Arthrocentesis versus glucocorticosteroid injection for internal derangement of temporomandibular joint
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ORIGINAL ARTICLE
Arthrocentesis versus glucocorticosteroid injection for internal derangement of temporomandibular joint Najwa Jamil AbdulRazzak 1 & Jafar Abdulhadi Sadiq 1 & Atheer Talib Jiboon 2 Received: 5 May 2020 / Accepted: 24 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background It is necessary to clarify that temporomandibular joint disorders (TMDs) are one of the most misdiagnosed and mistreated maladies in the medical practice. It is an umbrella term, embracing conditions which involve the temporomandibular joint (TMJ) and related muscles. One of these common irritating disorders is the internal derangement which is used specifically to describe the displacement of the TMJ disc. The treatment can vary according to the severity and chronicity into non-invasive, minimally invasive, and invasive procedures. However, permanent recovery is rarely obtained. Aim of the study This study was established to compare the effectiveness of two minimally invasive procedures: arthrocentesis and glucocorticosteroid (GCS) local single joint injection in the management of internal derangement of the TMJ. Methods Thirty patients aged from 18 to 42 years were included in this study with internal derangement which was confirmed clinically and with a cone beam CT scan. The patients were divided into two groups of 15 patients. Arthrocentesis was performed to one group (group A) by using Shepard’s cannula and lactated Ringer’s solution. Glucocorticosteroid injection was done to the other group (group B) using a 1 ml/40 mg methylprednisolone acetate vial. The study was performed in the Department of Oral and Maxillofacial Surgery, Ghazi Alhareery Hospital—Medical City, from October 2017 to September 2018. Results and conclusion After 4 months of clinical follow-up, the results revealed that the GCS injection has minimal outcomes in the treatment of TMJ internal derangement compared to arthrocentesis. On the other hand, arthrocentesis and lavage had dedicated promising outcomes. Keywords Temporomandibular joint . Internal derangement . Intra-articular glucocorticosteroid injection . Arthrocentesis
Introduction Disorders of the temporomandibular joint (TMJ) have an adverse effect on jaw functions which presented as limited mouth opening, painful chewing, and locking in the TMJ [1]. Intra-articular temporomandibular disorders present as various pathological conditions, often concerning derangements of the condyle-disc complex; they occur because of
* Atheer Talib Jiboon [email protected]; [email protected] 1
Maxillofacial Surgery Department, Alshaheed Ghazi Alhareery for Specialized Surgeries Hospital- Medical City, Baghdad, Iraq
2
Department of Oral Surgery, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
the changes in the physiological relationship between the articular disc and the condyle head [2]. Internal derangement was introduced by Hey in 1814 as a general orthopedic term for a localized mechanical fault in the joint which later on was used mo
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