Induction of haemarthrosis in the TMJ of rats: Validation by MR imaging (MRI) and histology

Arthrocentesis Followed by Autologous Blood Injection in the Treatment of Chronic Symptomatic Subluxation of Temporomandibular Joint

Introduction

Temporomandibular joint subluxation is defined as self-reducing partial dislocation of the TMJ during which the condyle passes anterior to the articular eminence.

Material and Method

The study consisted of 30 patients, 19 females and 11 males with 14 unilateral and 16 bilateral cases of chronic symptomatic subluxation. Treatment consisted of arthrocentesis followed by 2 ml of autologous blood injection into upper joint space and 1 ml into pericapsular tissues using an autoclaved soldered double needle with single puncture technique. Parameters evaluated were pain, maximum mouth opening, excursive jaw movements, deviation on mouth opening and quality of life, hard and soft tissue changes on X-ray TMJ view and MRI.

Results

At 12 month follow-up, average reduction in maximum interincisal opening, deviation on mouth opening, range of excursive movements on right and left sides and VAS scores were 20.54%, 32.84%, 29.59%, 27.37% and 74.53%, respectively. Out of 93.3% who responded to therapy, 66.7%, 20% and 6.7% responded after 1st, 2nd and 3rd AC + ABI, respectively. Remaining 6.7% patients had persistent painful subluxation and underwent open joint surgery. 93.3% patients responded to therapy, 80% were relieved of painful subluxation, 13.3% had painless subluxation and kept on follow-up. X-ray TMJ and MRI did not show any hard and soft tissue changes.

Conclusion

A soldered double needle, single puncture, AC + ABI are a simple, safe, cost-effective, repeatable and minimally invasive nonsurgical therapy for treatment of CSS without any permanent radiographically evident soft or hard tissue changes.

A prospective assessment of outcomes following the use of autologous blood for the management of recurrent temporomandibular joint dislocation

PURPOSE

The objective of the study was to compare results of treatment for chronic recurrent temporomandibular joint dislocation (CRTMD) by autologous blood injection (ABI) using two different methods of administration (combination intra- and peri-articular, and peri-articular alone).

MATERIALS AND METHODS

Forty patients diagnosed with CRTMD were randomly divided into two groups of 20 each (A and B). Group A were treated by intra- and peri-articular blood injection, group B were treated by peri-articular injection alone. The follow-up was done at 1, 3, 6, and 12 months. The study assessed presence of dislocations, pain (VAS, 0-10), interincisal mouth opening (IMO), and the presence of sound phenomena. The treatment was considered successful in patients without the persistence of CRTMD symptoms, as well as with a VAS of 0-1.

RESULT

After 12 months, a beneficial therapeutic effect in group B was seen in 11 patients, while 16 patients from group A had a therapeutic effect.

CONCLUSION

Intra- and peri-articular ABI is more effective than peri-articular blood application alone in the treatment of CRTMD, although the difference was not statistically significant.

Temporomandibular joint dislocation

Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation.