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Temporomandibular joint arthrocentesis for the remedy of osteoarthritis.
Stomatologija. 2015;17(Four):113-7
Authors: Leibur E, Jagur O, Voog-Oras Ü
Summary
UNLABELLED: The goal of the examine was to estimate the impact of arthrocentesis within the remedy of osteoarthritis of the temporomandibular joint (TMJ), consider and evaluate cytological and biochemical findings within the synovial fluid (SF) as properly in venous blood samples and to find out the effectiveness of arthrocentesis with regard to TMJ ache depth and mandibular motion.
PATIENTS AND METHODS: Twenty three consecutive sufferers with a prognosis of TMJ osteoarthritis (Wilkes´ phases III, IV) after noneffective conservative remedy had been handled with arthrocentesis utilizing push and pull approach (Alstergren et al. 1995). Preoperative radiographs and the scores pre- and posttreatment (after 6 months), maximal interincisal opening (MIO) and visible analogue scale (VAS) for ache estimation had been carried out. Blocking the auriculotemporal nerve with a 2 mL of two% lidocaine resolution, the needle was inserted into the higher joint compartment and related with the three-way stopcock for infusion remedy (Discofix® Braun) and 2-Three mL of saline resolution was pushed slowly to the higher compartment after which aspirated again. The primary SF aspirate was allotted for the next evaluation: SF viscosity, presence of crystals, SF rheumatoid issue (RF) in comparison with blood plasma RF. The washing was repeated Three-Four occasions till the aspirate was clear.
RESULTS: After 6 months MIO improved considerably (p<zero.05) and ache in accordance with VAS had considerably decreased (p<zero.01). Viscosity of the aspirate was zero.78 (medium), crystals had been present in 5 sufferers (21.7%). There was not statistical important distinction between SF RF and plasma RF values (p>zero.05).The effectiveness of arthrocentesis could also be defined by the joint area enlargement achieved with the introduction fluid, washing out inflammatory mediators, the particles of adhesions, fibrillations, crystals and many others.
CONCLUSIONS: Arthrocentesis with this system for the remedy of TMJ osteoarthritis provide beneficial outcomes with regard to growing MIO, lowering ache and dysfunction. The presence of crystals or chondromatosis granules within the synovial fluid and elevated viscosity of the synovial fluid signifies a pathological situation of an inflammatory nature.
PMID: 27189496 [PubMed – indexed for MEDLINE]