الفهرس 
Temporomandibular disordersOnly 14 pages are availabe for public view
 |  | from | 146 |  |  |
| | | from | 146 | | |
Abstract
A. Statement of the problem: Anteriordisc displacement is one of the most common temporomandibular joint disorders; it is accompanied with pain and clicking during jaw movements and limitation of mouth opening. Many trials were done to manage these problems the most useful and simple one was arthrocentesis that helped in lavage of the joint from inflammatory fluids and removing all joint adhesions .but many complications may happen like bleeding within the joint and temporary facial nerve paralysis as its procedures is considered unpredictable and blind, by making arthrocentesis procedures computer-guided, its accuracy was increased which lead to more improvement of the joint and decreasing the rate of complications. B. Purpose: The aim of this study was to compare computer- guided arthrocentesis versus conventional double puncture arthrocentesis in the treatment of anterior disc displacement with reduction of the TMJ. C. Patients and methods: Randomized clinical study was carried out on sixteen adult patients who had TMJ anterior disc displacement with reduction causing functional disability and pain, not responded to conservative treatment for more than 3 months, they were selected from the out-patient clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Tanta University. Patients were divided randomly into two equal groups. First one is consisting of eight patients were treated with guided arthrocentesis using premade customized 3D template designed for each patient and lavage with Ringer’s lactate solution then hyaluronic acid injection. Second one is consisting of eight patients; they were treated with arthrocentesis with the conventional double puncture technique and lavage with Ringer lactate solution and hyaluronic acid injection. Then followed up clinically at interval of 1 week, 2 weeks, 1,2,3 and 6 months to evaluate: pain during jaw movement by visual analogue scale, maximal mouth opening and clicking. And imaging by using magnetic resonance imaging after 3 months and 6 months to determine any change in disc position and inflammatory changes within the joint. D- Results: Sixteen patients underwent TMJ arthrocentesis. Their ages ranged from 17 to 35years, they included 3 males and 13 females. group I and group II showed highly significant results regarding the maximal mouth opening. The pain score showed a rapid highly significant decrease in group I and a significant decrease in group II. In group I, clicking disappeared from all joint except one case which had a little recurrence at 6 months follow up, while in group II 5 patients had a recurrence of clicking at 6 months follow up and magnetic resonance imaging showed no change in articular disc position but all joint effusion had disappeared from joints of both groups. E- Conclusion: Arthrocentesis is a useful minimally invasive technique in treatment of anterior disc displacement with reduction It plays a role in decreasing joint pain and improving its function and by making arthrocentesis computer- guided this makes the procedures more accurate, safe, less painful, time saving and preventing post-operative complications.