Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제32권5호
  • /
  • Pages.453-457
  • /
  • 2006
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

악관절 내장증 치료를 위한 악관절 세정술 후 관절강내 Hyaluronic Acid 주입 효과

THE EFFECT OF INTRA-ARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROCENTESIS IN TREATMENT OF INTERNAL DERANGEMENTS OF THE TMJ

  • 김재진 (청주성모병원 구강악안면외과)
  • Kim, Jae-Jin (Dept. of Oral and Maxillofacial Surgery, Cheongju St. Mary's Hospital)
  • 발행 : 2006.10.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

This study was designed to investigate the effect of intra-articular injection of hyaluronic acid for the treatment of internal derangements of the temporomandibular joint(TMJ). Sixteen patients with internal derangements of TMJ in 1 male and 15 females aged 68 to 18 years comprised the study material. The patients' complaint was limited mouth opening and pain during function. Patients were divided into 3 groups(articular disc displacement with reduction, articular disc displacement without reduction, osteoarthritis group). The preauricular area was disinfected anesthetized locally with 2% lidocaine hydrochloride. Arthrocentesis was performed. Hyaluronic acid(1.5 ㏄) was then injected into the superior compartment of the TMJ. Active range of motion exercises were instituted at approximately 24 hours postoperatively. Antibiotics and NSAID, three times daily by mouth, was prescribed for 3 days. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, final follow-up visit postoperatively. Pain during function was assessed using visual analog scales(VAS). Maximal mouth opening was recorded as a distance between upper incisal edge and lower incisal edge. Intra-articular injection of hyaluronic acid caused significant reduction of pain during function, significant increase of maximal opening range. These findings suggest that intra-articular injection of hyaluronic acid is useful for decreasing patient reports of pain while increasing functional mobility of the mandible in internal derangements of the TMJ.

키워드

참고문헌

  1. Ohnishi M: Arthroscopy of the temporomandibular joint. J Jpn Stomatol Assoc 1975;42:207-213 https://doi.org/10.5357/koubyou.42.207
  2. Nitzan DW, Dolwick MF, Heft MW: Arthroscopic lavage and lysis of the temporomandibular joint: A change in perspective. J Oral Maxillofac Surg 1990;48:798-801 https://doi.org/10.1016/0278-2391(90)90335-Y
  3. Nitzan DW, Dolwick MF, Martinez GA: Temporomandibular joint arthrocentesis: A simplified treatment for severe limited mouth opening. J Oral Maxillofac Surg 1991;49:1163-1167 https://doi.org/10.1016/0278-2391(91)90409-F
  4. Dionne RA: Pharmacologic treatments for temporomandibular disorders. Oral Surg Oral Pathol Oral Radiol Endod 1997;83:134-142 https://doi.org/10.1016/S1079-2104(97)90104-9
  5. Fader KW, Grunmons DC, Maijer R, et al: Pressurized infusion of sodium hyaluronate for closed lock of the temporomandibular joint. Part I: A case study. J Craniomandib Prac 1993;11:68-72
  6. Kopp S, Wenneberg B, Haraldson T, et al: The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction. J Oral Maxillofac Surg 1985;43:429-435 https://doi.org/10.1016/S0278-2391(85)80050-1
  7. Israel HA: Current concepts in the surgical management of temporomandibular joint disorders. J Oral Maxillofac Surg 1994;52:289-294 https://doi.org/10.1016/0278-2391(94)90303-4
  8. Davis CL, Kaminishi RM, Marshall NW: Arthroscopic surgery of closed lock. J Oral Maxillofac Surg 1991;49:704-707 https://doi.org/10.1016/S0278-2391(10)80232-0
  9. Fridrich KL, Wise JM, Zeitler DL: Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders. J Oral Maxillofac Surg 1996;54:816-820 https://doi.org/10.1016/S0278-2391(96)90526-1
  10. Carvajal WA, Laskin DM: Long-term evaluation of arthrocentesis for the treatment of internal derangements of the temporomandibular joint. J Oral Maxillofac Surg 2000;58:852-855 https://doi.org/10.1053/joms.2000.8201
  11. Ohnishi M: Clinical application of arthroscopy in the temporomandibular joint diseases. Bull Tokyo Med Dent Univ 1980;27:141-150
  12. Moses JJ, Sartorius D, Glass R, et al: The effect of arthroscopic surgical lysis and lavage of the superior joint space on TMJ disc position and mobility. J Oral Maxillofac Surg 1989;47:674-678 https://doi.org/10.1016/S0278-2391(89)80004-7
  13. Gibson T, Burry HC, Poswillo D, et al: Effect of intra-articular corticosteroid injections on primate cartilage. Ann Rheum Dis 1976;36:74-79 https://doi.org/10.1136/ard.36.1.74
  14. Balch HW, Gibson JM, El-Ghobarey AF, et al: Repeated corticosteroid injections into knee joints. Rheumatol Rehab 1977;16:137-140 https://doi.org/10.1093/rheumatology/16.3.137
  15. Asheim A, Lindblad G: Intra-articular treatment of arthritis in racehorses with sodium hyaluronate. Acta Vet Scand 1976;17:379-394
  16. Kopp S, Carlsson GE, Haraldson T, et al: The long-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis. J Oral Maxillofac Surg 1987;45:929-935 https://doi.org/10.1016/0278-2391(87)90443-5
  17. Guarda-Nardini L, Masiero S, Marioni G: Conservative treatment of temporomandibular joint osteoarthrosis: intra-articular injection of sodium hyaluronate. J Oral Rehabil 2005;32:729-734 https://doi.org/10.1111/j.1365-2842.2005.01505.x
  18. Alpaslan GH, Alpaslan C: Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements. J Oral Maxillofac Surg 2001;59:613-618 https://doi.org/10.1053/joms.2001.23368
  19. Fraser JRE, Clarris BJ, Baxter E: Patterns of induced variation in the morphology, hyaluronic acid secretion and lysosomal enzyme activity of cultured synovial cells. Ann Rheum Dis 1979;38:287-294 https://doi.org/10.1136/ard.38.3.287
  20. Balazs EA: The physical properties of synovial fluid and the special role of hyaluronic acid. In: Helfet A, ed. Disorders of the Knee. Philadelphia: Lippincott, 1974;61-64
  21. Rydell N, Balazs EA: Effect on the intra-articular injection of hyaluronic acid on the clinical symptoms of osteoarthritis and on granulation tissue formation. Clin Orthop 1971;80:25-32 https://doi.org/10.1097/00003086-197110000-00006
  22. Miyazaki K, Goto S, Ogasawara H, et al: Studies on analgesic and anti-inflammatory effects of sodium hyaluronate. Pharmacometrics 1984;228:1123-1135
  23. Dahl LB, Dahl IMS, Engstrom-Laurent A, Granath K: Concentration and molecular weight of sodium hyaluronate in synovial fluid from patients with rheumatoid arthritis and other arthropathies. Ann. Rheum Dis 1985;44:817-822 https://doi.org/10.1136/ard.44.12.817
  24. Henderson EB, Grootveld M, Farrell A, Smith EC, Thompson PW, Blake DR: A pathological role for damaged hyaluronan in synovitis. Ann Rheum Dis 1991;50:196-200 https://doi.org/10.1136/ard.50.3.196
  25. McKee CM, Lowenstein CJ, Horton MR, et al: Hyaluronan fragments induce nitric-oxide synthase in murine macrophage through a nuclear factor cob-dependent mechanism. J Boil Chem 1997;272:8013-8018 https://doi.org/10.1074/jbc.272.12.8013
  26. Nitzan DW, Etsion I: Adehesive force: the underlying cause of the disc anchorage to the fossa and/or eminence in the temporomandibular joint - a new concept. Int J Oral Maxillofac Surg 2002;31:94-99 https://doi.org/10.1054/ijom.2001.0153
  27. Peyron JG: Intraarticular hyaluronan injections in the treatment of osteoarthritis: state-of-the-art review. J Rheumatol 1993;20:17-27
  28. Laquerre T, Nouvellon M, Kraznowska K, Bruno MC, Vittecoq O, et al: Septic arthritis due to Actinomyces naeslundii: report of a case. Joint Bone Spine 2002;69:499-501 https://doi.org/10.1016/S1297-319X(02)00437-2
  29. Evanich JD, Evanich CJ, Wright MB, Rydlewicz JA: Efficacy of intraarticular hyaluronic acid injections in knee osteoarthritis. Clin Orthop 2001;390:173-181 https://doi.org/10.1097/00003086-200109000-00020
  30. Lida K, Kurita K, Tange K, Yoshida K: Necrosis of the articular tubercle after repeated injections of sodium hyaluronate in temporomandibular joint. A case report. Int J Oral Maxillofac Surg 1998;27:278-279 https://doi.org/10.1016/S0901-5027(05)80614-9