Patient's perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study.

This study evaluated patient's perception of recovery following surgical removal of mandibular third molars (SRM3s) including analyze of potential risk factors associated with impaired convalescent. Patient related parameters combined with preoperative questionnaires including Modified Dental Anxiety Scale, Oral Health Impact Profile-14, and Decayed, Missing, Filled Teeth index were correlated with questionnaires assessing pain, swelling, trismus, sick leave, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, impaired sensation of the lip, chin, and tongue, one month following SRM3s. Totally, 412 patients (223 females, 189 males) with mean age of 29.4 years were included. Treatment satisfaction and willingness to undergo similar surgery were reported by 92% and 95%, although 21% reported that the surgery and postoperative period had been worse than expected. Mean days with pain, sick leave, and swelling were 3.6, 2.1, and 3.6, respectively. Preoperative symptoms, dental anxiety level, and prolonged surgical time were associated with increased pain and swelling (P < 0.05). Pell and Gregory classification (I-IIIC) were associated with impaired sensation of the lower lip and chin (P < 0.05). Consequently, results from this study improve the surgeon's ability to predict parameters that predisposed to impaired recovery and neurosensory disturbances following SRM3s.

Arthrocentesis techniques used in the treatment of temporomandibular disorders: Literature review.

OBJECTIVE: The article presents a systematic overview of single- and double-puncture techniques of arthrocentesis methods published in the Scopus database during 2016-2020, highlighting the advantages and shortcomings of different methods. MATERIALS AND METHODS: A search was conducted in the Scopus database using the terms "TMJ OR temporomandibular OR mandibular OR jaw AND arthrocentesis". Arthrocentesis techniques were described and categorized mostly as single- or double-needle ones. RESULTS: The literature reviewed in the article represents studies of arthrocentesis treatment in 2675 patients involving 2740 joints. Arthrocentesis techniques can mainly be divided into single- and double-needle techniques. Single-needle techniques are subcategorized into type 1 and type 2, of which the first is a single-needle cannula technique where inflow and outflow pass through the same lumen, while the second uses a Y-shaped device, which has two ports and two lumens. Double needle techniques use two needles - one for the inflow and the other for the outflow. The literature found in the Scopus database during the period investigated presents 28% of single-puncture (type 1 - 10%, type 2 - 15%, single puncture with distention of the upper joint compartment - 3%), 69% of double-puncture, 1% of ancillary second-puncture methods and 1% employing a CBCT-based tragus-supported guide with 3 needles. CONCLUSION: All of the arthrocentesis techniques described in the literature are effective as treatment modalities, none appears to be superior to others. The selection of the method to be used depends on the surgeon´s choice and experience.

Intramuscular botulinum toxin injection additional to arthrocentesis in the management of temporomandibular joint pain.

OBJECTIVE: The aim of this study was to compare the effect of intramuscular injection of botulinum toxin (BTX-A) as an adjunct to arthrocentesis with the effect of BTX-A injections alone in the treatment of temporomandibular joint disorders (TMDs) with masticatory muscles tension. STUDY DESIGN: The clinical study included 20 TMD patients divided into 2 groups. The influence of daily activities on pain in the temporomandibular joint (TMJ) area was evaluated in both groups using the rating scale by List and Helkimo. Range of maximal interincisial opening (MIO) and joint pain as measured by the visual analogue scale (VAS) were examined to determine the clinical efficiency of the procedures before and after treatment. Group A consisted of 12 patients; they were treated with arthrocentesis and BTX-A injections in the temporal and masseter muscles. Group B consisted of 8 patients; they had only BTX-A injections in the same muscles as mentioned. RESULTS: In group A, VAS decreased significantly (P = .005), and MIO improved significantly (P < .005). CONCLUSIONS: Arthrocentesis with BTX-A seems to affect the clinical outcomes with regard to MIO and VAS compared with the results when BTX-A only was used. BTX-A in combination with arthrocentesis improved the TMJ area symptoms.

Synovial chondromatosis in the temporomandibular joint: case report with review of the literature.

Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium resulting in numerous attached and unattached osteocartilagenous (calcified) loose bodies within the joint. The purpose of this article is to present a case of SC of the TMJ and to discuss current diagnostic approaches, treatment options and relevant follow-up data. We present a case of SC in the TMJ that was confirmed by histopathological analysis and treated via arthrotomy, and present the typical imaging findings, including Computed Tomography (CT) and orthopantomography (OPTG) findings.