title: Cytokine and clinical predictors for treatment outcome of visually guided temporomandibular joint irrigation in patients with chronic closed lock.
abstract: OBJECTIVE
  This study investigates selected predictors for clinical outcome of temporomandibular joint (TMJ) irrigation in patients with chronic closed lock (CCL).
  
  
  METHODS
  Fifty-six patients with unilateral CCL, who underwent a visually guided TMJ irrigation (VGIR), were enrolled in this study. They were divided into either successful (s-group; n = 38) or unsuccessful groups (u-group; n = 18), according to the clinical success criteria. The investigated predictive factors were age, gender, duration of symptoms before the VGIR, preoperative painless range of mandibular motion, preoperative self-evaluated TMJ pain on visual analog scale (VAS), severity of arthroscopically observed pathologies, and presence and concentrations of a set of pro- and anti-inflammatory cytokines (ie, tumor necrosis factor [TNF]-alpha, interleukin [IL]-1beta, IL-6, IL-8, IL-12, and IL-10) in the aspirated synovial fluid (A-SF). Several comparative analyses and logistic regression analyses were used for statistical studies.
  
  
  RESULTS
  The preoperative VAS score, detection rate of IL-8, and concentrations of IL-6 and IL-8 in the A-SF were significantly higher in the u-group (P < .05). Conversely, the detection rate and concentrations of IL-10 were significantly higher in the s-group (P < .05). The multivariate adjusted odds ratio (OR) showed that the detectable IL-10 in the A-SF (OR, 10.882; P = .047) is significantly predictive for a successful VGIR.
  
  
  CONCLUSIONS
  The presence of IL-10 in the A-SF is a significant predictor of successful outcome of TMJ irrigation for CCL. Severe TMJ pain and detectable IL-6 or IL-8 in the A-SF seem to indicate a poor outcome after TMJ irrigation.
authors: First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan. hamada-y@tsurumi-u.ac.jp
authors: Yoshiki
authors: Y
authors: Hamada
authors: Toshirou
authors: T
authors: Kondoh
authors: Anders B
authors: AB
authors: Holmlund
authors: Kenji
authors: K
authors: Sakota
authors: Yoshiaki
authors: Y
authors: Nomura
authors: Kanichi
authors: K
authors: Seto
mesh_terms: D000367:Age Factors; D001182:Arthroscopy / Q000379:methods; D002908:Chronic Disease; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007378:Interleukins / Q000032:analysis*; D008297:Male; D016059:Range of Motion, Articular; D012737:Sex Factors; D013582:Synovial Fluid / Q000737:chemistry*; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D007507:Therapeutic Irrigation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007378:Interleukins