Discomfort localized to the temporomandibular joint (TMJ) is frequently reported among individuals afflicted with TMD. Unfortunately, the underlying factors that mediate this pain remain insufficiently characterized to allow for targeted therapeutic intervention. For this reason, understanding these mediators and their distinct roles in local inflammation and nociception is of great importance. This study was designed to evaluate the clinical efficacy of visually guided TMJ irrigation in patients with TMDs and to establish a clinical correlation between internal derangement disorders and CRP concentrations measured in synovial lavage fluid. A cohort of 72 individuals presenting with TMJ disorders, diagnosed based on clinical and radiographic findings, was recruited for the investigation. Synovial lavage fluid was collected before arthrocentesis by flushing the joint cavity with saline. These samples were subsequently analyzed for CRP concentrations employing the Nycocard test (a solid-phase sandwich immunometric assay), allowing quantitative measurement. The patients’ subjective pain perception was documented using a visual analog scale. Radiographic imaging identified bony alterations in the condyle, while arthroscopic visualization evaluated synovitis. CRP was identified at substantially elevated levels in the TMJ synovial fluid, with concentrations demonstrating a significant relationship to both clinical indicators and arthroscopic observations recorded in the study population. The measured CRP levels (determined by the Nycocard test) averaged 4.50 in the Internal Derangement type II group (SD ± 1.04), contrasting with an average of 9.64 (SD ± 3.08) in the Internal Derangement type III group, yielding a t-value of 1.01. The concentration of CRP in TMJ synovial fluid is a strong indicator of pain intensity and the degree of synovitis, and elevated levels of this protein may serve as a reliable biomarker for degenerative processes within the TMJ.
