Home Articles List Article Information
Alexandria Dental Journal
Journal Archive
Volume Volume 49 (2024)
Volume Volume 48 (2023)
Volume Volume 47 (2022)
Volume Volume 46 (2021)
Volume Volume 45 (2020)
Volume Volume 44 (2019)
Volume Volume 43 (2018)
Volume Volume 42 (2017)
Volume Volume 41 (2016)
Volume Volume 40 (2015)
Sinbel, A., Shaaban, A., Shokry, M. (2015). THE EFFICACY OF ARTHROCENTESIS ON RESTORING MANDIBULAR FUNCTION IN UNILATERAL SUBCONDYLAR FRACTURE FOLLOWING MAXILLOMANDIBULAR FIXATION (A CLINICO-RADIOGRAPHIC STUDY). Alexandria Dental Journal, 40(1), 51-57. doi: 10.21608/adjalexu.2015.58736
A Sinbel; A Shaaban; M Shokry. "THE EFFICACY OF ARTHROCENTESIS ON RESTORING MANDIBULAR FUNCTION IN UNILATERAL SUBCONDYLAR FRACTURE FOLLOWING MAXILLOMANDIBULAR FIXATION (A CLINICO-RADIOGRAPHIC STUDY)". Alexandria Dental Journal, 40, 1, 2015, 51-57. doi: 10.21608/adjalexu.2015.58736
Sinbel, A., Shaaban, A., Shokry, M. (2015). 'THE EFFICACY OF ARTHROCENTESIS ON RESTORING MANDIBULAR FUNCTION IN UNILATERAL SUBCONDYLAR FRACTURE FOLLOWING MAXILLOMANDIBULAR FIXATION (A CLINICO-RADIOGRAPHIC STUDY)', Alexandria Dental Journal, 40(1), pp. 51-57. doi: 10.21608/adjalexu.2015.58736
Sinbel, A., Shaaban, A., Shokry, M. THE EFFICACY OF ARTHROCENTESIS ON RESTORING MANDIBULAR FUNCTION IN UNILATERAL SUBCONDYLAR FRACTURE FOLLOWING MAXILLOMANDIBULAR FIXATION (A CLINICO-RADIOGRAPHIC STUDY). Alexandria Dental Journal, 2015; 40(1): 51-57. doi: 10.21608/adjalexu.2015.58736

THE EFFICACY OF ARTHROCENTESIS ON RESTORING MANDIBULAR FUNCTION IN UNILATERAL SUBCONDYLAR FRACTURE FOLLOWING MAXILLOMANDIBULAR FIXATION (A CLINICO-RADIOGRAPHIC STUDY)

Article 9, Volume 40, Issue 1, July 2015, Page 51-57  XML PDF (513.48 K)
Document Type: Original Article
DOI: 10.21608/adjalexu.2015.58736
View on SCiNiTO View on SCiNiTO
Authors
A Sinbel1; A Shaaban2; M Shokry3
1B.D.S 2008, Faculty of Dentistry, Alexandria University
2-Professor of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University
3Assistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Beirut Arab University
Abstract
Introduction: Arthrocentesis can be used as a treatment modality in cases of subcondylar fracture treated with maxillomandibular fixation to restore the normal mandibular movements. Objective: Was to evaluate the efficacy of arthrocentesis on restoring mandibular function in unilateral subcondylar fracture following maxillomandibular fixation. Materials and Methods: This study was conducted on twenty patients suffering from unilateral subcondylar fracture with/without contra-lateral parasymphyseal or body fracture where open reduction with plate fixation for the contralateral fracture and closed reduction with 2 weeks MMF for the subcondylar fracture was done. The patients were divided into two groups: Group I (study group) in which ten patients were treated with active mobilization and arthrocentesis following MMF removal, and Group II (control group) in which ten patients were treated with only active mobilization following MMF removal. Groups I & II were also subdivided into A & B each involved five patients with isolated subcondylar fracture and five patients with contralateral parasymphyseal or body fracture in addition. Results: There was a statistically significant decrease in pain and edema and a statistically significant increase in the mouth opening, lateral excursive and protrusive movements in addition to the bite force through-out all follow up periods in the study group especially after the application of arthrocentesis in comparison to the control group. Conclusions: Arthrocentesis (TMJ lavage) was an effective procedure for washing out inflammatory mediators present within the TMJ following the exposure to trauma and showed a significant improvement in mandibular movements immediately after performing it. This helped in improving the quality of the patients’ life enabling them to practice their usual activities and return back to normal life starting from the second week postoperatively i.e patients rehabilitation occurred in a short period.
Keywords
Arthrocentesis; Subcondylar fracture; maxillomandibular fixation
References
1. Ogundare BO, Bonnick A, Bayley N. Pattern of mandibular fractures in an urban major trauma center. J Oral Maxillofac Surg 2003; 61: 713-8.
2. Thaller SR. Management of mandibular fractures. Arch Otolaryngol Head Neck Surg 1994; 120: 44-7.
3. Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spa-nou A. Fractures of the mandibular condyle: a review of 466 cases. Literature review, reflections on treatment and proposals. J Craniomaxillofac Surg 2006; 34: 421-32.
4. Ward BB, Edward SP, Feinberg SE. Healing of Traumatic Injury. In: Fonseca, Walker, Betts, Barber, Powers. Oral and Maxillofacial Trauma. 3rd edition, Ch 19, Elsevier Saunders, USA 2005; 523-68.
5. Guillermo EC, Larsen PE. Principles of Management of Mandibular Fractures. In: Miloro M, Ghali GE, Larsen PE, Waite PD. Peterson's Principles of Oral and Maxillofacial Surgery. 2nd ed, Ch 22, BC Decker Inc, London 2004; 401-33.
6. Nogami S, Yamauchi K, Kataoka Y, Takano H, Yamashita Y, Takahashi T. Clinical comparison between arthrocentesis and conventional conservative treatment with maxillomandibular fixation for unilateral high condylar fractures. J Oral Rehabilitation 2013; 41: 141-7.
7. Suzuki T, Kawamura H, Kasahara T, Nagasaka H. Resorbable poly-L-lactide plates and screws for the treatment of mandibular condylar process fractures: a clinical and radiologic analysis. J Oral Maxillofac Surg 2004; 62: 919-24.
8. Ward BB, Edward SP, Feinberg SE. Healing of Traumatic Injury. In: Fonseca, Walker, Betts, Barber, Powers. Oral and Maxillofacial Trauma. 3rd edition, Ch 39, Elsevier Saunders, USA 2005; 1130-70.

9. Jokl P, Konstadt S. The effect of limb immobilization on muscle function and protein composition. Clin Orthop Relat Res 1983; 174: 222-9.

10. Ellis E, Dechow PC, Carlson DS. A comparison of
stimulated bite force after mandibular advancement using rigid and nonrigid fixation. J Oral Maxillofac Surg 1988; 46: 26-32.
11. Ellis E. Mobility of the mandible following advancement using maxillomandibular fixation and rigid internal fixation-an experimental investigation in Macaca mulatta. J Oral Maxillofac Surg 1988; 46: 118- 23.
12. Dooley P, Martic R. Corticosteroid injection and arthrocentesis. Canadian Family of Physicians 2002; 48: 285-92.
13. Nogami S, Takahashi T, Ariyoshi W, Yoshiga D, Morimoto Y, Yamauchi K. Increased levels of interleukin- 6 in synovial lavage fluid from patients with mandibular condyle fractures: correlation with magnetic resonance evidence of joint effusion. J Oral Maxillofac Surg 2013; 71: 1050-8.
14. Kaneyama K, Segami N, Nishimura M, Sato J, Fujimura K, Yoshimura H. The Ideal lavage volume of Bradykinin, Interleukin 6 and protein from the temporomandibular Joint by arthrocentesis. Journal of oral and Maxillofacial Surgery 2004; 62: 657-61.
15. Bamgbose B, Akinwande J, Adeyemo W, Ladeinde A, Arotiba G, Ogunlene M. Effects of co-administered dexamethasone & diclofenac potassium on pain, swelling & trismus following third molar surgery. Head & Face Medicine 2005; 1: 11-6.
16. Gert S, Hans K, Josef S. MRI imaging of the TMJ: MR diagnosis and intraoperative findings. Journal of Cranio Maxillofacial Surgery 1993; 21: 284-8.
17. Emshoff R, Gerhard S, Ennemoser T, Rudisch A. Magnetic resonance imaging findings of internal derangement, osteoartrosis, effusion and bone marrow edema before and after performance of arthrocentesis and hydraulic distension of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 784-90.
18. William C, Marianne P, Lewis R. A modified auriculotemporal nerve block for regional anesthesia of the temporomandibular joint. J Oral Maxillofac Surg 1984; 42: 544-5.
19. Kotz S, Balakrishnan N, Read CB, Vidakovic B. Encyclopedia of statistical sciences. 2nd ed. Hoboken, N.J.: Wiley-Interscience; 2006.
20. Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS statistics for version 20.0. Student ed. Belmont, Calif.: Wadsworth, Cengage Learning; 2013.
21. Bataineh AB. Etiology and incidence of maxillofacial fractures in the north of Jordan. Oral Surg Oral Med Oral Pathol 1998;86:31–5.
22. Adi M, Ogden GR, Chisholm DM. An analysis of mandibular fractures in Dundee, Scotland (1977 to 1985). Br J Oral Maxillofac Surg 1990;28:194–9.
23. Marke P, Nielsen A, Basian HL. Fractures of the mandibular condyle. Part 2: results of treatment of 348 patients.Br J Oral Maxillofac Surg 2000;385:422–6.
24. Marke P, Nielsen A, Basian HL. Fractures of the mandibular condyle.Part 1: Patterns of distribution of types and causes of fractures in 348 patients. Br J Maxillofac Surg 2000;38;417–21.
25. Khalil AF, Shaladi OA. Fractures of the facial bones in the Eastern region of Libya. Br J Oral Surg 1981;19:300–4.
26. Van Hoof RF, Merkx CA, Stekelenburg EC. The different patterns of fractures of the facial skeleton in four European countries. Int J OralSurg 1993;6:3–11.
27. Sakr k, Farag I, Zeitoun I. Review of 509 mandibular fractures treated at the university hospital, Alexandria, Egypt. Br J Oral Maxillofac Surg 2006; 44: 107-11.
28. Nogami S, Yamauchi K, Kataoka Y, Takano H, Yamashita Y, Takahashi T. Clinical comparison between arthrocentesis and conventional conservative treatment with maxillomandibular fixation for unilateral high condylar fractures. J Oral Rehabilitation 2014; 41: 141–7.
29. Sadhwani B, Anchlia S. Conventional 2.0 mm miniplates versus 3-D plates in mandibular fractures. Ann Maxillofac Surg 2013; 3: 154–9.

Statistics
Article View: 126
PDF Download: 407