, 95% CI: −2.5 to 4.32). There was no significant difference in pain between the study and control groups (P=0.3). Conclusion and Recommendation: Based on the results of the present study, arthrocentesis using piroxicam does not have any benefit over conventional arthrocentesis.