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Cytokine and Clinical Predictors for Treatment Outcome of Visually Guided Temporomandibular Joint Irrigation in Patients With Chronic Closed Lock

Authors :
Yoshiki Hamada
Kanichi Seto
Yoshiaki Nomura
Kenji Sakota
Anders Holmlund
Toshirou Kondoh
Source :
Journal of Oral and Maxillofacial Surgery. 66:29-34
Publication Year :
2008
Publisher :
Elsevier BV, 2008.

Abstract

This study investigates selected predictors for clinical outcome of temporomandibular joint (TMJ) irrigation in patients with chronic closed lock (CCL).Fifty-six patients with unilateral CCL, who underwent a visually guided TMJ irrigation (VGIR), were enrolled in this study. They were divided into either successful (s-group; n = 38) or unsuccessful groups (u-group; n = 18), according to the clinical success criteria. The investigated predictive factors were age, gender, duration of symptoms before the VGIR, preoperative painless range of mandibular motion, preoperative self-evaluated TMJ pain on visual analog scale (VAS), severity of arthroscopically observed pathologies, and presence and concentrations of a set of pro- and anti-inflammatory cytokines (ie, tumor necrosis factor [TNF]-alpha, interleukin [IL]-1beta, IL-6, IL-8, IL-12, and IL-10) in the aspirated synovial fluid (A-SF). Several comparative analyses and logistic regression analyses were used for statistical studies.The preoperative VAS score, detection rate of IL-8, and concentrations of IL-6 and IL-8 in the A-SF were significantly higher in the u-group (P.05). Conversely, the detection rate and concentrations of IL-10 were significantly higher in the s-group (P.05). The multivariate adjusted odds ratio (OR) showed that the detectable IL-10 in the A-SF (OR, 10.882; P = .047) is significantly predictive for a successful VGIR.The presence of IL-10 in the A-SF is a significant predictor of successful outcome of TMJ irrigation for CCL. Severe TMJ pain and detectable IL-6 or IL-8 in the A-SF seem to indicate a poor outcome after TMJ irrigation.

Details

ISSN :
02782391
Volume :
66
Database :
OpenAIRE
Journal :
Journal of Oral and Maxillofacial Surgery
Accession number :
edsair.doi.dedup.....e9b379500220e32b556cd85481c6676c
Full Text :
https://doi.org/10.1016/j.joms.2007.06.627