This study is aiming to assess effect of hypertonic saline 5% in comparison to dextrose 20% on pain ,inter-insical opening and movements of jaw in painful cases of disc displacement with reduction
pain.
audible clicking.
mandibular deviation on opening.
Failure of conservative treatment
The clinical or radiographic signs of disc displacement without reduction, osteoarthritis, or articular bony changes.
Previous TMJ surgery, arthrocentesis, , or the presence of any systemic disease that would affect the TMJ anatomy or mechanical function.
A history of allergic reactions to any components of the injectable solution.
Infection of the affected joint and pre-auricular area.
Parallel
hypertonic saline 5% sodium chloride
Other interventionHypertonic saline acts as an analgesic by alleviating nociceptive pain from inflamed tissues, which may include bone, connective tissue , synovium , or a combination of these Hypertonic saline results in safe and remarkable outcomes on knee pain, stiffness and function compared with intra-articular dextrose injection
hypertonic dextrose 20%
Other interventionA recent study showed the sensorineural analgesic effect of 5% dextrose prolotherapy in the treatment of chronic low back pain ,Therefore, the mechanism of action for dextrose prolotherapy is hypothesized to work through reducing peripheral sensitization and targeting structural dysfunction
Severity of pain
severity of pain is measured by Visual analog scale (VAS) From (0-10) Where 0: no pain 10: worst pain
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