EVALUATION OF TEMPOROMANDIBULAR JOINT ARTHROSCOPY WITH TENOXICAM VERSUS STANDARD ARTHROSCOPY FOR PATIENTS WITH INTERNAL DERANGEMENT. A CLINICAL STUDY

Purpose: To evaluate the clinical and radiological efficacy of adding the NSAID Tenoxicam to the irrigant solution during Temporomandibular Joint (TMJ) arthroscopy for patients with symptomatic internal derangement. Materials and Methods: A randomized controlled trial was conducted on 20 female patients (mean age 28 years) divided into two equal groups. All patients underwent arthroscopic lavage and lysis of the superior joint space under general anesthesia. Group I (Control) received standard Ringer’s lactate irrigation. Group II (Study) received Ringer’s lactate supplemented with 20 mg Tenoxicam. Clinical parameters, including Visual Analog Scale (VAS) for pain, Maximal Interincisal Opening (MIO), bite force (N), and chewing efficacy, were evaluated at 1 week, 2 weeks, and 1, 3, and 6 months postoperatively. Structural changes in disc position were assessed via MRI at 6 months. Results: Both groups showed significant improvements in VAS and MIO compared to preoperative baselines (P < 0.05). No statistically significant difference was found between groups regarding long-term pain, MIO, or MRI disc repositioning at 6 months (P > 0.05). However, Group II demonstrated statistically significant superior functional recovery. By the first week, 60% of Group II patients returned to a soft diet compared to 10% in Group I (P = 0.019). At 6 months, 60% of Group II achieved a hard diet, whereas Group I remained significantly lower (P = 0.025). Conclusion: While Tenoxicam does not significantly alter long-term structural or analgesic outcomes, it significantly accelerates functional masticatory recovery. Its use as an irrigant adjunct is recommended to improve immediate postoperative quality of life.