title: Dose-dependent sustained local release of dexamethasone from biodegradable thermosensitive hydrogel of PEG-PLGA-PEG triblock copolymers in the possible prevention of TMJ re-ankylosis (Arakeri's TMJ release technique).
abstract: Temporomandibular joint (TMJ) ankylosis is a devastating anatomico-pathological condition which severely affects the quality of human health. Over the last 70 years various treatments have been described to treat this distressing condition. But no single method has uniformly produced successful results. Although various surgical techniques have been improved periodically, the treatment results remain inefficient due to its recurrence as TMJ re-adhesion. Since recurrence remains as a problem in many cases, the TMJ ankylosis presents a major therapeutic challenge in head and neck surgery. The re-ankylosis is a unique phenomenon that so far has defied a full and logical explanation, based upon biological and mechanical factors that are linked together in a coherent fashion. Many factors have been implicated in the development of re-adhesion following TMJ surgery. But still the mechanism by which the TMJ re-adhesion develops is unclear. Hence, TMJ ankylosis demands an alternative effective treatment modality to prevent its recurrence as re-ankylosis. This paper postulates some critical biological factors responsible for re-ankylosis based on which a novel treatment modality is also proposed.
authors.affiliation: Peter Brennan's Indian Academy of Craniofacial Researches, Shahapur, Yadgir 585223, Gulbarga, Karnataka, India. gururaj.arakeri@gmail.com
authors.forename: Gururaj
authors.initials: G
authors.lastname: Arakeri
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brennan
mesh_terms: D020341:Absorbable Implants; D000844:Ankylosis / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001672:Biocompatible Materials; D003131:Combined Modality Therapy; D003692:Delayed-Action Preparations; D003907:Dexamethasone / Q000008:administration & dosage*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007249:Inflammation / Q000517:prevention & control; D008954:Models, Biological; D011092:Polyethylene Glycols; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*
chemical_list: D000893:Anti-Inflammatory Agents; D001672:Biocompatible Materials; D003692:Delayed-Action Preparations; C520330:polyethylene glycol-poly(lactic-co-glycolic acid)-polyethylene glycol; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D011098:Polyglactin 910; D011092:Polyethylene Glycols; D003907:Dexamethasone