Clinical signs, diagnosis and complex treatment of temporomandibular joint osteoarthritis

Abstract

Aim. To improve complex treatment of temporomandibular joint osteoarthritis. Methods. 45 patients with temporomandibular joint osteoarthritis aged 18-75 years were examined. The main group consisted of 25 patients who were treated using transcranial electric stimulation. Comparison group consisted of 20 patients in whom standard treatment was applied. Control group consisted of 10 healthy volunteers and was used to compare blood cytokine and β-endorphin levels. Clinical examination, computed tomography, immunological blood analysis were performed in all patients. Results. After the complex treatment all the symptoms resolved, and the position of mandibular condyles in mandibular fossae of the temporal bone and results of immunological blood analysis normalized. The baseline level of β-endorphin of patients with temporomandibular joint osteoarthritis did not differ from control group. After transcranial electric stimulation β-endorphin serum levels were significantly raised at day 6 and especially at day 9, while in patients with standard treatment the β-endorphin serum levels were only slightly higher compared to baseline levels. Decrease of interleukin-6 serum levels was more significant in the transcranial electric stimulation group. Transcranial electric stimulation has also leaded to elevation of interleukin-10 serum levels up to normal ranges at day 9, compared to low level (5 times below normal range) at all times in the standard treatment group. After 2 years of treatment there was no symptoms of the disease, normal ranges of motion in temporomandibular joints and no relapses registered in 24 out of 25 patients from transcranial electric stimulation group compared to 11 out of 20 patients from standard treatment group. In 1 patient from transcranial electric stimulation group and 9 patients from standard treatment group clicking on the involved side was still present, those patients were re-treated. Conclusion. Usage of transcranial electric stimulation as a component of complex treatment of patients with temporomandibular joint osteoarthritis increases the effectiveness of their treatment.