Browse > Article
http://dx.doi.org/10.5125/jkaoms.2014.40.4.155

Influencing factor on the prognosis of arthrocentesis  

Kim, Yoon Ho (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine)
Jeong, Tae Min (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine)
Pang, Kang Mi (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine)
Song, Seung Il (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.40, no.4, 2014 , pp. 155-159 More about this Journal
Abstract
Objectives: The purpose of this article is to evaluate factors influencing prognosis of arthrocentesis in patients with temporomandibular joint (TMJ) disorder. Materials and Methods: The subjects included 145 patients treated with arthrocentesis at the Dental Center of Ajou University Hospital from 2011 to 2013 for the purpose of recovering mouth opening limitation (MOL) and pain relief. Prognosis of arthrocentesis was evaluated 1 month after the operation. Improvement on MOL was defined as an increase from below 30 mm (MOL ${\leq}30mm$) to above 40 mm (MOL ${\geq}40mm$), and pain relief was defined as when a group with TMJ pain with a visual analog scale (VAS) score of 4 or more (VAS ${\geq}4$) decreased to a score of 3 or more. The success of arthrocentesis was determined when either mouth opening improved or pain relief was fulfilled. To determine the factors influencing the success of arthrocentesis, the patients were classified by age, gender, diagnosis group (the anterior disc displacement without reduction group, the anterior disc displacement with reduction group, or other TMJ disorders group), time of onset and oral habits (clenching, bruxism) to investigate the correlations between these factors and prognosis. Results: One hundred twenty out of 145 patients who underwent arthrocentesis (83.4%) were found to be successful. Among the influencing factors mentioned above, age, diagnosis and time of onset had no statistically significant correlation with the success of arthrocentesis. However, a group of patients in their fifties showed a lower success rate (ANOVA P=0.053) and the success rate of the group with oral habits was 71% (Pearson's chi-square test P=0.035). Conclusion: From this study, we find that factors influencing the success of arthrocentesis include age and oral habits. We also conclude that arthrocentesis is effective in treating mouth opening symptoms and for pain relief.
Keywords
Arthrocentesis; Prognostic factors; Temporomandibular joint;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Nitzan DW, Dolwick MF, Martinez GA. Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg 1991;49:1163-7.
2 Brennan PA, Ilankovan V. Arthrocentesis for temporomandibular joint pain dysfunction syndrome. J Oral Maxillofac Surg 2006;64:949-51.
3 Lee SH, Yoon HJ. MRI findings of patients with temporomandibular joint internal derangement: before and after performance of arthrocentesis and stabilization splint. J Oral Maxillofac Surg 2009;67:314-7.
4 Al-Belasy FA, Dolwick MF. Arthrocentesis for the treatment of temporomandibular joint closed lock: a review article. Int J Oral Maxillofac Surg 2007;36:773-82.
5 Shah K. Trismus: a bizarre finding. Br J Oral Maxillofac Surg 2000;38:397-8.
6 Nelson SJ, Nowlin TP, Boeselt B. Consideration of linear and angular values of maximum mandibular opening. Compendium 1992;13:362, 364, 366 passim.
7 Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, Truelove E, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc 1990;120:273-81.
8 Yi AN, Han SY, Yun KI. Clinical aspect of arthrocentesis. J Korean Assoc Oral Maxillofac Surg 2000;26:97-104.
9 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;59:613-8.
10 Fraser JR, Clarris BJ, Baxter E. Patterns of induced variation in the morphology, hyaluronic acid secretion, and lysosomal enzyme activity of cultured human synovial cells. Ann Rheum Dis 1979;38:287-94.
11 Balazs EA. The physical properties of synovial fluid and the special role of hyaluronic acid. In: Helfet AJ, ed. Disorders of the Knee. Philadelphia: Lippincott; 1974:61-4.
12 Kim JJ. The effect of intra-articular injection of hyaluronic acis after arthrocentesis in treatment of internal derangements of the TMJ. J Korean Assoc Oral Maxillofac Surg 2006;32:453-7.
13 Murakami K, Hosaka H, Moriya Y, Segami N, Iizuka T. Short-term treatment outcome study for the management of temporomandibular joint closed lock. A comparison of arthrocentesis to nonsurgical therapy and arthroscopic lysis and lavage. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:253-7.
14 Hosaka H, Murakami K, Goto K, Iizuka T. Outcome of arthrocentesis for temporomandibular joint with closed lock at 3 years follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:501-4.
15 Alpaslan C, Dolwick MF, Heft MW. Five-year retrospective evaluation of temporomandibular joint arthrocentesis. Int J Oral Maxillofac Surg 2003;32:263-7.
16 Nitzan DW, Samson B, Better H. Long-term outcome of arthrocentesis for sudden-onset, persistent, severe closed lock of the temporomandibular joint. J Oral Maxillofac Surg 1997;55:151-7.
17 Guarda-Nardini L, Olivo M, Ferronato G, Salmaso L, Bonnini S, Manfredini D. Treatment effectiveness of arthrocentesis plus hyaluronic acid injections in different age groups of patients with temporomandibular joint osteoarthritis. J Oral Maxillofac Surg 2012;70:2048-56.
18 Sakamoto I, Yoda T, Tsukahara H, Morita S, Miyamura J, Yoda Y, et al. Clinical studies of arthrocentesis of the temporomandibular joint: analysis of clinical findings in patients with a good outcome. Jpn J Oral Maxillofac Surg 1996;42:808-14.
19 Park YH, Lee SH, Yoon HJ. An effect of combination with arthrocentesis and stabilization splint treatment on temporomandibular joint disorder patient. J Korean Assoc Maxillofac Plast Reconstr Surg 2010;32:32-6.
20 Ghanem WA. Arthrocentesis and stabilizing splint are the treatment of choice for acute intermittent closed lock in patients with bruxism. J Craniomaxillofac Surg 2011;39:256-60.
21 Nishimura M, Segami N, Kaneyama K, Suzuki T. Prognostic factors in arthrocentesis of the temporomandibular joint: evaluation of 100 patients with internal derangement. J Oral Maxillofac Surg 2001;59:874-7.
22 Rydell N, Balazs EA. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of osteoarthritis and on granulation tissue formation. Clin Orthop Relat Res 1971;80:25-32.