Ultrasound Guided Versus Conventional Arthrocentesis in Treatment of Temporomandibular Joint Internal Derangement.

Samiha Abdelsalam Abdelaziz Abdelaziz

Status: Not yet enrolling

Conditions: Internal Derangement of the Tempromandibular Joint

Treatments: Procedure: Conventional anatomically guided arthrocentesis of tempromandibular joint; Procedure: Ultrasound guided arthrocentesis of tempromandibular joint

Study type: Interventional

Funder types: Other

Identifiers

NCT06657118

US guided arthrocentesis

Details and patient eligibility

About

The use of Ultrasound as a guide in arthrocentesis of tempromandibular joint versus conventional anatomically guided arthrocentesis in treatment of temporomandibular joint internal derangement: A randomized clinical trial.

Enrollment: 34 estimated patients

Sex: All

Ages: 16 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients aged 16 to 45 years of age having temporomandibular joint internal derangement.
• Patients free from any systemic conditions and bone metabolic diseases that might interfere with the surgical intervention, soft tissue or hard tissue healing.
• ASA 1-2 patients with no contraindications for GA
• Patients who did not respond to conservative treatment.

Exclusion criteria

• Patient with uncontrolled systemic diseases precluding administration of general anesthesia.
• Handicaps and special needs patients.
• Prisoners.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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34 participants in 2 patient groups

Conventional arthrocentesis

Active Comparator group

Description:

* Scrubbing and draping of the patient will be carried out in a standard fashion using betadine surgical scrub. * Head turned to the affected side. * External auditory meatus will be blocked with a cotton plug. * A line will be drawn from tragus of the ear to the outer canthus of the eye with ink. * Double needled canula is inserted into superior compartment of the joint space 2mm below and 10 mm ahead of mid-tragal end of Holmund Hellsing's line. Intra-operative procedures - continued in both groups: * Lavage is performed with 100 ml of saline solution. * 1 ml of Hyaluronic acid is injected into the superior joint space. * Puncture point is covered with sterile dressing for 24 hours

Treatment:

Procedure: Conventional anatomically guided arthrocentesis of tempromandibular joint

Ultrasound guided arthrocentesis

Active Comparator group

Description:

Scrubbing and draping of the patient will be carried out in a standard fashion using betadine surgical scrub. * Head turned to the affected side. * External auditory meatus will be blocked with a cotton plug. * Transducer is placed over TMJ, parallel to the long axis of mandibular ramus. • Transducer is tilted until the optimal visualization is obtained. * Disc is visualized as a thin homogenous, hypo-to-iso-echoic band lying adjacent to the inferior relation. The bony landmarks of the mandibular condyle and the articular eminence are visualized as hyperdense lines. * Superior joint space located between the disc and articular eminence is the targeted point of the needle. Intra-operative procedures - continued in both groups: * Lavage is performed with 100 ml of saline solution. * 1 ml of Hyaluronic acid is injected into the superior joint space. * Puncture point is covered with sterile dressing for 24 hours

Treatment:

Procedure: Ultrasound guided arthrocentesis of tempromandibular joint