Istanbul University, School of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey.
Int J Oral Maxillofac Surg. 2010 May;39(5):440-5. doi: 10.1016/j.ijom.2010.02.010. Epub 2010 Mar 7.
This study examined the clinical and radiological effects of intra-articular tenoxicam injection following arthrocentesis and compared them with arthrocentesis alone in patients with disc displacement without reduction (DDwoR). 24 temporomandibular joints (TMJs) in 21 patients with DDwoR were studied. Patients were divided randomly into Group A in which only arthrocentesis was performed (14 TMJs in 14 patients) and Group AT which received arthrocentesis plus intra-articular injection of tenoxicam (10 TMJs in 7 patients). Patients were evaluated before the procedure, on postoperative day 7, then 2, 3, 4 weeks, and 2, 3, 4, 5, 6 months postoperatively. Intensity of joint pain was assessed using a visual analog scale. Maximum mouth opening was recorded at each follow-up. TMJ sounds and palpation scores were noted as positive or negative. Magnetic resonance imaging (MRI) was performed before and 6 months after treatment in both groups. Disc form, disc location during neutral position, reduction with movement, joint effusion, structures of the articular surfaces, and bone marrow anomalies were evaluated all in MRIs. Both treatments succesfully increased maximum mouth opening and reduced TMJ pain; there were no complications. Difference between the groups was not statistically significant and a larger controlled study is necessary to clarify this use of tenoxicam.
本研究观察了关节内注射替诺昔康对未复位的盘前移位(DDwoR)患者关节内穿刺后的临床和影像学效果,并与单纯关节内穿刺进行了比较。 21 例 DDwoR 患者的 24 个颞下颌关节(TMJ)参与了研究。患者随机分为 A 组(仅行关节内穿刺,14 例患者的 14 个 TMJ)和 AT 组(行关节内穿刺加关节内注射替诺昔康,7 例患者的 10 个 TMJ)。患者在术前、术后第 7 天、第 2、3、4 周以及术后第 2、3、4、5、6 个月进行评估。使用视觉模拟评分法评估关节疼痛强度。在每次随访时记录最大张口度。记录 TMJ 声音和触诊评分是否为阳性或阴性。两组均在治疗前和治疗后 6 个月进行磁共振成像(MRI)检查。评估 MRI 中所有的盘形态、中立位时的盘位置、运动时的复位、关节积液、关节表面结构和骨髓异常。两种治疗方法均成功增加了最大张口度并减轻了 TMJ 疼痛;无并发症。组间差异无统计学意义,需要更大规模的对照研究来阐明替诺昔康的这种用途。