Cytokine and clinical predictors for treatment outcome of visually guided temporomandibular joint irrigation in patients with chronic closed lock.
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.
Hamada
Yoshiki
Y
First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan. hamada-y@tsurumi-u.ac.jp
Kondoh
Toshirou
T
Holmlund
Anders B
AB
Sakota
Kenji
K
Nomura
Yoshiaki
Y
Seto
Kanichi
K
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
D007378:Interleukins