The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: a retrospective study of 18 cases.
Temporomandibular joint disorders affect a big portion of the population. There are a variety of treatment methods currently in use. Conservative treatment modalities are followed by more invasive approaches like arthrocentesis or arthroscopy. The aim of the study is to compare the effects of intra-articular tenoxicam injection and arthrocentesis plus viscosupplementation on patients in which a previous arthrocentesis plus viscosupplementation has failed to relieve pain and restore function. The study group consists of 18 TMJs in 16 patients (15 female and 1 male) and the patients were randomly divided into two groups as the arthrocentesis plus viscosupplementation group (n: 8) and tenoxicam injection (n: 10). 20 mg of tenoxicam was injected to the upper compartments of 10 joints without arthrocentesis. The other 8 joints were treated with a second arthrocentesis and sodium hyaluronate injection. VAS scores and maximum mouth opening with and without assistance were recorded in the post operative first week, first month and third month. The results show that there is little benefit in using relatively conservative methods once an arthrocentesis together with viscosupplementation has failed to relieve the patients pain. It is concluded that more invasive procedures should be considered for the patients who do not benefit from arthrocentesis.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey. Electronic address: yusufemes@yahoo.com.
Y
Y
Emes
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
I Ş
IŞ
Arpınar
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
B
B
Oncü
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
B
B
Aybar
Medical Park Private Bahcelievler Hospital, Istanbul, Turkey.
I
I
Aktaş
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
N
N
Al Badri
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
B
B
Atalay
Department of Public Health, Faculty of Medicine, Istanbul University, Turkey.
H
H
Işsever
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
S
S
Yalçın
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D005157:Facial Pain / Q000188:drug therapy* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019152:Paracentesis / Q000379:methods*; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D016059:Range of Motion, Articular / Q000187:drug effects / Q000502:physiology; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy* / Q000628:therapy; D055676:Viscosupplementation / Q000379:methods; D055675:Viscosupplements / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D055675:Viscosupplements; D010894:Piroxicam; D006820:Hyaluronic Acid; C032801:tenoxicam
Arthrocentesis; Intra-articular injection; Temporomandibular joint; Tenoxicam