Cytokine and Clinical Predictors for Treatment Outcome of Visually Guided Temporomandibular Joint Irrigation in Patients With Chronic Closed Lock
Purpose
This study investigates selected predictors for clinical outcome of temporomandibular joint (TMJ) irrigation in patients with chronic closed lock (CCL).
Patients and Methods
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]-α, interleukin [IL]-1β, 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.
Results
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.
Conclusions
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.
⁎Assistant Professor, First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
†Professor and Chairman, Department of Maxillofacial Surgery, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
‡Professor, Department of Oral and Maxillofacial Surgery, Karolinska Institutet, Huddinge, Sweden.
§Assistant Professor, Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Japan.
¶Assistant Professor, Department of Preventive Dentistry and Public Health, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
∥Professor and Chairman, First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Address correspondence and reprint requests to Dr Hamada: First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi Tsurumi-ku, Yokohama 230-8501, Japan
This study was supported in part by Tsurumi University Dental Society Research Grant 17004.
ABSTRACT