Role of intra-articular ozone gas injection in the management of internal derangement of the temporomandibular joint

  • Emad T. Daif
    Reprint requests: Prof. Emad T. Daif, 2 Street No. 100,, Maadi, Cairo 00202, Egypt
    Professor of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University; Chairman of Oral Maxillofacial Surgery Department, Alharm Hospital, Ministry of Health, Cairo, Egypt
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      This study was carried out to compare intra-articular ozone gas injection and drug therapy as conservative treatment modalities for internal derangement of the temporomandibular joint (TMJ).

      Study Design

      Sixty patients (49 female and 11 male) with bilateral internal derangement of the TMJs, disc displacement with reduction, were included in this study. They were divided randomly into 2 equal groups. The first group was treated by a direct injection of ozone gas into the superior joint space. Each joint received 2 mL ozone-oxygen mixture (ozone gas concentration 10 μg/mL). The injections were repeated 2 times per week for 3 weeks. The second group received nonsteroidal antiinflammatory drugs and muscles relaxants. The clinical signs and symptoms before and after the treatment were assessed according to Helkimo's clinical dysfunction index.


      The results showed that 87% of the patients who received ozone gas injections into the superior joint space (n = 26) either completely recovered (37%; n = 11) or improved (50%; n = 15). In the second group, 33% of the patients who were treated with nonsteroidal antiinflammatory drugs and muscle relaxants (n = 10) showed only an improvement in their clinical dysfunction indexes.


      Based on the findings of the present study, we can consider that intra-articular ozone gas injection is a promising new treatment modality for internal derangement of the TMJ. However, further clinical and experimental studies are required to provide direct evidence for its mechanism of action and to substantiate our results.
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