Abstract

BackgroundThe systemic immune-inflammation index (SII) has been demonstrated to be a valid biomarker of a patient's immunological and inflammatory state, with the ability to accurately predict outcomes in a variety of disease conditions. In the absence of comparable studies, we intended to examine the relevance of pretreatment SII in predicting the success rates of temporomandibular joint arthrocentesis (TMJA) at 1-week, 1-month, and 6-month periods, defined as maximum mouth opening (MMO) > 35 mm and VAS ≤ 3.MethodsA sum of 136 patients with disc displacement without reduction (DDwo-red) who underwent TMJA was included. For each patient, pre-TMJA SII was calculated as; SII = Platelets × neutrophils/lymphocytes. Additionally, baseline MMO and VAS measurements were recorded for each patient. The success criteria of TMJA included MMO > 35 mm and VAS ≤ 3. The optimal pre-TMJA SII cutoff that predicts TMJA success was determined using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the link between the pre-treatment SII and TMJA success (simultaneous achievement of MMO > 35 mm and VAS ≤ 3).ResultsThe median pre-TMJA jaw locking duration, maximum mouth opening (MMO), and visual analog score (VAS) were 7 days, 24 mm, and 8, respectively. The overall TMJA success rates were determined as 80.1%, 91.9%, and 69.1% at 1-week, 1-month, and 6-months, respectively. The results of ROC curve analysis exhibited the optimal SII cutoff at 526 (AUC: 67.4%; sensitivity: 66.7%; specificity: 64.2%) that grouped the patients into two subgroups: Group 1: SII ≤ 526 (N = 81) and SII > 526 (N = 55), respectively. Spearman correlation analysis revealed a strong inverse relationship between the pretreatment SII values and the success of TMJA 1-week (rs: − 0.83; P = 0.008) and 1-month, (rs: − 0.89; P = 0.03). Comparative analyses displayed that TMJA success rates at 1-week (87.7% vs. 69.1%; P = 0.008) and 1-month (96.2% vs. 80%; P = 0.03) were significantly higher in the SII ≤ 526 than SII > 526 group, respectively, while the 6-month results favored the SII ≤ 526 group with a trend approaching significance (P = 0.084).ConclusionThe current study's findings suggested the SII as a unique independent prognostic biomarker that accurately predicts treatment outcomes for up to 6 months.Trial registration The results of this research were retrospectively registered.

Highlights

  • The systemic immune-inflammation index (SII) has been demonstrated to be a valid biomarker of a patient’s immunological and inflammatory state, with the ability to accurately predict outcomes in a variety of disease conditions

  • temporomandibular joint (TMJ) arthrocentesis (TMJA), with its 70% to 90% longterm success rate, is a relatively easy to perform and highly feasible minimally invasive procedure that efficiently reduces the complaints of DDwo-red patients who are resistant to conservative treatments and drugs [7, 8]

  • The median jaw locking duration, pre-temporomandibular joint arthrocentesis (TMJA) maximum mouth opening (MMO), pre-TMJA visual analog score (VAS) were 7 days [95% confidence interval (CI): 2.8–14 days], 24 mm, and 8, respectively

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Summary

Introduction

The systemic immune-inflammation index (SII) has been demonstrated to be a valid biomarker of a patient’s immunological and inflammatory state, with the ability to accurately predict outcomes in a variety of disease conditions. In the absence of comparable studies, we intended to examine the relevance of pretreatment SII in predicting the success rates of temporomandibular joint arthrocentesis (TMJA) at 1-week, 1-month, and 6-month periods, defined as maximum mouth opening (MMO) > 35 mm and VAS ≤ 3. Severe pre-auricular and masticatory area pain, joint sounds, and diminished mouth opening capacity embodies the most frequent TMD-related presenting symptoms [3]. The reported prognostic factors for the TMJA procedure usually refer to the patient’s age, disease duration, pain severity, maximum mouth opening (MMO) capacity, and the presence of degenerative changes in the magnetic resonance imaging (MRI) scans. Sadly, emphasizing the compelling need for the identification of novel reliable prognosticators, accessible research results are often conflicting [10]

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