scholarly journals An additional lysis procedure during arthrocentesis of the temporomandibular joint

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Keon-Mo Lee ◽  
Wan-Hee Jang ◽  
Myoung-Sang You ◽  
Bu-Kyu Lee
Keyword(s):  
Temporomandibular Joint ◽  
Arthroscopic Surgery ◽  
Mouth Opening ◽  
Invasive Procedure ◽  
Joint Space ◽  
Temporomandibular Joint Disorders ◽  
Invasive Procedures ◽  
The Mean ◽  
Mechanical Lysis ◽  
Over Time

Abstract Background Arthrocentesis of the temporomandibular joint (TMJ) is an easy, highly efficient, minimally invasive procedure for treating temporomandibular joint disorders (TMDs). However, in some cases of mouth opening limitation (MOL), routine arthrocentesis is ineffective due to severe fibrotic adhesion in the superior joint space of the TMJ. In this condition, mechanical lysis of the adhesions might be needed to resolve the MOL, as well as other symptoms, such as chronic pain. Currently, this can be achieved by arthroscopic surgery or open TMJ surgery. The objective of this study was to introduce and evaluate our trial of the adhesion lysis procedure during arthrocentesis of the TMJ using normal 18-gauge needles. Results In this study, 40 patients with MOL due to disc derangement underwent conventional arthrocentesis at first and then physical detachment was conducted using the same needle. The change in maximum mouth opening (MMO) and the pain at the TMJ were recorded before, during, and after treatment according to our protocol. The mean increase in MMO after conventional arthrocentesis was 6.6 ± 4.2mm. The mean increase in MMO after the detachment procedure with the same needle was 4.2 ± 2.0 mm. The MMO in ten patients was significantly increased after the detachment procedure than after arthrocentesis alone. In all cases, the pain intensity in the TMJ significantly decreased over time, whereas the MMO increased over time. No adverse effect was observed in all joints during our observation periods. Conclusion We confirmed that our simple lysis procedure with the same needle of the arthrocentesis of the TMJ could not only improve the MMO more than after a conventional arthrocentesis but also resolve severe adhesion of the joint space that was ineffective by conventional arthrocentesis. Although this additional lysis procedure is simple, it might reduce the number of cases of more invasive procedures such as arthroscopic surgery or open TMJ surgery.

scholarly journals Arthrocentesis and Sodium Hyaluronate Infiltration in Temporomandibular Disorders Treatment. Clinical and MRI Evaluation

2020 ◽  
Vol 5 (1) ◽  
pp. 18 ◽  
Author(s):  
Mario Santagata ◽  
Roberto De Luca ◽  
Giorgio Lo Giudice ◽  
Antonio Troiano ◽  
Giuseppe Lo Giudice ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Joint Damage ◽  
Mouth Opening ◽  
Sodium Hyaluronate ◽  
Mean Value ◽  
Temporomandibular Joint Disorders ◽  
Mean Values ◽  
Masticatory Efficiency ◽  
The Mean

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.

scholarly journals Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Giacomo De Riu ◽  
Mirella Stimolo ◽  
Silvio Mario Meloni ◽  
Damiano Soma ◽  
Milena Pisano ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Case Series ◽  
Sodium Hyaluronate ◽  
Invasive Procedure ◽  
Temporomandibular Joint Disorders ◽  
Scale Scores ◽  
Clinical Benefits ◽  
Mri Changes ◽  
Clinical And Radiological Results

Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ) disorders.Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO), joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpairedt-tests, and McNemar’s test was used to evaluate CBCT and MRI changes ().Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs.Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered withNCT01903512.

Non-primate Lentiviral Vector Administration in the TMJ

2004 ◽  
Vol 83 (1) ◽  
pp. 65-70 ◽  
Author(s):  
S. Kyrkanides ◽  
P. Kambylafkas ◽  
J.H. Miller ◽  
R.H. Tallents
Keyword(s):  
Temporomandibular Joint ◽  
Reporter Gene ◽  
Soft Tissues ◽  
Lentiviral Vector ◽  
Retrograde Transport ◽  
Lentiviral Vectors ◽  
Treatment Method ◽  
Joint Space ◽  
Nerve Fibers ◽  
Temporomandibular Joint Disorders

Gene therapy is emerging as a novel treatment method for the management of temporomandibular joint disorders. The aim of this investigation was to study the effects of lentiviral vectors on the temporomandibular joint. Consequently, we injected into the articular joint space a defective feline immunodeficiency virus capable of infecting dividing as well as terminally differentiated cells with the reporter gene lacZ, the expression of which was studied by means of PCR, X-gal histochemistry, and β-galactosidase immunocytochemistry. Our results showed successful transduction of hard and soft tissues of the temporomandibular joint. Interestingly, a subset of primary sensory neurons of the ipsilateral trigeminal ganglion also stained positive for the reporter gene, presumably following uptake of the lentiviral vector by peripheral nerve fibers and retrograde transport to the nucleus. These findings suggest that lentiviral vectors can potentially serve as a platform for the transfer of anti-nociceptive genes for the management of temporomandibular joint pain.

A SYSTEMATIC REVIEW OF CLINICAL OUTCOMES IN THE TREATMENT OF TEMPOROMANDIBULAR JOINT DYSFUNCTION USING ULTRASOUND GUIDED ARTHROCENTESIS AND CONVENTIONAL THERAPY

2021 ◽  
pp. 19-22
Author(s):  
Chirag Bhatia ◽  
Hirkani Attarde
Keyword(s):  
Systematic Review ◽  
Temporomandibular Joint ◽  
Operating Time ◽  
Mouth Opening ◽  
Risk Of Bias ◽  
Temporomandibular Joint Disorders ◽  
Current Evidence ◽  
Cochrane Library ◽  
Review Protocol ◽  
Reported Data

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.

Changes in The Temporomandibular Joint after Occlusal Deprogramming

2020 ◽  
pp. 1-21
Author(s):  
Rohit Kulshrestha ◽  
Keyword(s):  
Controlled Trial ◽  
Arthroscopic Surgery ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Joint Space ◽  
Pharmacological Intervention ◽  
Occlusal Splints ◽  
Condylar Position ◽  
Surgery Education

Common signs and symptoms of TMD include masticatory muscle pain, TMJ sounds, limited mouth opening, and deviations in mandibular movements. Treatment generally involves some combination of occlusal splints, physiotherapy, relaxation therapy, pharmacological intervention, arthroscopic surgery, education, and behavioural counselling. One randomized controlled trial indicated that an occlusal deprogramming splint is more effective than other methods in treating TMD, although another study produced contradictory results. Measurements of the radiographic joint space a radiolucent area between the mandibular condyle and the temporal bone were introduced by Ricketts to describe condylar position. The clinical significance of condyle-fossa relationships in the TMJ is controversial, but several studies have suggested an association between eccentric condylar position and TMD. This chapter describes key changes in the condyle-fossa relationship after the use of an occlusal deprogramming splint in patients with TMD.

scholarly journals A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

2018 ◽  
Vol 18 (3) ◽  
pp. 379 ◽  
Author(s):  
Issa K. Al-Nuumani ◽  
Abdulaziz Bakathir ◽  
Ahmed Al-Hashmi ◽  
Mohammed Al-Abri ◽  
Hussein Al-Kindi ◽  
...  
Keyword(s):  
Case Report ◽  
Temporomandibular Joint ◽  
Obstructive Sleep Apnoea ◽  
Mouth Opening ◽  
Sleep Apnoea ◽  
Temporomandibular Joint Disorders ◽  
University Hospital ◽  
Tmj Ankylosis ◽  
Obstructive Sleep ◽  
Mandibular Retrognathia

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.

scholarly journals Ultrasonography: A step forward in temporomandibular joint imaging. A preliminary descriptive study

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Surej Kumar L.K. ◽  
Georgie P. Zachariah ◽  
Sumesh Chandran
Keyword(s):  
Temporomandibular Joint ◽  
Temporomandibular Disorders ◽  
Imaging Modality ◽  
Mouth Opening ◽  
Diagnostic Technique ◽  
High Specificity ◽  
Cost Effective ◽  
Joint Space ◽  
Dynamic Relationship ◽  
Disc Position

Ultrasonography (USG) is a cost-effective and noninvasive imaging modality commonly employed for imaging the abdominal region and extremities. Currently, with the availability of higher frequency probes and higher resolution devices, USG imaging of the temporomandibular joint (TMJ) looks promising. The aim is to evaluate and demonstrate the role of USG as an imaging modality of TMJ by visualizing the static and dynamic relationship of the joint, assessment of joint space and eliciting reproducibility at both open and closed mouth positions. 30 volunteers were selected based on the inclusion criteria in line with the research diagnostic criteria/temporomandibular disorders guidelines. High-resolution USG (≥12 MHz) of the right TMJ (chosen for uniformity) was done in the left decubitus position on (n=30) volunteers. The joint disc movement was directly visualized during opening and closing motions. The vertical joint space was assessed using the firmware and accurate reproducibility was checked. At the closed mouth position, the measured values ranged from 0.2 mm to 0.7 mm with a median of 0.05 cm and a mean of 0.4±0.15 mm. At the position of maximal mouth opening, the measured values ranged from 0.9 mm to 1.5 mm with a median of 1.1 mm and a mean of 1.1±0.17 mm. USG enables visualization of the dynamic relationship between joint structures, with particular importance to the condyle and disc position. The articular disc appears on the USG as a thin layer of hyperechogenicity surrounded by a hypoechoic halo, located between 2 hyperechoic lines viz, the condyle and the articular eminence. We recommend ultrasonographic imaging as a noninvasive diagnostic technique with relatively high specificity for patients with temporomandibular disorders.

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