Utskrift från Malmö högskolas webbplats www.mah.se

Lavage Questionable for Treatment of Painful Jaw Movements at Disc Displacement without Reduction. A randomized controlled trial in a short-term perspective

Contact person: Lotta Englesson Sahlström
Responsible: Lars Eriksson
Co-workers: EwaCarin Ekberg, Thomas List and Arne Petersson
Partner: Region Skåne
Funding: Malmö högskola
Timeframe: 2003-03-19 -- 2010-06-30
Research profile: Oral hälsa
Faculty/Department: Faculty of Odontology
Subject: Odontologi

The aim was to compare in a randomized controlled three months trial the effect of extraarticular local anaesthetics (A) and local anaesthetics and lavage (AL) in patients with permanently displaced discs and TMJ pain on jaw movements.   The hypothesis was that patients treated with extraarticular local anaesthetics + lavage have a better treatment outcome than patients treated with extraarticular local anaesthetics.  Forty-five patients, mean age 35 years were included. All patients had non-reducing disc displacement confirmed on MRI. At baseline, one and three month follow-ups history and examination was performed according to RDC/TMD criteria. Primary outcome was assessed as a reduction in TMJ pain of at least 30% (VAS). There was no statistically significant difference between the groups. Additional outcomes: Pain reduction ≥50%  was reported in group A and AL at the three month follow-up by 16 out of 23 patients (2 drop outs) and 10 out of 14 (6 drop outs) patients, respectively and mouth opening capacity improved in both groups. There was statistically no difference between the groups. Use of lavage, to supplement extra-articular local anaesthetic treatment of painful jaw movements at non-reducing discs, does not appear to improve treatment outcome.

Beskrivning på svenska

Avsikten med studien var att i en randomiserad kontrollerad tremånaders uppföljning studera effekten av extraartikulär lokalanestesi (A) jämfört med lokalanestesi + lavage (AL) hos patienter med permanent displacerade diskar och käkledssmärta vid rörelse av käken. Hypoetesen var att behandling med anestesi + lavage gav ett bättre resultat en enbart anestesi. Förtiofem patienter, med en medelålder på 35 år deltog i studien. Diskdisplaceringen verifierades med MRI. Vi starten, en och tremånaderskontrollerna togs anamnes och statusuppgifter enligt RDC/TMD kriterierna. Primary outcome bedömdes som en smärtreduktion avseende TMJ pain på minst 30% (VAS). Det förelåg ingen statistisk skillnad mellan grupperna. Additional outcome visade minst en 50%  smärtreduktion  hos 16 av 23 patienter (2 drop outs) och 10 av 14 patienter (6 drop outs) i A respektive AL gruppen. Gapförmågan ökade i båda grupperna. Det fanns ingen statistisk skillnad mellan grupperna. Lavage med anestesi förefaller inte ge en bättre behandlingseffekt än enbart anestesi.

Publikationer inom projektet

L Englesson Sahlström, E Ekberg, T List, A Petersson, L Eriksson. Lavage questionable in treatment of painful reduced mouth opening capacity. J Cranio Maxillofac Surg 36, Suppl 1, 162, 2008

 

Senast uppdaterad av Magnus Jando