Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지

EVALUATION OF EFFICACY OF TMJ ARTHROCENTESIS IN THE PATIENTS WITH MANDIBULAR FRACTURE

하악골 골절 환자의 치료시 상관절강 세정술의 유용성 평가

  • Kim, Young-Kyun (Dept. of Oral & Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Yun, Pil-Young (Dept. of Oral & Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Kim, Ji-Hong (Dept. of Oral & Maxillofacial Surgery, Section of Dentistry, Bundang Jesaeng General Hospital, Daejin Medical Center)
  • 김영균 (분당서울대학교병원 치과 구강악안면외과) ;
  • 윤필영 (분당서울대학교병원 치과 구강악안면외과) ;
  • 김지홍 (대진의료재단 분당제생병원 치과 구강악안면외과)
  • Published : 2005.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients (47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.

Keywords

References

  1. 김영균: 외상성 악관절 손상. 대한치과의사협회지. 1997;19:191
  2. 김종원, 여환호: 악관절 외상의 진단과 치료. 나래출판사. 1996
  3. Okeson JP: Management of temporomandibular disorders and occlusion. 4th edition. St. Louis, Mosby Co. 1999
  4. Pullinger AG, Monteiro AA: History factors associated with symptoms of temporomandibular disorders. J Oral Rehabilation 1988;15:117 https://doi.org/10.1111/j.1365-2842.1988.tb00760.x
  5. Zhang ZK, Ma XC, Gao S et al: Studies on contributing factors in temporomandibular disorders. Chin J Dent Res 1999;2:7
  6. 김영균, 김현태, 이도훈 등: 하악골 골절 환자들의 악관절 상태 평가: 일차보고. 관절내시경적 검사, 조직형태학적 및 관절활액 분석. 대한구강악안면외과학회지 2001;27:308
  7. Eiji T et al: Impulsive compression influences the viscous behavior of procine temporomandibular joint disc. European J Oral Sciences 2003;111:353 https://doi.org/10.1034/j.1600-0722.2003.00049.x
  8. Carol G et al: Traumatic onset of temporomandibular disorders: Positive effects of a standardized conservative treatment program. Clinical J Pain 1997;13:337 https://doi.org/10.1097/00002508-199712000-00012
  9. Israel HA, Diamond B, Saed-Nejad F, Ratcliffe A: The relationship between arafunctional masticatory activity and arthroscopically diagnosed emporomandibular joint pathology. J Oral Maxillofac Surg 1999;57:255
  10. Nitzan DW, Dolwick F, Heft MW: Arthroscopic lavage and lysis of the temporomandibular joint: A change in perspective. J Oral Maxillofac Surg 1990;48:798 https://doi.org/10.1016/0278-2391(90)90335-Y
  11. Pullinger AG, Seligman DA: Trauma history in diagnostic groups of temporomandibular disorders. Oral Surg Oral Med Oral Pathol 1991;71:529 https://doi.org/10.1016/0030-4220(91)90355-G
  12. Howard RP, Hatsell CP, Guzman HM: Temporomandibular joint injury potential imposed by the low-velocity extension-flexion maneuver. J Oral Maxillofac Surg 1995;53:256
  13. Plesh O, Gansky SA, Curtis DA, Pogrel MA: The relationship between chronic facial pain and a history of trauma and surgery. Oral Surg 1999;88:16
  14. Milam SB, Schmitz JP: Molecular biology of temporomandibular joint disorders: proposed mechanism of disease. J Oral Maxillofac Surg 1995;53:1448 https://doi.org/10.1016/0278-2391(95)90675-4
  15. McCain JP: Principles and Practice of Temporomandibular Joint Arthroscopy. Mosby Co., 1996, p 169
  16. Goss AN, Bosanquet AG. The arthroscopic appearance of acute emporomandibular joint trauma. J Oral Maxillofac Surg 1990;48:780 https://doi.org/10.1016/0278-2391(90)90330-5
  17. Kim YK, Yeo HH, Cho SI, Kim MS: Enzymeimmuno-assay of PGE2 in the synovial fluid from TMJ of the patients with mandibular condylar fracture and internal derangement. J Korean Assoc Oral Maxillofac Surg 1996;22:65
  18. Holmlund A, Hellsing G: Arthroscopy of the temporomandibular joint: occurrence and location of osteoarthrosis and synovitis in a patient material. Int J Oral Maxillofac Surg 1988;17:36
  19. Merill RG, Yie WY, Langan M: A histologic evaluation of the accuracy of TMJ diagnostic arthroscopy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1990;70:393
  20. Sandler NA, Buckley MJ, Cillo JE, Braun TW: Correlation of inflammatory cytokines with arthroscopic findings in patients with temporomandibular joint internal derangements. J Oral Maxillofac Surg 1998;56:534 https://doi.org/10.1016/S0278-2391(98)90446-3
  21. Murakami K, Segami N, Fujimura K, Iizuka T: Correlation between pain and synovitis in patients with internal derangement of the temporomandibular joint. J Oral Maxillofac Surg 1991;49:1159 https://doi.org/10.1016/0278-2391(91)90407-D
  22. Quinn JG, Bazan NG: Identification of prostaglandin E2 and leukotriene B4 in the synovial fluid of painful, dysfunctional temporomandibular joints. J Oral Maxillofac Surg 1990;48:968 https://doi.org/10.1016/0278-2391(90)90011-P
  23. Alstergren P, Kopp S: Pain and synovial fluid concentration of serotonin, in arthritic temporomandibular joint. Pain 1997;72:137 https://doi.org/10.1016/S0304-3959(97)00022-5
  24. Appelgren A, Appelgren B, Kopp S, Lundeberg T, Theodorsson E: Substance P-associated increase of intra-articular temperature and pain threshold in the arthritic TMJ. J Orofac Pain 1998;12:101
  25. Murakami EI, Segami N, Moriya Y, Iizuka T: Correlation between pain and dysfunction and intra-articular adhesions in patients with internal derangement of the temporomandibular joint. J Oral Maxillofac Surg 1992;50:705