title: Tumor necrosis factor-alpha levels in the synovial fluid of patients with temporomandibular joint internal derangement.
abstract: OBJECTIVE
  The purpose of this study was to investigate the level of tumor necrosis factor-alpha (TNF-α) in the synovial fluid (SF) of patients with temporomandibular joint (TMJ) internal derangement and to show the relationship between the level of TNF-α and the severity of the disease.
  
  
  METHODS
  Arthrocentesis was performed on 32 female and five male patients (aged between 17 and 45) referred to our clinic with the complaint of TMJ pain and discomfort. TNF-α levels were determined in the SF samples obtained during arthrocentesis. As a measure of pain, visual analog scale (VAS) scores were also evaluated.
  
  
  RESULTS
  There were statistically significant differences in VAS scores between the stages. VAS scores were found to be elevated as the stage of disease progressed. Increased levels of TNF-α were found in progressive stages of internal derangement.
  
  
  CONCLUSIONS
  In our study, both SF TNF-α levels and pain levels (VAS scores) were found to be increased in patients with internal derangement as the stage of the disease progresses. TNF-α might contribute to the pathogenesis of synovitis and the degeneration of the TMJ cartilage and bone.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey. Electronic address: oguven@dentistry.ankara.edu.tr.
authors.forename: Orhan
authors.initials: O
authors.lastname: Güven
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Kirikkale, Kirikkale, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Tekin
authors.affiliation: Department of Biochemistry, Faculty of Veterinary Medicine, University of Ankara, Ankara, Turkey.
authors.forename: Berrin
authors.initials: B
authors.lastname: Salmanoğlu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kaymak
mesh_terms: D000293:Adolescent; D000328:Adult; D000069237:Arthrocentesis / Q000379:methods; D018450:Disease Progression; D005260:Female; D006261:Headache / Q000145:classification; D006801:Humans; D004204:Joint Dislocations / Q000145:classification; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000145:classification; D010147:Pain Measurement / Q000379:methods; D010173:Palpation / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D013582:Synovial Fluid / Q000737:chemistry*; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000145:classification / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D055815:Young Adult
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: Internal derangement; Proinflammatory cytokines; TMJ; TNF-α