Arthrocentesis and Temporomandibular Joint Disorders a Conservative Alternative to Surgical Treatments
Study Details
Study Description
Brief Summary
This study aims to evaluate the efficacy of arthrocentesis in the treatment of internal derangement of the temporomandibular joint (TMJ).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
This work was designed as a prospective case series clinical study. Patients imaging was evaluated with Cone-Beam Computed Tomography and Nuclear Magnetic Resonance at the beginning of the treatment and after the last arthrocentesis.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| arthrocentesis in TMJ internal derangement 30 patients with TMJ internal derangement and pain with history of failed conservative management. |
Procedure: TMJ arthrocentesis
lavage of the superior TMJ space with saline and sodium hyaluronate (SH)
|
Outcome Measures
Primary Outcome Measures
- Pain decrease [baseline (preop), 1 week, 1 month, 2 months, 6 months, 12 months (postop)]
Patients were followed up for 1 year. The mean pre-operative pain, using visual analog scale, showed an average decrease of 6.7 at 1 year.
- increase in the mouth opening [Baseline (preop), 1 week, 1 month, 2 months, 6 months, 12 months (postop)]
The mean maximum mouth opening(MMO) pre-operatively was 15,8 mm and increased to 34 mm immediately following arthrocentesis which increased by 0.5-1 mm at every month followup with mean MMO of 39,4 mm at 6 months. Thereafter it remained consistent till 1 year. The mean increase in the mouth opening at 1 year was 23,6 mm
- TMJ click and noises reduction [Baseline (preop), 12 months (postop)]
At the end of 1 year, (75%) patients stated no evidence of clicking.
Secondary Outcome Measures
- number of subjects showing signs of TMJ inflammation or structural alterations at Magnetic Resonance Imaging and Cone Beam Computerized Tomography pre- and postop. [Baseline (preop)- 60 days postop]
40% of subjects who showed clear signs of inflammation showed significant improvement, in 30% with structural alterations was evident the absence of intra-articular adhesions and debris, in 30% with internal derangement did not appear any radiographic change.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
TMJ pain
-
TMJ noises and click
-
history of unsuccessful conservative management (NSAID and occlusal bite)
-
occlusal bite still present
Exclusion Criteria:
-
degenerative joint disease (such as osteoarthritis, rheumatoid arthritis etc.)
-
history of condylar fractures or previous TMJ trauma
-
TMJ surgery
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Maxillofacial Unit, University of Sassari | Sassari | SS, | Italy | 07100 |
Sponsors and Collaborators
- Università degli Studi di Sassari
Investigators
- Principal Investigator: Silvio M Meloni, assist prof, University of Sassari, Italy
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IT010713