Prognostic criteria for the management of temporomandibular disorders using arthrocentesis with normal saline and arthrocentesis with normal saline and platelet-rich plasma.

Temporomandibular joint disorders (TMDs) are ailments affecting the jaws and allied structures, resulting in many pathologies (TMJ hypermobility, internal disc derangement, bone changes, degenerative disorders, and ankylosis). Pain, clicking or crepitus, restricted range of motion, deranged jaw function, and deflected or deviated mouth opening and closing are the commonly observed manifestations in TMDs. Internal derangement refers to an aberrant relation of the articular disc to the condyle and fossa, respectively. Conventional therapies highlight the role of non-invasive conservative treatment strategies, namely joint unloading, anti-inflammatory drugs, and physiotherapy. Current literature has emphasized the use of corticosteroids and platelet-rich plasma (PRP) as treatment strategies in TMDs. This study aimed to evaluate whether intra-articular injection of PRP after normal saline lavage in TMJ minimizes the symptoms of TMDs, as compared to injection of normal saline. Thirty patients with TMD according to research diagnostic criteria (RDC) were selected. One group received arthrocentesis with normal saline, and the other group received arthrocentesis with PRP injection. The patients were assessed for pain, maximum inter-incisal mouth opening, bite force, and TMJ sounds. TMDs treated by PRP injection had slightly better results. More studies are required to substantiate the outcome. Injections of PRP were more effective in reducing the symptoms than arthrocentesis with normal saline.

Adult unilateral supraglottitis as a consequence of acute submandibular sialadentis.

Acute Submandibular sialadenitis (ASS) may spread to sublingual and submandibular spaces. On rare occasions it can spread along the floor of the mouth, to the base of the tongue and to the pre epiglottic space, valleculae and epiglottis, leading to supraglottitis. Adult supraglottitis is an acute inflammation of the supraglottic structures. Unilateral supraglottitis in an adult as a consequence of ASS is a unique complication as described in this case report. Sore throat with severe odynophagia and tachycardia were the early warning signs. Early suspicion, prompt airway management, antibiotics, proper rehydration and analgesics are the mainstay of treatment.