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.

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 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 Different Treatments in Patients with Temporomandibular Joint Disorders: A Comparative Randomized Study

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 113
Author(s):  
Bruno Macedo De Sousa ◽  
Nansi López-Valverde ◽  
Antonio López-Valverde ◽  
Francisco Caramelo ◽  
Javier Flores Fraile ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Platelet Rich Plasma ◽  
Randomized Study ◽  
Mouth Opening ◽  
Sodium Hyaluronate ◽  
Temporomandibular Joint Disorders ◽  
Treatment Modalities ◽  
Plasma Injection ◽  
Maximum Pain

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.

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.

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 Correlation of Condylar Translation During Maximal Mouth Opening with Presence of Signs of Temporomandibular Joint Disorders in an Asymptomatic Population of 18-25 Years Age Group of Northern India

2018 ◽  
Vol 12 (1) ◽  
pp. 770-781
Author(s):  
Deepak Gupta ◽  
Soheyl Sheikh ◽  
Shambulingappa Pallagatti ◽  
Ravinder Singh ◽  
Amit Aggarwal
Keyword(s):  
Temporomandibular Joint ◽  
Clinical Signs ◽  
Mouth Opening ◽  
Temporomandibular Joint Disorders ◽  
Older Age ◽  
Direct Result ◽  
Age Group ◽  
Anterior Translation ◽  
Northern India ◽  
Significant Difference

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.

scholarly journals Efficacy of Manual Therapy in Temporomandibular Joint Disorders and Its Medium-and Long-Term Effects on Pain and Maximum Mouth Opening: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (11) ◽  
pp. 3404
Author(s):  
Andres Herrera-Valencia ◽  
Maria Ruiz-Muñoz ◽  
Jaime Martin-Martin ◽  
Antonio Cuesta-Vargas ◽  
Manuel González-Sánchez
Keyword(s):  
Systematic Review ◽  
Temporomandibular Joint ◽  
Manual Therapy ◽  
Temporomandibular Disorder ◽  
Mouth Opening ◽  
Temporomandibular Joint Disorders ◽  
Treatment Manual ◽  
Therapeutic Exercise ◽  
Long Term Treatment

The aim of this study was to conduct a systematic review of the medium- and long-term efficacy of manual therapy for temporomandibular joint disorders, alone or in combination with therapeutic exercise. Information was compiled from the PubMed, SCOPUS, Cochrane, SciELO and PEDro databases. The inclusion criteria were established: randomized controlled trials only; participants must present any kind of temporomandibular disorder; the treatments must include manual therapy in at least one of the experimental groups; a minimum of 3 months of follow-up; pain must be one of the primary or secondary outcomes; and the article must be available in English, Spanish, Italian, Portuguese or French. Six documents that fulfilled all the criteria were obtained for analysis, two of them considered low quality and four considered high quality. A significant improvement in pain and mouth opening compared to baseline was observed after manual therapy treatment. Manual therapy seems to be an effective treatment for temporomandibular disorders in the medium term, although the effect appears to decrease over time. However, when complemented with therapeutic exercise, these effects can be maintained in the long term. This review underlines the importance of manual therapy and therapeutic exercise for the medium- and long-term treatment of temporomandibular joint disorders in daily practice.

scholarly journals Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

2013 ◽  
Vol 18 (5) ◽  
pp. 128-133 ◽  
Author(s):  
Eduardo Machado ◽  
Daniel Bonotto ◽  
Paulo Afonso Cunali
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Temporomandibular Joint ◽  
Sodium Hyaluronate ◽  
Temporomandibular Joint Disorders ◽  
Controlled Clinical Trials ◽  
Double Blind ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

INTRODUCTION: In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ) is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve patients' functions who present arthrogenic temporomandibular disorders. OBJECTIVE: This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treating internal derangements of the TMJ. METHODS: Carry out a research in the following databases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs, and BBO, considering publications issued between 1966 and October of 2010, focusing on randomized or quasi-randomized controlled clinical trials, single or double-blind. RESULTS: After applying the inclusion criteria we collected 9 articles, 7 of which were randomized controlled double-blind clinical trials and 2 randomized controlled single-blind clinical trials. CONCLUSION: After analyzing the literature, it was found that intra-articular injection with corticosteroids and sodium hyaluronate seems to be an effective method for treating internal derangements of the TMJ. However, further randomized controlled clinical trials, with representative samples and longer follow-up time must be carried out in order to assess the real effectiveness of this technique.

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