Susana Perdigoto
Queen D. Leonor Perioimplantology Clinic, Portugal
Title: Viscosupplementation in the upper and lower compartments of the temporomandibular joint: Control of temporomandibular joint dysfunction with degenerative disease
Biography
Biography: Susana Perdigoto
Abstract
Statement of the problem: Temporo-Mandibular joint Disorder (TMD) is a widely researched disease in the literature since it has a high prevalence and is often associated with chronic pain and limited function of the Temporo-Mandibular Joint (TMJ).
Osteoarthritis (OA) is considered a whole joint disease with deterioration and loss of the cartilage, changes in bone structures and subchondral and synovial inflammation with reactive oxygen species formation producing the induction of neuropeptides and inflammatory cytokines.
TMJ Visco-Supplementation (VS) is a minimally invasive procedure that consists of an intra-articular injection of sodium Hyaluronate (HA) into the joint compartments. HA is an efficient therapy to promote articular homeostasis and analgesia by stimulating type B synoviocytes to produce additional synovial liquid, with improvements on the lubrication, rheological properties of the synovial liquid, absorption of loads and stimulation of chondrocyte proliferation in fibrocartilage.
Our group did a study to assess a VS protocol, with Cone-Beam Computed Tomography (CBCT) and Ultra-Sonography (US). It was a 3 stages study. First stage: Check the correspondence between the facial points and the osseous components of the TMJ using CBCT. Second stage: Injection of the upper and lower compartments of 20 TMJs of frozen cadavers with colored liquids and dissecting the specimens, Third stage: VS in 20 TMJs with verification by ultrasonography. The proposed protocol was effective for accessing the upper and lower compartments of the TMJ. The evaluated protocol proved to be accurate, safe and clinically reproducible for the assessment of upper and lower compartments.
Superior and inferior joint space injections of Hyaluronic Acid (HA) are effective methods for the treatment of temporomandibular without reduction (ADDWR) in association with TMJ OA. The injection of HA within the inferior joint space appears to result in better condylar reparative remodeling and improvement in jaw function