Intra-articular Injections for Internal Derangement of the Temporomandibular Joint: Mechanisms, Efficacy, and Clinical Perspectives
G. Satheesh
*
Department of Oral and Maxillofacial Surgery, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Sri Balaji Vidyapeeth (Deemed – to be-University), Pondicherry, India.
Pratebha Balu
Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed – to be-University), Pondicherry, India.
James Antony Bhagat
Department of Oral and Maxillofacial Surgery, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India.
Ajaykumar Jagdish
Department of Oral and Maxillofacial Surgery, Asan Memorial Dental College and Hospital, Chengalpattu, Tamil Nadu, India.
R. Selvakumar
Department of Oral and Maxillofacial Surgery, Asan Memorial Dental College and Hospital, Chengalpattu, Tamil Nadu, India.
*Author to whom correspondence should be addressed.
Abstract
Internal Derangement (ID) of the Temporomandibular Joint (TMJ) is a common disorder manifesting as disc Displacement, pain, clicking, and restricted mandibular movement. This chapter aims to provide a comprehensive overview of intra-articular (IA) injections as a treatment option for TMJ internal derangement. While conservative management remains the primary approach, a subset of patients continue to experience persistent symptoms requiring minimally invasive interventions. Intra-articular (IA) injections have experienced rapid development in TMJ therapeutics, with agents such as corticosteroids, hyaluronic acid (HA), platelet-rich plasma (PRP), and botulinum toxin A (bont-a) demonstrating varying degrees of efficacy. This expanded review critically synthesises the mechanisms, clinical outcomes, comparative efficacy, safety, and emerging evidence for IA therapies. The review further incorporates summary tables and schematic-style figures to aid understanding. Current literature suggests that PRP and HA offer the most favourable long-term benefits, whereas corticosteroids remain useful for short-term inflammatory relief. Bont-a, though promising, requires further evidence to justify routine IA use. Understanding indications, limitations, and biologic rationale will guide clinicians toward evidence-based TMJ internal derangement management.
Keywords: Temporomandibular joint, internal derangement, platelet-rich plasma, hyaluronic acid, intra-articular injection, temporomandibular joint pain