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 Lateral Antebrachial Cutaneous Nerve as a Donor Source for Digital Nerve Grafting: A Concept Revisited

2017 ◽  
Vol 11 (1) ◽  
pp. 1041-1048 ◽  
Author(s):  
Mehmet Bekir Unal ◽  
Kemal Gokkus ◽  
Evrim Sirin ◽  
Eren Cansü
Keyword(s):  
Pearson Correlation ◽  
Mean Value ◽  
Cutaneous Nerve ◽  
Digital Nerve ◽  
Mean Values ◽  
Nerve Grafts ◽  
The Mean ◽  
The Difference ◽  
Mean Time

Objective: The main objective of this study is to evaluate the availability of lateral antebrachial cutaneous nerve (LACN) autograft for acute or delayed repair of segmented digital nerve injuries. Patients and Methods: 13 digital nerve defects of 11 patients; treated with interposition of LACN graft that harvested from ipsilateral extremity were included in the study. Mean follow up period was 35, 7 months. The mean time from injury to grafting is 53, 3 days. The results of the mean 2PDT and SWMT values of injured /uninjured finger at the end of follow up period were evaluated with Paired T test. The correlation between the defect length and the difference of 2PDT, SWMT values between the uninjured and injured finger at the end of follow up period; were evaluated with Pearson - correlation analysis. Results: The mean value of our 2PDT and SWMT results are ~5,923, ~3, 52, respectively in which can be interpreted between the normal and diminished light touch. The defect length and difference percentage of SWMT values is positively and significantly correlated statistically. Mean length of interposed nerve grafts was 18.5 mm. The age of the patient and the mean values of 2PDT and SWMT with the difference % of 2PDT and % of SWMT are not statistically correlated. Conclusion: Based on results regarding sensory regaining at recipient side and negligible sensory deficit at harvesting side, we suggest that lateral antebrachial cutaneous nerve might be a valuable graft option for digital nerve defects.

scholarly journals Assessment of the TMJ Dysfunction Using the Computerized Facebow Analysis of Selected Parameters

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Edward Kijak ◽  
Danuta Lietz-Kijak ◽  
Bogumiła Frączak ◽  
Zbigniew Śliwiński ◽  
Jerzy Margielewicz
Keyword(s):  
Age Groups ◽  
Mouth Opening ◽  
Mean Value ◽  
Qualitative And Quantitative Analysis ◽  
Temporomandibular Joint Dysfunction ◽  
Mean Values ◽  
Qualitative And Quantitative ◽  
Maximum Value ◽  
Function Test ◽  
The Mean

The Purpose of the Paper.Qualitative and quantitative analysis of selected parameters of mandible movements, electronically registered in patients with temporomandibular joint dysfunction and healthy ones.Material. Function test of the mandible movements was conducted in 175 patients. Gender distribution was 143 women and 32 men, aged 9 to 84.Methods. The studied population, after accurate clinical examination, was divided into age groups with the range of five years. All the patients had Zebris JMA computerized facebow examination done, according to the generally accepted principles and procedures.Results.Mean values of mouth opening calculated to 45.6 mm in healthy group and 37.6 mm in TMJ dysfunction group. Mean length of condylar path amounted to39±7% of the maximum value of mouth opening in the group of healthy people,44±11% in the case of muscle-based disorders, and35±11% with joint-based. The mean value of the condylar path inclination oscillated in the range of 25° to 45°.Conclusions. The ratio of length of the condylar path to the size of mouth opening may be a significant value characterising the type and degree of intensification of the TMJ dysfunctions.

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.

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.

Outcomes of infants undergoing laparoscopic pyeloplasty: A single-center experience

2018 ◽  
Vol 86 (1) ◽  
pp. 27-31 ◽  
Author(s):  
İbrahim Erol ◽  
Kaan Karamık ◽  
Mahmut Ekrem İslamoğlu ◽  
Mutlu Ateş ◽  
Murat Savaş
Keyword(s):  
Operation Time ◽  
Significant Degree ◽  
Stent Migration ◽  
Mean Value ◽  
Laparoscopic Pyeloplasty ◽  
Mean Values ◽  
Single Center Experience ◽  
The Mean ◽  
Split Function

Purpose: The aim of this study was to evaluate the outcomes of laparoscopic pyeloplasty in children less than 12 months of age. Materials and methods: The records of 20 infants, who had pelviureteric junction obstruction and subsequently underwent LP from January 2013 to November 2016 with at least 1 year of follow-up, were retrospectively reviewed. Patients demographics, the results of preoperative and postoperative imaging studies, perioperative details, complications, and results were noted. Results: The mean age of 20 infants was 4.75 months. The gender of cases was 5 females (25%) and 15 males (75%). Of that, 13 (65%) laparoscopic pyeloplasties were in left side and 7 (35%) were in right side. No cases needed open conversation. Aberrant crossing vessel was observed in three patients (15%). The mean operation time was 79.35 min (45–128 min). The mean hospital stay was 2.9 ± 0.308 days (2–3 days). There were complications in three children (15%); two patients developed stent migration and one child had fever over 38°. Three children with complications did not require a second intervention. In one child, the kidney was non-functioning in follow-up and nephrectomy was performed. The anteroposterior diameter significantly reduced. Preoperative mean value was 24.305 ± 5.6157 and postoperative mean value was 15.40 ± 6.030 (p = 0.000, p < 0.05). There was a significant degree of improvement in renal split function for all patients. Preoperative mean values were 45.53 ± 11.512, while postoperative values were 47.850 ± 13.347 (p = 0.029, p < 0.05). Conclusion: Although there are doubts about the reliability and efficacy of results for pyeloplasty in children less 12 months, many studies including this study show that laparoscopic pyeloplasty is an effective and reliable method for infants.

scholarly journals Derangement of Liver Enzymes, Hyperglycemia, Anemia, and Associated Factors among HIV-Infected Patients Treated with Tenofovir Disoproxil Fumarate-Based Regimen in Ethiopia: A Prospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Taklo Simeneh Yazie
Keyword(s):  
Cohort Study ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Associated Factors ◽  
Liver Enzymes ◽  
Mean Value ◽  
Mean Values ◽  
Elevated Liver Enzymes ◽  
The Mean

Hepatotoxicity was found in different case reports and studies in tenofovir disoproxil fumarate- (TDF-) based regimen. However, there was no data regarding liver enzymes, glucose, and hemoglobin in Ethiopian patients receiving TDF-based regimen. The aim of this study was to determine elevated liver enzymes and its associated factors as well as elevated fasting plasma glucose and anemia. A hospital-based observational prospective cohort study was conducted on conveniently selected 63 patients in Tikur Anbessa Specialized Hospital (TASH) from January to September 2019. Laboratory values were determined at pre-TDF-based regimen baseline and six-month follow-up. The data was analyzed by using SPSS version 21.0, and multivariate logistic regression was used to determine associated factors with elevated liver enzymes. The overall elevated liver enzymes were found in 26 (41.3%) participants. From this, elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) comprise 3 (4.8%), 3 (4.8%), and 20 (31.8%), respectively. Elevated fasting plasma glucose (FPG) was found in 9 (14.3%) and 14 (22.2%) of participants at baseline and six-month visit, respectively. At six-month visit, 4 (6.4%) of participants experienced anemia. The mean value of ALP and FPG at six months was significantly higher than their respective baseline mean values ( mean   difference   MD = + 63.38 , 95% CI (39.84, 86.92), p = 0.0001 ; MD = + 6.64 , 95% CI (2.63, 10.64), p = 0.002 , respectively). The mean value of ALT, AST, and Hg at six months was slightly increased compared to their respective baseline mean values, but the difference was not significant. In multivariate analysis, only female sex was significantly associated with elevated ALP ( AOR = 4.5 , 95% CI (1.03, 19.6), p = 0.045 ). Overall mild and moderate hepatotoxicity was found to be high (26, 41.3%) in the present study, and from this, the majority was comprised by elevated ALP (20, 31.8%). The proportion of participants with hyperglycemia was increased at the end of follow-up compared to its baseline value, but anemia was not. Female sex was significantly associated with elevated ALP. This study warrants monitoring of liver enzymes and glucose in TDF-based regimen.

scholarly journals Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of inflammatory-degenerative disease of temporomandibular joint

2021 ◽  
Vol 33 (1) ◽  
pp. 1-5
Author(s):  
Enas A Abdulmaged ◽  
Thair Abdul Lateef
Keyword(s):  
Hyaluronic Acid ◽  
Life Quality ◽  
Mouth Opening ◽  
Sodium Hyaluronate ◽  
Degenerative Disease ◽  
Therapeutic Benefits ◽  
Masticatory Efficiency ◽  
Pain Symptoms

Background:Temporomandibular joint (TMJ) problems refer to a group of heterogeneous pain and dysfunction conditions involving the mastication, reducing life quality of the patients. Arthrocentesis is a simple and less invasive surgical method for the treatment of inflammatory-degenerative disease than other conservative procedures and better than arthroscope. This clinical study aimed at evaluating the benefit of arthrocentesis with injection of hyaluronic acid in the management of inflammatory-degenerative disease of the TMJ. Material and methods: Eighty consecutive patients were enrolled in this study with pain symptoms of TMJ, insufficient masticatory efficiency during function and limitation of mouth opening; they were assessed with clinical examination and approved with computed tomography scan. Arthrocentesis was done by inserting 18 gauge needles in the upper joint compartment, lavage by normal saline solution and at the end of the procedure 1ml of hyaluronic acid (HA) was injected. Intensity of the TMJ pain and masticatory efficiency was analyzed by visual analog scale (VAS), maximum mouth opening (MMO) was assessed by a ruler. All the assessed parameters were measured before the procedure then 1 and 4 months later. Results: During 5 months follow-up, comparison of the obtained results showed reduction in pain at chewing and rest 87.5%, improvement in mouth opening 100% and significant improvement in masticatory efficiency 87.5% of patients. Conclusion: The procedure of arthrocentesis with Sodium Hyaluronate injection, used in patients who suffered from inflammatory-degenerative disease (IDD), showed therapeutic benefits, simplicity, safety, patient satisfaction, lack of significant side effects and complications.  

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.

Seasonal trends in the stable isotopic composition of snow and meltwater runoff in a subarctic catchment at Okstindan, Norway

2004 ◽  
Vol 35 (2) ◽  
pp. 119-137 ◽  
Author(s):  
S.D. Gurney ◽  
D.S.L. Lawrence
Keyword(s):  
Isotopic Composition ◽  
Mean Value ◽  
Mean Values ◽  
Stable Isotopic Composition ◽  
Meltwater Runoff ◽  
Stable Isotopic ◽  
The Mean ◽  
The Difference ◽  
Δ18o And Δd

Seasonal variations in the stable isotopic composition of snow and meltwater were investigated in a sub-arctic, mountainous, but non-glacial, catchment at Okstindan in northern Norway based on analyses of δ18O and δD. Samples were collected during four field periods (August 1998; April 1999; June 1999 and August 1999) at three sites lying on an altitudinal transect (740–970 m a.s.l.). Snowpack data display an increase in the mean values of δ18O (increasing from a mean value of −13.51 to −11.49‰ between April and August), as well as a decrease in variability through the melt period. Comparison with a regional meteoric water line indicates that the slope of the δ18O–δD line for the snowpacks decreases over the same period, dropping from 7.49 to approximately 6.2.This change points to the role of evaporation in snowpack ablation and is confirmed by the vertical profile of deuterium excess. Snowpack seepage data, although limited, also suggest reduced values of δD, as might be associated with local evaporation during meltwater generation. In general, meltwaters were depleted in δ18O relative to the source snowpack at the peak of the melt (June), but later in the year (August) the difference between the two was not statistically significant. The diurnal pattern of isotopic composition indicates that the most depleted meltwaters coincide with the peak in temperature and, hence, meltwater production.

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