Long term oral health related quality of life after TMJ arthrocentesis with hyaluronic acid. A retrospective cohort study.

The purpose of the study was to assess the long-term oral health-related quality of life (oQoL) in patients with temporomandibular joint (TMJ) internal derangement (ID) after TMJ arthrocentesis plus hyaluronic acid (HA). Patients were analysed at different follow-up times using an analytical observational design. The Oral Health Impact Profile-14 (OHIP-14) score was evaluated according to age, sex, disc position, presence of degenerative joint disease (DJD), joint pain, maximum mouth opening and follow-up time. A total of 60 participants were enrolled, 88% female, with a mean age of 38 years (SD = 13.48). In an average follow-up of 25.02 months (SD = 5.32), the OHIP-14 total score decreased 8.67 (95% confidence interval [CI]: -11.21 to -6.11) after the intervention (Cohen's d = 1.22; 95% CI = 0.81 to 1.64). All OHIP-14 domain scores decreased (p < 0.05) except for the Functional limitation domain (p = 0.378). The oQoL after the intervention worsened in female patients (p = 0.039) and with a higher level of pain at baseline (p = 0.002). Self-perceived QoL improvement should be considered stable long term after temporomandibular joint arthrocentesis plus HA, regardless of concurrence with DJD or ID subtype. QoL should be used as clinical assessment measure of ID patients, with special attention to those with higher levels of pain.

Method of help for the diagnosis of the temporomandibular joint internal derangements. Discriminant analysis applied to the temporomandibular derangements.

OBJECTIVE: The purpose of the study is to find an objective method of help for the clinician in the diagnosis of the pathology of the temporomandibular joint, different of the image methods habitually utilized until this moment. MATERIAL AND METHOD: This study is based initially on the data obtained of a sample of 1164 patients with symptoms and/or signs of pathology of the temporomandibular joint. Nine different and excluding diagnostic groups settled down, according to the classification of the American Academy of Orofacial Pain (AAOP), in collaboration with the International Headache Society (IHS). We realized magnetic resonances to the patients and were selected those that adjust to the clinical criterion and of diagnosis for the image, and could only in a diagnostic group. Finally 449 patients were selected, 390 women and 59 men. RESULTS: The results obtained (expressed in percentage of well classified cases) by means of the proposed method were: Arthrosis 98.9%, Anterior Disk Displacement with Reduction (ADDR) 87.5%, Anterior Disk Displacement without Reduction (ADD) 100%, Capsulitis 100%, Disk Immobile (DIN) 97.9%, Hypermobility Condylar (HC)95.8%, Lateral Displacement Without Reduction (LD) 100%, Pathology Muscular (PM)100%, Disk Hipomobile (DHM) 86.4%. CONCLUSION: The proposed method reaches a fine percentage of successes in the diagnosis of these processes good enough, through its effectiveness as for its cost and should be considered an alternative in the diagnosis of temporomandibular derangements.

Método de ayuda para el diagnóstico de los trastornos de la articulación temporomandibular. Análisis discriminante aplicado a los Trastornos Temporomandibulares / Method of help for the diagnosis of the temporomandibular joint internal derangements. Discriminant Analysis applied to the temporomandibular derangements

Objetivo: El propósito del estudio es encontrar un método objetivo de ayuda para el clínico en el diagnóstico de la patología de la articulación temporomandibular, diferente de los métodos de imagen habitualmente utilizados hasta este momento.Material y método:Para ello se diseño un estudio basado en los datos obtenidos inicialmente de una muestra de 1164 pacientes con síntomas y/o signos de patología de la articulación temporomandibular. Se establecieron nueve grupos diagnósticos distintos y excluyentes, según la clasificación de la Academia Americana de Dolor Orofacial (AAOP), en colaboración con la de la Sociedad Internacional de Cefalea (IHS). Se realizaron resonancias magnéticas a los pacientes y se seleccionaron aquellos que cumplían el criterio clínico y de diagnóstico por la imagen de poder ser clasificados sólo en un grupo diagnóstico, 449 pacientes resultaron entonces seleccionados, 390 mujeres y 59 hombres.Resultados:Los resultados obtenidos (expresados en porcentaje de casos bien clasificados) mediante el método propuesto fueron: Artrosis 98,9 %, Desplazamiento Anterior con Reducción del disco (DACR) 87,5 %, Desplazamiento sin Reducción del disco (DASR) 100 %, Capsulitis 100 %, Disco Inmóvil (DIN) 97.9 %, Hipermovilidad Condilar 95,8%, Desplazamiento Lateral Sin Reducción DLSR 100 %, Patología Muscular 100 %, Disco Hipomóvil 86,4 %.Conclusión:El método propuesto alcanza un porcentaje de éxitos en el diagnóstico de estos procesos suficientemente bueno como para ser considerado, tanto por su eficacia como por su costo, una alternativa a considerar

Objective: The purpose of the study is to find an objective method of help for the clinician in the diagnosis of the pathology of the temporomandibular joint, different of the image methods habitually utilized until this moment. Material and method: This study is based initially on the data obtained of a sample of 1164 patients with symptoms and/or signs of pathology of the temporomandibular joint. Nine different and excluding diagnostic groups settled down, according to the classification of the American Academy of Orofacial Pain (AAOP), in collaboration with the International Headache Society (IHS). We realized magnetic resonances to the patients and were selected those that adjust to the clinical criterion and of diagnosis for the image, and could only in a diagnostic group. Finally 449 patients were selected, 390 women and 59 men. Results: The results obtained (expressed in percentage of well classified cases) by means of the proposed method were: Arthrosis 98,9%, Anterior Disk Displacement with Reduction (ADDR) 87,5%, Anterior Disk Displacement without Reduction (ADD) 100%, Capsulitis 100%, Disk Immobile (DIN) 97.9%, Hypermobility Condylar (HC)95,8%, Lateral Displacement Without Reduction (LD) 100%, Pathology Muscular (PM)100%, Disk Hipomobile (DHM) 86,4%. Conclusion: The proposed method reaches a fine percentage of successes in the diagnosis of these processes good enough, through its effectiveness as for its cost and should be considered an alternative in the diagnosis of temporomandibular derangements (AU)

Trastornos intracapsulares de la articulación temporomandibular [AMT] y proporción fosa-cóndilo mandibular / Intracapsular disorders of the temporomandibular joint [TMJ] and mandible condyle-cavity proportion

Introducción: las características anatómicas de una articulación pueden hacerla más vulnerable a desarrollar alteraciones internas; el objetivo de este estudio fue determinar como posible factor predisponente de los trastornos intracapsulares de la ATM a la proporción fosa-cóndilo mandibular. Material y metodo: se valoraron 103 pacientes y con técnica de Resonancia Magnética (RM) se midió la proporción fosa-cóndilo mandibular, que fue asociada con la relación cóndilo-disco y osteoartrosis (0A) de la ATM Se aplicó test de Fisher (p<0,001). Resultados: se observó que a medida que aumentaba la proporción fosa-cóndilo eran más frecuentes las alteraciones discales, llegando a ser del 100 por ciento a partir de la proporción 5 (Fisher p<0,001). La OA también aumentó con la proporción fosa-cóndilo, exceptuando en los discos inmóviles (DI) (Fisher p<0,001). Conclusiones. por los resultados obtenidos consideramos que la proporción fosa-cóndilo mandibular es un factor predisponente a tener en cuenta en las alteraciones intracapsulares de la ATM (AU)