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Efficacy of Arthrocentesis by Injection of Ringer With or Without Corticosteroid in Treatment of Internal Derangement

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ClinicalTrials.gov Identifier: NCT01958879
Recruitment Status : Completed
First Posted : October 9, 2013
Last Update Posted : October 7, 2014
Sponsor:
Information provided by (Responsible Party):
Reza Tabrizi, Shiraz University of Medical Sciences

Brief Summary:
The study aims to evaluate effectiveness of ringer injection with or without corticosteroid during arthrocentesis of the temporomandibular joint in the treatment of internal derangement of the temporomandibular joint (TMJ).

Condition or disease Intervention/treatment Phase
Temporomandibular Joint Dysfunction Pain Arthrocentesis Drug: ringer with corticosteroid Drug: ringer without corticosteroid Phase 2

Detailed Description:
This prospective clinical study was approved by Local ethical committee and written informed consent will be obtained before the trial starts. Criteria for selection of the patients was based on history and clinical findings characteristic of internal derangement. All these patients were initially treated with NSAIDS for 1 week and occlusal splints for 1 month had failed to respond to these conservative treatments. The patients with systemic problems which affect bone and joints,psychological problems ,history of maxillofacial fractures and orthognathic surgery were excluded from the study. A total of 60 patients with TMJ internal derangement with failed conservative management, were subjected to TMJ arthrocentesis. All arthrocentesis were performed by the same maxillofacial surgeon. Subjects were randomly allocated into two groups (30 cases in each group). Subjects in the group 1 received irrigation with Ringer solution and in the group 2 ,subjects underwent irrigation with Ringer solution with corticosteroid (Dexamethasone ) .Two examiners evaluated Temporomandibular disorder's signs ( mouth opening,click , crepitus and pain) before, one month and 6 months after arthrocentesis.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Treatment of Temporomandibular Disorder
Study Start Date : September 2012
Primary Completion Date : October 2013
Study Completion Date : November 2013

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Experimental: ringer with corticosteroid
Intra-articular irrigation was performed under local anesthesia with subcutaneous injection of 1%lidocaine solution (0.6 to 0.9 mL anaesthetic solution )was injected to block the auriculotemporal nerve. Then the skin on the TMJ was penetrated with a 21-gauge needle at the articular fossa followed by the injection of 3 mL Ringer solution to distend the joint space, pumping it in and out repeatedly. Another 21-gauge needle was inserted into the distended compartment in the area of the articular eminence, and the superior joint space was irrigated with 200 mL Ringer solution, allowing a free flow through the first needle in the both groups .In this group patients received 1mg dexamethasone after finishing the irrigation .
Drug: ringer with corticosteroid
200 mL Ringer solution+1mg dexamethasone after finishing the irrigation
Placebo Comparator: Ringer with out corticosteroid
Intra-articular irrigation was performed under local anesthesia with subcutaneous injection of 1%lidocaine solution (0.6 to 0.9 mL anaesthetic solution )was injected to block the auriculotemporal nerve. Then the skin on the TMJ was penetrated with a 21-gauge needle at the articular fossa followed by the injection of 3 mL Ringer solution to distend the joint space, pumping it in and out repeatedly. Another 21-gauge needle was inserted into the distended compartment in the area of the articular eminence, and the superior joint space was irrigated with 200 mL Ringer solution, allowing a free flow through the first needle in the both groups
Drug: ringer without corticosteroid
200 mL Ringer solution



Primary Outcome Measures :
  1. pain [ Time Frame: 6 months ]
    Pain will be assessed preoperatively and again at 1 and 6 months using a visual analogue scale


Secondary Outcome Measures :
  1. function [ Time Frame: 6 months ]
    Mouth opening was measured as the maximum interincisal distance in millimeters using a scale



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Ages Eligible for Study:   15 Years to 80 Years   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with clinical findings characteristic of internal derangement(clicking and joint pain lasting for more than 6 months) unilaterally or bilaterally and history of previous conservative drug therapy (NSAIDs and Muscle relaxant ),splint therapy and physiotherapy without improvement.
  • Patients of both sexes between 15 to 80 year's old
  • Patients who are willing for evaluation in 1 and 6 months after arthrocentesis
  • Patients who are provided written consent form

Exclusion Criteria:

  • Patient had systemic problems which affect bone and joints disease
  • Patient with psychological problems
  • Patient with history of maxillofacial fractures and orthognathic
  • Patients who can not continue the study for private or social reasons

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01958879


Locations
Iran, Islamic Republic of
Shiraz university of medical sciences
Shiraz, Iran, Islamic Republic of
Sponsors and Collaborators
Shiraz University of Medical Sciences
Investigators
Study Chair: Reza Tabrizi, DMD SUMS
Study Director: Reza Tabrizi, DMD SUMS
Principal Investigator: Touba Karagah, DMD SUMS

Responsible Party: Reza Tabrizi, OMFS, Shiraz University of Medical Sciences
ClinicalTrials.gov Identifier: NCT01958879     History of Changes
Other Study ID Numbers: 12345
First Posted: October 9, 2013    Key Record Dates
Last Update Posted: October 7, 2014
Last Verified: October 2013

Keywords provided by Reza Tabrizi, Shiraz University of Medical Sciences:
internal derangement,arthrocentesis,corticosteroid

Additional relevant MeSH terms:
Joint Diseases
Temporomandibular Joint Disorders
Temporomandibular Joint Dysfunction Syndrome
Musculoskeletal Diseases
Craniomandibular Disorders
Mandibular Diseases
Jaw Diseases
Muscular Diseases
Stomatognathic Diseases
Myofascial Pain Syndromes
Pharmaceutical Solutions