TME disk deplasmanında synovial sıvı pro-inflamatuar sitokinlerin ve klinik bulguların değerlendirilmesi

Abstract

Amaç: Temporomandibular bozukluklar (TMB), temporomandibular eklemin (TME) yumuşak dokularını ve kemik yapılarını etkileyen yaygın bir kas-iskelet sistemi hastalığıdır. İnflamatuar mediatörler, çeşitli moleküler mekanizmaları etkileyerek TMB etiyolojisinde kritik bir rol oynamaktadır. Bu çalışmanın amacı, proinflamatuar sitokinlerin TME internal düzensizlikleri üzerindeki etkisini araştırmak ve klinik özellikler arasındaki ilişkiyi değerlendirmektir. Yöntemler: Bu çalışmaya TMD nedeniyle artrosentez yapılan hastalar dahil edildi. Hastalar anterior disk deplasmanına göre redüksiyonlu (Grup 1) ve redüksiyonsuz (Grup 2) olarak 2 gruba ayrıldı. Artrosentez öncesi ve sonrası klinik bulgular retrospektif olarak değerlendirildi. Sinoviyal sıvı TNF-α, IL-1β ve IL-6 seviyeleri ELISA yöntemi ile analiz edildi. Bulgular: Grup 1'de 15, Grup 2'de 13 olmak üzere toplam 28 hasta çalışmaya alındı. Hastaların tümü kadındı ve ortalama yaşları 30,75±14,9'du. Ameliyat öncesi ortalama ağrı skoru tüm hastalarda 6.6±1.95 idi. Artrosentez sonrası ortalama ağrı skoru 2,0 ( 1,0 - 2,5) olup aradaki fark anlamlıydı (p<0,001). Grup 1, Grup 2'den daha yüksek maksimum ağız açıklığına (MMO) sahipti ve fark istatistiksel olarak anlamlıydı (p=0,013). Sinoviyal sıvı sitokin seviyelerindeki fark, gruplar arasında istatistiksel olarak anlamlı değildi. Sitokinler ile klinik bulgular arasında istatistiksel olarak anlamlı bir ilişki yoktu. Sonuç: Artrosentez, TME internal düzensizlikleri olan hastalarda eklem ağrısını azaltmada faydalıdır. Redüksiyonlu ve redüksiyonsuz disk deplasmanı olan hastalarda proinflamatuar sitokin seviyeleri benzerdir.

Keywords

• Temporomandibular Eklem
• TME
• enflamatuar
• sitokin
• sinovyal sıvı

Investigation of the synovial fluid pro-inflammatory cytokines and clinical findings in disc displacements of TMJ

Abstract

Aims: Temporomandibular disorders (TMD) are common musculoskeletal disease that affects the soft tissues and bone structures of the temporomandibular joint (TMJ). Inflammatory mediators play a critical role in the etiology of TMD by affecting various molecular mechanisms. This study aims to investigate the effect of pro-inflammatory cytokines on TMJ internal derangements and evaluate the relationship between clinical features. Methods: Patients who underwent arthrocentesis because of TMD were included in this study. Patients were divided into 2 groups according to anterior disc displacement with reduction (Group 1) and without reduction ( Group 2). Clinical findings before and after the arthrocentesis were evaluated retrospectively. Synovial fluid TNF-α, IL-1β, and IL-6 levels were analyzed with the ELISA method. Results: A total of 28 patients were included, with 15 patients in Group 1 and 13 patients in Group 2. All patients were female with an average age of 30.75±14.9. The average pre-operative pain score was 6.6±1.95 in all patients. After the arthrocentesis, the average pain score was 2.0 ( 1.0 - 2.5) and the difference was significant (p<0.001). Group 1 have a higher maximum mouth opening (MMO) than Group 2 preoperatively and the difference was statistically significant (p=0.013). The difference in synovial fluid cytokine levels was not statistically significant between groups. There was no statistically significant correlation between cytokines and clinical findings. Conclusion: Arthrocentesis is beneficial for reducing joint pain in patients with TMJ internal derangements. Pro-inflammatory cytokine levels are similar in TMJs with disc displacement with and without reduction.

Keywords

• Temporomandibular Joint
• TMJ
• inflammatory
• cytokine
• synovial fluid

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