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Arthrocentesis versus conservative treatments for TMJ dysfunctions: A preliminary prospective study
بزل المفصل مقابل العلاجات المحافظة لخلل وظائف المفصل الفكي الصدغي: دراسة مستقبلية أولية

Authors: Reiadh K. Al-Kamali --- Saeed Hameed Saeed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 2 Pages: 739-745
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The temporomandibular disorders present with a variety of signs and symptoms which include pain in the joint and its surrounding, jaw sounds, limited jaw opening, jaw deviation and headache. The aim of this study was to compare the results and efficacy of arthrocentesis with those of conservative treatments for temporomandibular joint disorders.Methods: In a clinical comparative prospective study, 45 patient of both sexes were enrolled in this study according to inclusion criteria’s. The arthrocentesis group consisted of 22 patients (31 joints). The conservative treatment group consisted of 23 patients (34 joints). For both groups, pretreatment and four months post treatment parameters (visual analogue scale for pain, maximum mouth opening and joint sounds score) were recorded.Results: The results revealed that highly statistically significant difference between all pretreatment and forth months post treatment parameter means for both groups (P < 0.001). Both arthrocentesis and conservative treatments were effective. There was a highly statistical significant difference between the four months post treatment parameter means for both groups (P < 0.001). Arthrocentesis was superior to conservative treatments. The overall success rate was 87.1% for arthrocentesis and 55.9% for conservative treatments.Conclusion: Both conservative treatment and arthrocentesis are effective in the treatment of temporomandibular joint dysfunctions. However, arthrocentesis seems to be superior.


Article
Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint

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Abstract

Background: Temporomandibular joint disorders refer to a group of heterogeneous pain and dysfunction conditionsinvolving the masticatory system, reducing life quality of the sufferers. Arthrocentesis is simple and less invasivesurgical procedure for the treatment of internal derangement than arthroscopy and better than other conservativeprocedures such as drugs, occlusal appliances and physiotherapy. The aim of the study was to evaluate the effectof arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibularjoint for the restoration of its function, reducing pain and preventing further deterioration of the temporomandibularjoint dysfunction.Materials and methods: This study was performed in Al-Sheed Ghazi Al-Hariri Hospital, Department of Oral andMaxillofacial Surgery, from November 2012 to October 2013, included 60 patients, aged 18 to 45 years withsymptoms of temporomandibular joint pain, clicking during function and limited mouth opening.Temporomandibular joint internal derangement was assessed with clinical examination and confirmed withcomputed tomography scan. Arthrocentesis was done with insertion of two 18 gauge needles in the upper jointcompartment, lavaged with ringer’s lactate solution and at the end of the procedure 1ml of hyaluronic acid wasinjected. Intensity of temporomandibular joint pain was assessed using visual analog scale, maximum mouth openingwas assessed with ruler scale and joint clicking was assessed clinically by stethoscope and manual palpation. All theparameters were measured before the procedure then 1 and 3 months later.Results: During 4 months follow-up, clinical examination and comparison of the results showed reduction in pain withsuccess rate 95%, improvement in mouth opening with success rate 100% and clicking disappeared in 95% ofpatients.Conclusion: The technique of arthrocentesis using Sodium Hyaluronate injection, used in patients who presented withinternal derangement, showed therapeutic benefits, simplicity, safety, patients acceptance of the technique andlack of significant side effects and complications.

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