Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy

Abstract

The efficacy of a combination treatment of arthrocentesis and stabilisation splint for patients with bilateral anterior disc displacement without reduction (ADDWoR) and erosive change of the TMJ remains controversial. To evaluate clinical outcomes of patients with ADDWoR and erosive change of the TMJ after performance of unilateral arthrocentesis and stabilisation splint therapy. A retrospective study of 44 patients (37 females, 7 males, mean age of 34 years) with bilateral ADDWoR and erosive change of the TMJ were included in this study. Their clinical outcomes before and after arthrocentesis and stabilisation splint therapy were compared. Evaluation criteria were as follows: (a) Maximal mouth opening (MMO); (b) Right and left maximal lateral movement (RLM, LLM) and maximal protrusive movement (PM); (c) Visual analog scale (VAS) pain score during MMO, RLM, LLM and PM; and (d) VAS pain score during palpation of masticatory muscles. Wilcoxon signed‐rank test, Mc Nemar test and paired t test were used for statistical analysis. Differences in VAS pain score between arthrocentesis and non‐arthrocentesis sites were not statistically significant except MMO and LLM (P < .05) after 6 months. Differences in mean VAS pain scores for all variables between before arthrocentesis and 6 months follow‐up in the arthrocentesis site were statistically significant. (P < .01). Unilateral arthrocentesis on more symptomatic TMJ and subsequent stabilisation splint therapy was highly successful for pain and achievement of normal range of mandibular movements in patients with both ADDWoR and bony change.

Comparison of magnetic resonance imaging findings in 880 temporomandibular disorder patients of different age groups: a retrospective study

“…We know that joint motion is related to disc displacement. Limited mouth opening may restricted by disc displacement, such as ADDWoR and ADDWR with intermittent locking [ 27 – 29 ]. Hypermobility may related with morphology of the musculoskeletal system[ 30 ].…”

Clinical Evaluation of Arthrocentesis and Modified Anterior Repositioning Splint in Management of Symptomatic TMJ Internal Derangement

“…MMO means significantly (p<0.001) increased from (26.67±5.47 mm) preoperative to (43.11±2.08 mm) at the 6 th month postoperative with a change percent of 61.65% increase from preoperative these results supported by other studies. (21,22) The right-side lateral excursion was significantly (p<0.001) increased from (7.00±0.87) preoperatively to (8.07±0.56) at the 6 th month postoperatively. The overall change was a 15.24% increase from preoperative.…”

“…The protocol of part-time modified ARS use and its change to stabilizing splint to overcome longtime use of ARS, as, it will have frequently been associated with many complications such as posterior open bite, occlusal alterations, and muscle contracture of the lateral pterygoid, all these in accordance with the results of many studies. (16,(18)(19)(20) Pain score in this study was measured by VAS. A significant (p<0.001) reduction in means was observed between (6.80±1.26) preoperative and (1.53±1.06) at the 6 th month postoperative, as a change percent was -77.45 %.…”

Evaluation of Patient Comfort and Impact of Different Anesthesia Techniques on the Temporomandibular Joint Arthrocentesis Applications by Comparing Gow-Gates Mandibular Block Anesthesia with Auriculotemporal Nerve Block

“…When comparing the preoperative period with 3 rd and 6 th months, there was no statistically significant difference between the ANB and the GG groups in terms of MMO, PM, and VAS pain parameters in our study. Heo et al [ 22 ] and Ghanem [ 23 ] found that MMO and PM values were statistically higher in the 6 th month compared to the preoperative period. The results of the present study reflect these findings.…”