Clinical evaluation of arthrocentesis for temporomandibular joint disorders:The relationship between findings in the posterior portion of the superior joint space with use of an ultrathin arthroscope and the prognosis of arthrocentesis

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• The therapeutic method of superior joint space irrigation with two needles, so called arthrocentesis, for seventeen patients complaining of severe and persistent pain localized in the TMJ region at jaw movement was clinically evaluated. Furthermore, the conditions in the posterior portion of the superior joint space were observed simultaneously using a very fine athroscope through a 18-gauge needle for arthrocentesis.The visual analogue scale (VAS) of pain and maximum opening range (MOR) of each patient were recorded every week in order to evaluate the change of these factors between pre- and postoperation.As for VAS, 11 patients (64.7%) sufficiently improved 2 weeks after irrigation: The success rate on pain was increased to 70.6% at one month and to 82.4% at 3 months later.Concerning the improvement of MOR, four patients were unlocked during this procedure, and the others were still locking. The unlocked group showed more than 40mm on average of MOR immediately after irrigation which was continued. On the other hand, the average of MOR in the locking group was 30.2mm at 2 weeks later, but the average gradually increased to 34.5mm at 3 months post-operatively.Arthroscopic view showed fibrilar degeneration (81.3%), including furrowing, ulceration, fibrillation, and crater formation of the surface of cartilage and/or articular disc, synovitis (75.0%), floating debrises (75.0%), adhesion (50.0%), and bleeding (43.8%). The relationship between these findings and prognosis of each person was suggested to be correlative.Therefore, this method was found to be effective in a patients with painful internal derangement of TMJ.

• 一般社団法人 日本顎関節学会の論文

一般社団法人 日本顎関節学会 | 論文

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