RECIPROCAL CLICKING LOCATION ANALYSIS IN THE INTRAARTICULAR TEMPOROMANDIBULAR DISORDERS AFTER AXIOGRAPHY INVESTIGATION

OBJECTIVE

The aim: To investigate the peculiarities of hinge axis trajectories in patients with condyle-disc complex intraarticular Temporomandibular Disorders (TMD) and determine the average coordinates of the reciprocal clicking location by axiography.

PATIENTS AND METHODS

Materials and methods: The results of axiographic examination of 151 patients (108 females and 43 males) with TMD confirmed by MRI were analyzed. This population included 44 persons with disc displacement with reduction (DDR), 45 persons with disc displacement with reduction and intermittent locking (DDRI), 62 persons with disc displacement without reduction (DDWR). Axiographic examination was carried out using CADIAX diagnostic device. Analysis of hinge axis movements was performed and the coordinates of articular disc reduction were determined.

RESULTS

Results: The quality of hinge axis trajectories in persons with DDR, DDRI was defined mainly as average and in patients with DDWR as poor. Quantitative indicators of trajectories during protrusion-retrusion movements were not beyond the average level. The length of the mouth opening-closing trajectory in patients with DDRI and DDWR has shown a tendency to decrease. We found that on average the reciprocal closing clicking (disc reduction) occurs at a distance of 0-1.4 mm on the X-axis, 0.1-2.9 mm on the Z-axis, and 0-0.85 mm on the Y-axis.

CONCLUSION

Conclusions: The obtained wide range of reciprocal clicking location parameters indicates the priority of a personalized approach when planning preliminary treatment in order to restore the disc-condylar complex of TMJ.

COL5A1 RS12722 Is Associated with Temporomandibular Joint Anterior Disc Displacement without Reduction in Polish Caucasians

Numerous reports describe the association between the single-nucleotide polymorphism (SNP) rs12722 and rs13946 in the COL5A1 gene and injuries, such as Achilles tendon pathology, anterior cruciate ligament (ACL) injuries, and tennis elbow. Hence, there were no studies investigating COL5A1 and temporomandibular joint (TMJ) pathology. The aim of this study is to evaluate the relationship between COL5A1 rs12722 and rs13946 SNPs and TMJ articular disc displacement without reduction (ADDwoR). In this case-control study, the study group consisted of 124 Caucasian patients of both sexes. Each patient had a history of ADDwoR no more than 3 months prior. The control group comprised 126 patients with no signs of TMD according to DC/TMD. Genotyping of the selected SNPs was performed by real-time PCR using TaqMan probes. The significance of the differences in the distribution of genotypes was analyzed using Pearson’s chi-square test. Logistic regression modeling was performed to analyze the influence of the 164 investigated SNPs on ADDwoR. The COL5A1 marker rs12722 turned out to be statistically significant (p-value = 0.0119), implying that there is a difference in the frequencies of TMJ ADDwoR. The distribution of rs12722 SNPs in the study group TT(66), CC(27), CT(31) vs. control group TT(45), CC(26), CT(51) indicates that patients with CT had an almost 2.4 times higher likelihood of ADDwoR (OR = 2.41) than those with reference TT (OR = 1), while rs13946 genotypes were shown to be insignificant, with a p-value of 0.1713. The COL5A1 rs12722 polymorphism is a risk factor for ADDwoR in the Polish Caucasian population.

Arthrocentesis versus glucocorticosteroid injection for internal derangement of temporomandibular joint

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.