scholarly journals Effect of arthrocentesis on the clinical outcome of various treatment methods for temporomandibular joint disorders

Author(s):  
Chang-Woo Kim ◽  
Sung-Jae Lee ◽  
Euy-Hyun Kim ◽  
Dong-Keon Lee ◽  
Mong-Hun Kang ◽  
...  

Abstract Background We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. Results We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). Conclusion The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.

2018 ◽  
Vol 12 (1) ◽  
pp. 770-781
Author(s):  
Deepak Gupta ◽  
Soheyl Sheikh ◽  
Shambulingappa Pallagatti ◽  
Ravinder Singh ◽  
Amit Aggarwal

Objective(s):The objective of this study was to determine the frequency of “subluxation” and presence of clinical signs of Temporomandibular Joint Disorder (TMD) in asymptomatic individuals and its distribution according to age and sex.Materials and Methods:The material investigated comprised of 200 asymptomatic subjects with 400 joints. The subjects were divided into two groups of 18-25 years and 50-60 years of age consisting of equal number of males and females. Clinical examination involved measurement of maximal inter-incisal distance, joint sounds and deviation. For radiological examination, Temporomandibular Joint (TMJ) open mouth close mouth view option (TMJ1/2) was used on a Digital Panoramic Machine. All the radiographs were traced to assess subluxation and anterior translation of the condyle. The statistical analysis was carried out using Statistical Package for Social Sciences (SPSSInc., Chicago, IL, version 15.0 for Windows).Results:The prevalence of the signs of TMDs in the asymptomatic population was found to be very high and more predominant in females as compared to males. Furthermore, the older age group had comparatively less signs of TMDs. It was of interest that the subjects presenting with clinical signs of TMD were significantly less as compared to the subjects presenting with subluxation. The value of anterior translation was found to be more in females in the younger age group as compared to the males. Similarly, it was more in males as compared to females in older age group. But the mean anterior translation difference in females in 18-25 years and 50-60 years showed a statistically significant difference withP-value 0.017.Conclusion:Subluxation is a very common feature found in almost all the subjects in this study with a high prevalence. Hence, we may assume that the increased incidence of TMDs could be a direct result of the phenomena of subluxation. The decrease in mandibular length could be the cause of decreased mouth opening and increased subluxation.


Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 113
Author(s):  
Bruno Macedo De Sousa ◽  
Nansi López-Valverde ◽  
Antonio López-Valverde ◽  
Francisco Caramelo ◽  
Javier Flores Fraile ◽  
...  

Background and Objectives: Temporomandibular joint disorders (TMJDs) are associated with pain and reduced jaw mobility. The aim of this study was to compare the outcome of patients with TMJ arthralgia when submitted to four different treatment modalities, in some cases using intra-articular injections of substances with anti-inflammatory properties and in others, a more conservative approach consisting only of a bite splint. Materials and Methods: The sample was made up of 80 patients, randomly distributed into 4 groups of 20 patients each. Each patient was given a nocturnal bite splint. One of the groups was treated with the bite splint only, while each patient in the other 3 was injected with betamethasone, sodium hyaluronate, or platelet-rich plasma in addition to using the bite splint. Two variables were assessed, namely pain intensity between 0 to 10 according to the visual analogue scale and maximum pain-free mouth opening in mm. The patients were evaluated at four different points: at the beginning of the treatment, as well as one week, one month and six months after initiation. Results: The results showed that maximum pain-free mouth opening improved in all the groups that made up the sample, with either a reduction in pain severity or with no pain. However, the group injected with platelet-rich plasma yielded the best results after six months, while patients treated with sodium hyaluronate or betamethasone obtained the best results at the end of the first week. Conclusions: We concluded that all the treatments used caused a reduction in pain and increased pain-free mouth opening. The splint combined with the platelet-rich plasma injection achieved long-term success.


2017 ◽  
Vol 29 (2) ◽  
Author(s):  
Elita Rafni ◽  
Yanwirasti Y. ◽  
Eriyati Darwin ◽  
Rasmi Rikmasari

Introduction: Saliva is the type of liquid which contains enzyme, hormone, antibody, constituent microbe, and cytokines. Matrix metalloproteinase-9 (MMP-9) is one kind of proteolysis cellular enzyme in saliva that has a role in inflammation. Saliva is very easy to take and noninvasive treatment, proved efficient for early diagnosis. The purpose of this research was to study the difference MMP-9 level in saliva patient with temporomandibular joint disorders between myofascial pain and disc displacement. Methods: Cross sectional comparative study. The research was carried out at the Prosthodontics Clinic of Arifin Achmad Pekanbaru Hospital and at Biomedical Laboratory of Faculty of Medicine, Universitas Andalas Padang, Indonesia. The saliva samples were taken from 37 myofascial pain patients and 37 disc displacement patients. MMP-9 levels were examined by the Elisa and the data result was analyzed using the t-test. Result: The average value of MMP-9 level of disc displacement was 650.98±384.94 pg/mL and myofascial pain was 168.70±41.24 pg/mL. There was a significant difference on MMP-9 level in saliva between myofascial pain and disc displacement (p<0.05). Conclusion: The MMP-9 level in saliva of patients with disc displacement of temporomandibular joint disorders was higher than patients with myofascial pain.


Author(s):  
Ilayaraja Alagia Thiruvevenkadam ◽  
Lee Tze Ling

Background and Objectives: Awareness of temporomandibular joint disorder (TMD) is fairly concerning in management of physiotherapy as patients often seek for treatment from orthodontics when pain become their main concerns. In this case, cervical aspects are often overlooked in the treatment of temporomandibular joint disorder. This study aims to determine the effect of cervical extensor strengthening on severity of temporomandibular joint disorder. Methods: A randomized controlled trial study was carried out for 4 weeks to determine the effect of cervical extensor strengthening on severity of temporomandibular joint disorder among university students. A total of 40 participants were recruited via convenient sampling method. Subjects were randomly assigned into two groups: experimental group (E) and control group (C) through lottery randomization. Subjects in experimental group were instructed to perform 1 set of cervical extensor strengthening with 10 repetitions and goldfish exercises whereas subjects in control group were asked to perform goldfish exercises only. A pre-test and post-test severity of TMD, maximal mouth opening and maximal isometric cervical extensor strength were measured for both groups. Results: After 4 weeks of training, there was significant difference in pre-test and post-test severity of TMD and maximal mouth opening for both E and C group. On the other hand, there was significant difference of pre and post-test of maximal isometric cervical extensor strength in experimental group. There was no significant difference in post-test for severity of TMD (p=0.67), maximal mouth opening (p=0.21) and maximal isometric cervical extensor strength (p=0.40) between two groups. Conclusions: The study concluded that, 4 weeks of anti-gravity cervical extensor strengthening exercises protocol showed there was no significantly difference of the severity of TMD and maximal mouth opening between both control and experimental group. On the other hand, goldfish exercises showed significant improvement of maximal mouth opening and reduction in severity of TMD after 4 weeks of intervention period.


2021 ◽  
pp. 19-22
Author(s):  
Chirag Bhatia ◽  
Hirkani Attarde

Objective: This systematic review aimed to compare outcomes between ultrasound (US)-guided arthrocentesis and conventional arthrocentesis for the management of temporomandibular joint disorders (TMDs). Methods: PubMed, MEDLINE, Cochrane Library, Google Scholar and th EBSCOhost databases were searched up to 30 September 2020 for randomized control trials (RCTs) comparing US-guided and conventional arthrocentesis. The review protocol followed the PRISMA guidelines and was registered in PROSPERO (CRD42020211942). The risk of bias of the studies was independently evaluated using Cochrane Risk of Bias tool. Results: Four RCTs were included. It did not demonstrate any statistically signicant difference in pain or maximal mouth opening (MMO) scores after 1 week and 1 month of follow-up between US-guided and conventional arthrocentesis. Studies also reported data on intra-operative needle relocations and operating time but with conicting results. Conclusion: This study indicates that the use of US during arthrocentesis may not improve postoperative pain and MMO in the short term. Further high-quality adequately powered RCTs are required to strengthen current evidence.


2018 ◽  
Vol 18 (3) ◽  
pp. 379 ◽  
Author(s):  
Issa K. Al-Nuumani ◽  
Abdulaziz Bakathir ◽  
Ahmed Al-Hashmi ◽  
Mohammed Al-Abri ◽  
Hussein Al-Kindi ◽  
...  

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening.Keywords: Temporomandibular Joint Disorders; Temporomandibular Ankylosis; Retrognathia; Obstructive Sleep Apnea; Case Report; Oman.


2020 ◽  
Vol 5 (1) ◽  
pp. 18 ◽  
Author(s):  
Mario Santagata ◽  
Roberto De Luca ◽  
Giorgio Lo Giudice ◽  
Antonio Troiano ◽  
Giuseppe Lo Giudice ◽  
...  

Arthrocentesis in temporomandibular joint disorders can be associated with the intra-articular infiltration of various drugs with the objective of increase treatment efficacy. The aim of this study was to evaluate the clinical indexes variation in patients affected by temporomandibular joint disorders treated with arthrocentesis and sodium hyaluronate (SH) injections. A total of 28 patients suffering from temporomandibular joint disorders underwent one cycle of five arthrocentesis and infiltrations of sodium hyaluronate. Spontaneous mouth opening improved from 36.3 ± 7.5 mm to 45.1 ± 1.9 mm at six months follow-up. A significant reduction in the pain at rest and during mastication mean values emerged at follow-up (p < 0.0001). The mean masticatory efficiency, evaluated through a visual analogic scale, showed improvement at the follow-up period, highlighted by the increase of mean value from a baseline of 3.1 ± 1.2 to a mean value of 8.5 ± 1.2 (p < 0.0001). The mean severity of the joint damage at baseline time was 2.4 ± 0.9 and decreased to 0.4 ± 0.3 at the end of the follow-up period. The decrease in values is confirmed by statistical test (p < 0.05). Our data show how arthrocentesis integrated with sodium hyaluronate infiltrations performed under local anesthesia is a valid method of treating temporomandibular joint disorders.


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