Double-Needle Arthrocentesis with Viscosupplementation in Patients with Temporomandibular Joint Disc Displacement without Reduction

Rossini, Rafael; Grossmann, Eduardo; Poluha, Rodrigo Lorenzi; Setogutti, Enio Tadashi; DosSantos, Marcos F.

doi:10.6061/clinics/2021/e2840

Cited by 6 publications

(14 citation statements)

References 29 publications

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“…In addition, pain reduction was comparable between these two techniques, as the double technique showed a VAS reduction from a mean value of 6.6 to 1.2 and the single-puncture technique showed a reduction from a mean value of 6.0 to 0.4, also without significant differences in the paired t -tests. Thus, concluding that both the single-or double technique are similarly efficient in the reduction in pain and increasing mouth opening in patients with DDWOR [ 3 , 6 , 7 , 8 , 9 , 16 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Increased values of MMO following the operation interfered with the more decreased VAS reported by patients in the analyzed material.…”

Section: Discussionmentioning

confidence: 94%

State of the Art in Temporomandibular Joint Arthrocentesis—A Systematic Review

Siewert-Gutowska

Pokrowiecki²,

Kamiński

et al. 2023

JCM

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Temporomandibular joint disorders are a heterogenic group of clinical conditions, which impair physiological functioning of the masticatory system. Arthrocentesis of the temporomandibular joint has become a widely approved method for non-invasive treatment, bridging the gap between conservative and surgical approaches. Regardless of technique, treatment is based upon joint lavage and lysis of the inflammatory fibrous tissue adhesions, which, in turn, improves joint mobility and reduces pain and closed lock. Recently, approaches for intra-articular injections have been proposed as adjuvant or replacement therapy. The aim of this study was to assess the most efficient technique of arthrocentesis. A systematic search based on PRISMA guidelines, including a computer search with specific keywords, a reference list search and a manual search, was performed. Relevant articles were selected after three search rounds for final review. The studies pulled for the analysis presented information about the relevant predictors, including the technique of arthrocentesis (single- or two-needle method), fluid used for lavage (Ringer lactate or saline), volume of the fluid, application of the injectable, number of interventions, pain (VAS) and mouth opening scores (MMO) and follow-up. All cohorts showed improvement in mouth opening, but significant pain reduction was observed only in cohorts treated either by arthrocentesis alone or arthrocentesis followed by intra-articular injectables. Intra-articular injectables used alone failed to reduce pain post-operatively when compared to other cohorts. We concluded that both double-needle and single-puncture arthrocentesis techniques are equally efficient. Application of the adjuvant injectable did not improve the outcomes of arthrocentesis performed alone. The volume of the fluid used for joint lavage and its chemical composition were not significant in clinical outcomes. However, due to the lack of homogeneity in the study settings, a meta-analysis could not be applied and a systematic review was conducted. We still, however, state that there is a knowledge gap in the current literature regarding the use of injectables alone, as well as a longitudinal follow-up, which provides information about treatment efficiency. More high-quality and randomized controlled trials are required to shed light on this subject.

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Section: Discussionmentioning

confidence: 94%

State of the Art in Temporomandibular Joint Arthrocentesis—A Systematic Review

Siewert-Gutowska

Pokrowiecki²,

Kamiński

et al. 2023

JCM

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“…Previous study showed comparable results to our study. [20] Effusions are massive collections of synovial fluid in the joint area, and they are related with degenerative joint disease (DD). [21] As a result of this research, it is possible to anticipate better treatment outcomes for those suffering from degenerative disc disease (DD) by tracking the position of the effusion.…”

Section: Discussionmentioning

confidence: 99%

Arthrocentesis in Temporomandibular Joint disc Derangement Patients, with and without Hyaluronic Acid, A Clinical Trial

Mehdi¹,

Siddiq²,

Haq³

et al. 2022

PJMHS

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Objective: Our research looked at the effectiveness of arthrocentesis in the treatment of TMJ issues with and without the addition of hyaluronic acid. Study Design: Prospective study Place and Duration: Dental College, HITEC-IMS, Taxila Cantonment. December 2019- May 2022 Methods: In this study 60 patients of both genders who had temporomandibular Joint disc derangement disorders were presented. After obtaining informed written consent, the demographics of enrolled patients were analyzed, including age, sex, side, and type of effusion. In two groups, patients were split evenly. Group I received arthrocentesis alone with lavage and group II received arthrocentesis with hyaluronic acid. We used standard two needle arthrocentesis among all cases. Post treatment effectiveness among both groups were assessed and compared in terms of maximum mouth opening, reduction in pain score and complications. SPSS 24.0 version was used to analyzed completed data. Results: There were majority females in group I was 20 (66.7%) and in group II was 23 (76.7%). Mean age of the patients in group I was 34.6±11.44 years and had mean BMI 22.8±7.28 kg/m2 while in group II mean age was 32.11±14.34 years with mean BMI 21.5±8.41 kg/m2. Right side was the most common side among both groups found in 16 (53.3%) in group I and 17 (56.7%) in group II. In group I effusion in upper compartment found in 22 (73.3%) cases while in group II 24 (80%) cases had upper compartment. Pre-operative maximum mouth opening in group I was 30.4±9.45 mm and in group II MMO was 31.9±14.41. Post-operative we found increased in MMO in group I was 42.6±12.32 mm and in group II 44.7±11.29 mm but no any significantly difference was observed after 2 years of follow up 39.3±15.49 in group I and 41.13±6.51 mm in group II. Post-operative reduction in pain score was observed 1.8±5.1 in group I and 0.1±1.9 in group II by using VAS significantly with p value <0.003. Conclusion: We concluded in this study that the arthrocentesis is an effective and safe method in the treatment of temporomandibular joint disc derangement in terms of increase in MMO and reduction in pain score while arthrocentesis with hyaluronic acid showed better results but difference was not significant. Keywords: Temporomandibular Joint disc, Arthrocentesis, MMO, Pain score

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“…Arthrocentsis, arthroscopy, arthroplasty are aggressive procedures performed with anesthesia with several adverse reactions 11,43,45,48,73–76…”

Section: Therapiesmentioning

confidence: 99%

“…Finally, arthroplasty is an open joint procedure,11,73–75 it may involve disk repositioning, articular surface recontouring, disk removal or a combination thereof 11…”

Section: Therapiesmentioning

confidence: 99%

See 1 more Smart Citation

Temporomandibular Joint Disk Displacement: Etiology, Diagnosis, Imaging, and Therapeutic Approaches

Minervini¹,

D’Amico

Cicciù

et al. 2022

Journal of Craniofacial Surgery

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An estimated 8 to 15% of women, and 3 to 10% of men currently suffer from Temporomandibular disorders, and it has been reported that sounds are a common finding and have been observed in 28% to 50% of the adult population; sounds are almost always connected to "internal derangements" a condition in which the articular disk displaced from its position on the mandibular condyle. Due to the multifactorial etiology of temporomandibular joint dysfunction, any accurate diagnosis based on clinical examination alone often proves to be difficult, so a clinical examination should be utilized together with other imaging methods to determine the relationship between the disk and condyle before and after treatment. In general, management of temporomandibular joint-related conditions is necessary when pain or dysfunction is present, so many surgical or nonsurgical methods of treatment have been reported. The Occlusal splint is 1 of the most widespread treatment it induces a slight vertical condylar distraction and eliminates the occlusal factor, which can be responsible for Temporomandibular joint disturbances, removing the influence of the teeth on the joint position by the slight distraction of the joint which, in turn, enables damaged connective tissue to heal.

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Double-Needle Arthrocentesis with Viscosupplementation in Patients with Temporomandibular Joint Disc Displacement without Reduction

Cited by 6 publications

References 29 publications

State of the Art in Temporomandibular Joint Arthrocentesis—A Systematic Review

State of the Art in Temporomandibular Joint Arthrocentesis—A Systematic Review

Arthrocentesis in Temporomandibular Joint disc Derangement Patients, with and without Hyaluronic Acid, A Clinical Trial

Temporomandibular Joint Disk Displacement: Etiology, Diagnosis, Imaging, and Therapeutic Approaches

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