Effect of intra-articular ozone infiltration on temporomandibular joint sounds in individuals with bilateral arthralgia: a randomized split-face clinical trial

Background Temporomandibular joint (TMJ) sounds are frequent complaints in joint-related temporomandibular disorders. This study evaluated intra-articular ozone infiltration versus saline for self-reported TMJ sound intensity and otologic symptoms in individuals with bilateral TMJ arthralgia.Methods This secondary analysis of a single-center, randomized, double-blind, split-face trial included 21 participants (42 TMJs). Ozone (10 μg/mL) was administered in one TMJ and saline in the contralateral TMJ. Self-reported TMJ sound intensity and otologic symptoms were assessed using the Numeric Rating Scale (NRS) and Patient Global Impression of Change (PGIC).Results Both ozone and saline reduced self-reported TMJ sound intensity over time (p = 0.001 and p = 0.002, respectively), with no treatment effect (p = 0.864) or treatment-by-time interaction (p = 0.615). Otologic symptoms improved in both groups (both p = 0.003), without treatment effect (p = 0.427) or interaction (p = 0.781). PGIC showed significant time effects for self-reported TMJ sound intensity (p = 0.011) and otologic symptoms (p = 0.040), with no between-treatment differences.Conclusion Both interventions improved self-reported TMJ sound intensity and otologic symptoms over time. However, under the conditions of this study, no additional benefit of ozone over saline was demonstrated for self-reported TMJ sound intensity or otologic symptoms.Clinical trial registration Brazilian Registry of Clinical Trials (ReBEC), https://ensaiosclinicos.gov.br, identifier is RBR-6dvfcwd.