Effects of arthrocentesis and low-level laser therapy on patients with osteoarthritis of the temporomandibular joint.

This retrospective study examined whether arthrocentesis combined with 10 sessions of low-level laser therapy (LLLT) improved the clinical outcomes of patients with temporomandibular joint osteoarthritis (TMJ-OA) compared with arthrocentesis alone. Data from two groups of patients (total: n=36) with unilateral TMJ-OA were evaluated. The groups were established according to their treatment regimens: Group 1 (arthrocentesis alone; n=19) and Group 2 (arthrocentesis plus LLLT; n=17). All patients had been diagnosed in accordance with the Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD) (Axis I Group IIIb) protocol. They all underwent the same arthrocentesis protocol, but those in Group 2 also received 10 sessions of LLLT immediately afterwards. The outcome variables were the visual analogue scale scores (VAS 1, VAS 2) for various treatment outcomes and millimetric measurements of mandibular movements over both the short and long term. Intra-group comparisons showed significant short and long-term improvements for both groups, but outcomes were better over the long term than the short term in both. In addition, greater improvements in muscle palpation scores and mandibular movements were achieved in Group 2 than in Group 1. In conclusion, although both techniques improved joint pain and function, a combination with LLLT seemed to have an additional benefit for myofascial components.

Retrospective evaluation of the duration of arthrocentesis in the treatment of temporomandibular joint diseases.

OBJECTIVE: This study investigated the duration of arthrocentesis in treatment of patients with different diagnoses of temporomandibular disorders. METHODS: This retrospective study evaluated the duration of arthrocentesis used for 65 patients who were diagnosed with osteoarthritis (OA), disc displacement with reduction (DDWR), or disc displacement without reduction (DDWoR), in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders protocol. RESULTS: Mean operation times were 423.79 (± 66.77) seconds in OA patients, 459.92 (± 56.67) seconds in DDWR patients, and 609.00 (± 106.88) seconds in DDWoR patients; these significantly differed among groups (P < 0.001). In addition, post hoc analyses revealed statistically significant differences in mean operation times between DDWoR and OA (P<0.05) and DDWoR and DDWR (P<0.05). CONCLUSION: The appropriate duration of arthrocentesis may vary among joint disorders, and the duration of arthrocentesis in DDWoR treatment is longer than that in DDWR and OA treatments. In addition there was no relationship between the age or gender and operation time of the patients. Changes in anatomic structures due to temporomandibular diseases are presumed to influence the duration of arthrocentesis treatment.

Efficiency of arthrocentesis treatment for different temporomandibular joint disorders.

This study was performed to determine whether arthrocentesis therapy has different outcomes in three groups of patients with different temporomandibular disorders (TMDs). A clinical trial was conducted including 45 patients with 45 unilaterally affected joints divided into three groups (n=15): osteoarthritis (OA), disc displacement with reduction (DDWR), and disc displacement without reduction (DDWoR). All patients underwent the same arthrocentesis treatment protocol. The outcome variables, including visual analogue scale evaluations and measurements of mandibular motion (in millimetres), were recorded at baseline and at 1 and 6 months postoperative. Inter-group assessments showed significant short-term differences in joint sounds (P=0.016) and significant long-term differences in masticatory efficiency (P=0.046) and protrusive movement (P=0.048). The estimation of mean changes between baseline and long-term follow-up revealed significant differences in joint sounds (P<0.001), disruption in daily activities (P=0.002), maximum mouth opening (P=0.008), and protrusive movement (P=0.002) between the groups. Arthrocentesis therapy may be useful to improve clinical symptoms and range of mandibular movement in patients with all three types of TMD. However, the benefit of arthrocentesis may be greater for patients with DDWoR than for those in the other groups.

Biomechanical comparison of transoral and transbuccal lateral cortical plate fixation for the management of mandibular angle fractures.

OBJECTIVES: The purpose of this experimental study was to compare the biomechanical behaviors of two different types of osteosynthesis that are used in the treatment of mandibular angle fractures. MATERIALS AND METHODS: Twenty synthetic polyurethane human mandible replicas, with medullar and cortical portions, were used in this study. These polyurethane hemimandibles were randomly divided into two groups (n = 10). The transbuccal group (Group A) was fixed with 7 mm long self-tapping 2.0 mm titanium screws at 85° to the reference line and the transoral group (Group B) was fixed with the same screws at 15° to the reference line. All testings were performed on a servo-hydraulic testing machine. The data were transmitted directly from the load cell to a computer, which showed the emergent results of the material characteristics under resisted forces as a graphic containing force and displacement. The peak point loading and displacement for each subject were measured. RESULTS: The comparison between the groups was analyzed with an independent-samples t-test, and P < 0.05 was considered to be significant. The results show that there were no significant differences between the groups for the peak loads and displacement values at the peak loads. CONCLUSION: The results of this experimental study demonstrated that there were no significant differences between the transbuccal and transoral methods in terms of fixation stability. In other words, the screw position and angle seemed to no have influence on the fixation stability in single miniplate treatments of a mandibular angle fracture.

Case report of giant sialolith (megalith) of the Wharton's duct.

Sialolithiasis is the most common disease of salivary glands. Its estimated frequency is 1.2% in the adult population. Sialoliths most commonly occur in the submandibular glands. The sublingual gland and minor salivary glands are rarely affected. The sialolith usually measures from 1 to <10 mm. Giant sialoliths are classified as those exceeding 15 mm in any one dimension. In literature, large sialoliths or megalith (> mm) of Wharton's duct have rarely been reported. This case report describes a patient presenting with an unusually large sialolith (megalith) of Wharton's duct, which was 37 mm ×16 mm in the size, the subsequent patient management, the etiology, diagnosis, and its treatment.

Biomechanical comparison of osteosynthesis with poly-L-lactic acid and titanium screw in intracapsular condylar fracture fixation: An experimental study.

BACKGROUND AND AIMS: The aim of this study was to compare the biomechanical stability of poly-L-lactic acid and titanium screws in the fixation of intracapsular condylar fractures, in 10 polyurethane hemimandibles. MATERIALS AND METHODS: Artificial intracapsular fractures were created with a steel disk and electronic micromotor. The first group was fixed with 15 mm long self-tapping 2.0 mm system titanium screws and the second group was fixed with 15 mm long 2.4 mm bioresorbable screws. Linear loads of 25, 50, 75, 100 N was applied in anteroposterior direction to the hemimandibles and the data were transmitted directly from the load cell to a computer that shows emergent results of material characteristics under same forces as a graphic containing force and displacement. RESULTS: The results show that there were no significant differences between the two methods, with 25 N of loading. (P > 0,05) The difference became significant with a higher value of loading. CONCLUSION: The results suggest that treatment with a single resorbable screw is not functionally stable as a single titanium screw.