Abstract
Aim: To compare the outcome of arthrocentesis in patients with internal derangement of temporomandibular joint, with disc reduction and without disc reduction.
Materials and Methods: Twenty patients were included in this study. Dynamic ultrasonography was done to assess the status of the temporomandibular joint disc. Patients were divided into 2 groups, those with disc reduction and without disc reduction. Arthrocentesis was done under local anesthesia. The outcome variables were pain level, inter incisal distance, and lateral excursion of the TMJ. Post-operative ultrasonography was taken to check whether arthrocentesis can release the closed lock of the articular disc.
Results: The results showed a statistically significant difference in the outcome between the two groups and the patients without disc reduction responded to the procedure well. Post-operative dynamic ultrasonography revealed no change in the status of the disc in patients without disc reduction.
Conclusion: Arthrocentesis gives better results in patients with internal derangement of temporomandibular joint without disc reduction. Even though there is a significant reduction in the symptoms associated with temporomandibular joint, arthrocentesis failed to release the closed lock of the articular disc, and disc recapturing is not essential to obtain good function and for relief of pain in patients with closed lock
Keywords: Temporomandibular Joint Arthrocentesis, TMJ pain, Mouth Opening, Closed lock, Disc reduction.
References
- Dorrit W. Nitzan D. Arthrocentesis Indication for Using This Minimally Invasive Approach for Temporoma-ndibular Disorders. Oral Maxillofacial Surg Clin N Am. 2006;18:311–28.
- Salvatore Sembronio M, a Alberto Maria Albiero, MD,bCorrado Toro, MD,c, Massimo Robiony M, FEBOMFS,d and Massimo Politi, MD, DMD,e Udine, Italy. Is there a role for arthrocentesis in recapturing the displaced disc in patients with closed lock of the temporomandibular joint? Oral surgery, Oral medicine, Oral pathology, Oral radiology, and Endodontology 2008. 2008;Vol. 105(No. 3):274-80.
- Takafumi Hayashi JI, Jun-ichi Koyama, and Kazuhiro Yamada. The Accuracy of Sonography for Evaluation of Internal Derangement of the Temporomandibular Joint in Asymptomatic Elementary School Children: Comparison with MR and CT. AJNR Am J Neuroradiol 22.2001;22:728–34
- Emshoff R, Jank S, Bertram S, Rudisch A, Bodner G. Disk Displacement of the Temporomandibular Joint: Sonography Versus MR Imaging. AJR 2002.;178:1557
- Dimitroulis MFD, A. Martinez. Temporomandibular joint arthrocentesis and lavage for the treatment of closed
- Lukas M. Vos JJRHS, Boudewijn Stegenga,. Lavage therapy versus non-surgical therapy for the Treatment of Arthralgia of the Temporomandibular Joint: A Systematic Review of Randomized Controlled Trials. J Orofac Pain 2013.2013;27:171-9
- MarcelloMelis D, RPharm, Simona Secci MD, Caroline Ceneviz, DDS, MS. Use of ultrasonography for the diagnosis of temporomandibular joint disorders: A review. American Journal of Dentistry.2007;20(2):73-8.
- LJ Pereira1 MGo,, LR Bonjardim and PM Castelo. Ultrasound and tomographic evaluation of temporomandibular joints in adolescents with and without signs and symptoms of temporomandibular disor-ders: a pilot study. Dento maxillofacial Radiology. 2007;36:402-8
- Keiseki Kaneyama D, PhD, Natsuki Segami, DDS, PhD, Jun Sato D, PhD, Kazuma Fujimura, DDS, PhD,, Toshikazu Nagao D, PhD, and, Hiroshi Yoshimura D, PhD. Prognostic Factors in Arthrocentesis of the Temporomandibular Joint: Comparison of Bradykinin, Leukotriene B4, Prostaglandin E2, and Substance P level in synovial fluid between successful and unsuccessful cases. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons. 2007;65:242-
- Rüdiger Emshoff M, DMD,* and Ansgar Rudisch, MD†. Temporomandibular joint internal derangement and osteoarthrosis: Are effusion and bone marrow edema prognostic indicators for arthrocentesis and hydraulic distention. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons. 2007;65:66-73.
- Demirhan Dıraçog˘lu M, a I˙lknur Bayraktar Saral, MD,aBarıs¸ Keklik, MD,b Hanefi Kurt, DT,c, UfukEmekli M, b LeventÖzçakar, MD,d,eAys¸e Karan, MD,a and Cihan Aksoy, MD. Arthrocentesis versus nonsurgical methods in the treatment of temporomandibular disc displacement without reduction.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:3-8.
- Ezher Hamza Dayisoylua EC, Sina Uckan. Ultrasound-guided arthrocentesis of the temporomandibular joint. British Journal of Oral and Maxillofacial Surgery.2013; 51:667–8.
Corresponding Author
Manoj S
Additional Professor, Department of OMFS,
Govt. Dental College, Thiruvananthapuram, Kerala
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