A randomized controlled trial comparing the effectiveness of arthrocentesis alone, oral duloxetine alone, and a combination of both in the treatment of temporomandibular joint disorders.

Temporomandibular disorder (TMD) is a musculoskeletal disorder within the masticatory system. It has an adverse effect on jaw function so that patients may present with limited mouth opening or difficulty in chewing because of pain and locking in the temporomandibular joint (TMJ).

Most TMJ disorders include internal derangement which has been described as conditions in which the articular disc has become displaced from its original position in relation to the condylar head and articular eminence. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking) and disc displacement without reduction (with or without limited opening). TMJ disorder presents with symptoms like pain, joint sounds, and jaw function issues. Accurate diagnosis involves history, clinical examination, and imaging. Effective management is crucial to alleviate pain and maintain joint function.

Arthrocentesis is defined as a procedure in which the fluid in a joint cavity is aspirated with a needle and a therapeutic substance is injected. Duloxetine inhibits serotonin and norepinephrine reuptake, addressing central sensitization in chronic pain. In TMJ disorder, it reduces IL-6 production, easing inflammation and pain.

The purpose of this study is to evaluate the efficacy of arthrocentesis, oral duloxetine alone and combination of arthrocentesis with oral duloxetine in reducing pain and improving the maximum mouth opening in temporomandibular joint disorders.