Effects of arthrocentesis and low-level laser therapy on patients with osteoarthritis of the temporomandibular joint.

This retrospective study examined whether arthrocentesis combined with 10 sessions of low-level laser therapy (LLLT) improved the clinical outcomes of patients with temporomandibular joint osteoarthritis (TMJ-OA) compared with arthrocentesis alone. Data from two groups of patients (total: n=36) with unilateral TMJ-OA were evaluated. The groups were established according to their treatment regimens: Group 1 (arthrocentesis alone; n=19) and Group 2 (arthrocentesis plus LLLT; n=17). All patients had been diagnosed in accordance with the Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD) (Axis I Group IIIb) protocol. They all underwent the same arthrocentesis protocol, but those in Group 2 also received 10 sessions of LLLT immediately afterwards. The outcome variables were the visual analogue scale scores (VAS 1, VAS 2) for various treatment outcomes and millimetric measurements of mandibular movements over both the short and long term. Intra-group comparisons showed significant short and long-term improvements for both groups, but outcomes were better over the long term than the short term in both. In addition, greater improvements in muscle palpation scores and mandibular movements were achieved in Group 2 than in Group 1. In conclusion, although both techniques improved joint pain and function, a combination with LLLT seemed to have an additional benefit for myofascial components.

Retrospective evaluation of the duration of arthrocentesis in the treatment of temporomandibular joint diseases.

OBJECTIVE: This study investigated the duration of arthrocentesis in treatment of patients with different diagnoses of temporomandibular disorders. METHODS: This retrospective study evaluated the duration of arthrocentesis used for 65 patients who were diagnosed with osteoarthritis (OA), disc displacement with reduction (DDWR), or disc displacement without reduction (DDWoR), in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders protocol. RESULTS: Mean operation times were 423.79 (± 66.77) seconds in OA patients, 459.92 (± 56.67) seconds in DDWR patients, and 609.00 (± 106.88) seconds in DDWoR patients; these significantly differed among groups (P < 0.001). In addition, post hoc analyses revealed statistically significant differences in mean operation times between DDWoR and OA (P<0.05) and DDWoR and DDWR (P<0.05). CONCLUSION: The appropriate duration of arthrocentesis may vary among joint disorders, and the duration of arthrocentesis in DDWoR treatment is longer than that in DDWR and OA treatments. In addition there was no relationship between the age or gender and operation time of the patients. Changes in anatomic structures due to temporomandibular diseases are presumed to influence the duration of arthrocentesis treatment.

Efficiency of arthrocentesis treatment for different temporomandibular joint disorders.

This study was performed to determine whether arthrocentesis therapy has different outcomes in three groups of patients with different temporomandibular disorders (TMDs). A clinical trial was conducted including 45 patients with 45 unilaterally affected joints divided into three groups (n=15): osteoarthritis (OA), disc displacement with reduction (DDWR), and disc displacement without reduction (DDWoR). All patients underwent the same arthrocentesis treatment protocol. The outcome variables, including visual analogue scale evaluations and measurements of mandibular motion (in millimetres), were recorded at baseline and at 1 and 6 months postoperative. Inter-group assessments showed significant short-term differences in joint sounds (P=0.016) and significant long-term differences in masticatory efficiency (P=0.046) and protrusive movement (P=0.048). The estimation of mean changes between baseline and long-term follow-up revealed significant differences in joint sounds (P<0.001), disruption in daily activities (P=0.002), maximum mouth opening (P=0.008), and protrusive movement (P=0.002) between the groups. Arthrocentesis therapy may be useful to improve clinical symptoms and range of mandibular movement in patients with all three types of TMD. However, the benefit of arthrocentesis may be greater for patients with DDWoR than for those in the other groups.

Study of kissing molars in Turkish population sample.

BACKGROUND: "Kissing" or "rosetting" of molars are extremely rare phenomenon with limited cases in the dental literature. It was first described in 1973, refers to contacting occlusal surfaces of the impacted mandibular second and third molars. The aim of the present study was to report the incidence of kissing molars (KMs), classification, incorporated pathologies, and its management in a group of Turkish population. MATERIALS AND METHODS: The panoramic radiographs of the patients who referred to Gaziantep University Faculty of Dentistry between January 2012 and November 2014 for surgical treatment retrospectively were evaluated. The cases of KM were determined and evaluated with respect to its type, combined pathology, and treatment. RESULTS: Of the 6570 radiographs included in the study, 4 were seen to present as KM illustrating 0.060% of the sample. Three cases were Class II (0.045%), and only one case was encountered as Class III (0.015%). The mean age at the time that the KM teeth were identified was 34 years with a range from 29 to 40 years. Three of the patients were male, one of the patients was female, and all cases were seen unilaterally. One of the KMs was associated with dentigerous cyst formation. CONCLUSION: KM is a very rare clinical condition and few treatment options described. Early detection is essential to preclude complications and to provide more successful treatment. In this study, we evaluated the cases of KM and review of the literature also presented.

Simultaneous oroantral communication closure, sinus-lifting, and particulate bone grafting and immediate dental implant perforation.

The aim of this paper is to introduce an alternative technique for the treatment of oroantral communication (OAC). Closure of OAC, reconstruction of the posterior maxilla by sinus-lifting procedure with a particulate xenograft, and implant insertion were performed in the same operation. A lateral antral approach was used in the sinus elevations. The sinus membranes were elevated gently around the perforation area, and then a barrier membrane was used to close the perforation. Care was taken not to extend the perforation. Next, the maxillary sinus was filled with a particulate xenograft, and an implant was inserted simultaneously. Forty-seven and 40 months of clinical and radiographic follows-up revealed healthy and functional implants in the teeth area.

Open intramedullary Kirschner wire versus screw and plate fixation for unstable forearm fractures in children.

PURPOSE: To compare the outcomes of intramedullary Kirschner wire versus screw and plate fixation for unstable forearm fractures in children aged older than 10 years. METHODS: Records of 32 children aged 10 to 15 (mean, 12) years with displaced fractures of the radius and ulna were retrospectively reviewed. 17 boys and 4 girls underwent intramedullary Kirschner wiring, whereas 10 boys and one girl underwent plating. All patients had been initially treated with closed reduction and casting. Indications for surgical intervention were fractures with angulation of >10 degrees and total displacement. Patients were followed up for a mean of 24 (range, 13-40) months. Angulation and range of movements of the elbow, wrist, and forearm, as well as clinical and cosmetic results were compared. RESULTS: Both treatments achieved excellent clinical outcomes, but intramedullary Kirschner wiring resulted in better cosmesis, shorter operating times, easier hardware removal, and lower implant costs. CONCLUSION: Intramedullary Kirschner wiring is a better option than plating for the treatment of unstable forearm fractures in older children.

Chylous ascites and chylothorax due to constrictive pericarditis in a patient undergoing haemodialysis.

Chylous ascites and chylothorax are rare clinical entities and usually caused by neoplasms, particularly lymphomas, liver cirrhosis, superior vena cava thrombosis, nephrotic syndrome, and some cardiac events such as dilated cardiomyopathy or right heart failure. Constrictive pericarditis is an extremely rare cause of this clinical state. We report a 41-year-old male patient undergoing haemodialysis who presented with chylous ascites and chylothorax. Echocardiography and heart catheterisation revealed constrictive pericarditis. He underwent pericardiectomy and after the operation the ascites and pleural effusion resolved rapidly. We suggest that constrictive pericarditis should be considered in the differential diagnosis of chylous ascites and chylothorax.