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Temporomandibular joint arthrocentesis for the therapy of osteoarthritis.
Stomatologija. 2015;17(Four):113-7
Authors: Leibur E, Jagur O, Voog-Oras Ü
Summary
UNLABELLED: The purpose of the research was to estimate the impact of arthrocentesis within the therapy of osteoarthritis of the temporomandibular joint (TMJ), consider and evaluate cytological and biochemical findings within the synovial fluid (SF) as effectively 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 analysis of TMJ osteoarthritis (Wilkes´ phases III, IV) after noneffective conservative therapy had been handled with arthrocentesis utilizing push and pull method (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 answer, 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 answer 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 instances till the aspirate was clear.
RESULTS: After 6 months MIO improved considerably (p<zero.05) and ache in keeping 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 vital distinction between SF RF and plasma RF values (p>zero.05).The effectiveness of arthrocentesis could also be defined by the joint area growth achieved with the introduction fluid, washing out inflammatory mediators, the particles of adhesions, fibrillations, crystals and many others.
CONCLUSIONS: Arthrocentesis with this method for the therapy of TMJ osteoarthritis provide beneficial outcomes with regard to rising MIO, decreasing 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]