JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Investigation of the synovial fluid pro-inflammatory cytokines and clinical findings in disc displacements of TMJ
Abstract
Aims: Temporomandibular disorders (TMD) are common musculoskeletal disease that affects the soft tissues and bone structures of the temporomandibular joint (TMJ). Inflammatory mediators play a critical role in the etiology of TMD by affecting various molecular mechanisms. This study aims to investigate the effect of pro-inflammatory cytokines on TMJ internal derangements and evaluate the relationship between clinical features.
Methods: Patients who underwent arthrocentesis because of TMD were included in this study. Patients were divided into 2 groups according to anterior disc displacement with reduction (Group 1) and without reduction ( Group 2). Clinical findings before and after the arthrocentesis were evaluated retrospectively. Synovial fluid TNF-?, IL-1ß, and IL-6 levels were analyzed with the ELISA method.
Results: A total of 28 patients were included, with 15 patients in Group 1 and 13 patients in Group 2. All patients were female with an average age of 30.75±14.9. The average pre-operative pain score was 6.6±1.95 in all patients. After the arthrocentesis, the average pain score was 2.0 ( 1.0 - 2.5) and the difference was significant (p<0.001). Group 1 have a higher maximum mouth opening (MMO) than Group 2 preoperatively and the difference was statistically significant (p=0.013). The difference in synovial fluid cytokine levels was not statistically significant between groups. There was no statistically significant correlation between cytokines and clinical findings.
Conclusion: Arthrocentesis is beneficial for reducing joint pain in patients with TMJ internal derangements. Pro-inflammatory cytokine levels are similar in TMJs with disc displacement with and without reduction.

Keywords : Temporomandibular joint, TMJ, inflammatory, cytokine, synovial fluid

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1. Laskin DM. Arthrocentesis for the treatment of internalderangements of the temporomandibular joint. Alpha Omegan.2009;102(2):46-50.
2. Sato J, Segami N, Suzuki T, Kaneyama K, Yoshitake Y, NishikawaK. The expression of vascular endothelial growth factor insynovial tissues in patients with internal derangement of thetemporomandibular joint. Oral Surg Oral Med Oral Pathol OralRadiol Endod. 2002;93(3):251-256.
3. Matsumoto K, Honda K, Ohshima M, et al. Cytokine profile insynovial fluid from patients with internal derangement of thetemporomandibular joint: a preliminary study. DentomaxillofacRadiol. 2006;35(6):432-441.
4. Brennan PA, Ilankovan V. Arthrocentesis for temporomandibularjoint pain dysfunction syndrome. J Oral Maxillofac Surg.2006;64(6):949-951.
5. Laskin DM. Arthroscopy versus arthrocentesis for treatinginternal derangements of the temporomandibular joint. OralMaxillofac Surg Clin North Am. 2018;30(3):325-328.
6. Nitzan DW. Arthrocentesis--incentives for using this minimallyinvasive approach for temporomandibular disorders. OralMaxillofac Surg Clin North Am. 2006;18(3):311-328.
7. Quinn JH, Bazan NG. Identification of prostaglandin E2 andleukotriene B4 in the synovial fluid of painful, dysfunctionaltemporomandibular joints. J Oral Maxillofac Surg.1990;48(9):968-971.
8. Kaneyama K, Segami N, Nishimura M, Suzuki T, Sato J.Importance of proinflammatory cytokines in synovial fluidfrom 121 joints with temporomandibular disorders. Br J OralMaxillofac Surg. 2002;40(5):418-423.
9. Fu K, Ma X, Zhang Z, Chen W. Tumor necrosis factor in synovialfluid of patients with temporomandibular disorders. J OralMaxillofac Surg. 1995;53(4):424-426.
10. Fu K, Ma X, Zhang Z, Pang X, Chen W. Interleukin-6 in synovialfluid and HLA-DR expression in synovium from patients withtemporomandibular disorders. J Orofac Pain. 1995;9(2):131-137.
11. Nitzan DW, Dolwick MF, Martinez GA. Temporomandibularjoint arthrocentesis: a simplified treatment for severe, limitedmouth opening. J Oral Maxillofac Surg. 1991;49(11):1163-1167.
12. Shibata T, Murakami KI, Kubota E, Maeda H. Glycosaminoglycancomponents in temporomandibular joint synovial fluid as markersof joint pathology. J Oral Maxillofac Surg. 1998;56(2):209-213.
13. de Lange-Brokaar BJ, Ioan-Facsinay A, van Osch GJ, et al. Synovialinflammation, immune cells and their cytokines in osteoarthritis:a review. Osteoarthritis Cartilage. 2012;20(12):1484-1499.
14. Ernberg M. The role of molecular pain biomarkers intemporomandibular joint internal derangement. J Oral Rehabil.2017;44(6):481-491.
15. Luo P, Feng C, Jiang C et al. IL-37b alleviates inflammation inthe temporomandibular joint cartilage via IL-1R8 pathway. CellProlif. 2019;52(6):12692.
16. Wake M, Hamada Y, Kumagai K, et al. Up-regulation ofinterleukin-6 and vascular endothelial growth factor-A in thesynovial fluid of temporomandibular joints affected by synovialchondromatosis. Br J Oral Maxillofac Surg. 2013;51(2):164-169.
17. Hamada Y, Kondoh T, Holmlund AB, Sakota K, Nomura Y, SetoK. Cytokine and clinical predictors for treatment outcome ofvisually guided temporomandibular joint irrigation in patientswith chronic closed lock. J Oral Maxillofac Surg. 2008;66(1):29-34.
18. Wang XD, Cui SJ, Liu Y, et al. Deterioration of mechanicalproperties of discs in chronically inflamed TMJ. J Dent Res.2014;93(11):1170-1176.
19. Segami N, Miyamaru M, Nishimura M, Suzuki T, KaneyamaK, Murakami K. Does joint effusion on T2 magnetic resonanceimages reflect synovitis? Part 2. Comparison of concentrationlevels of proinflammatory cytokines and total protein in synovialfluid of the temporomandibular joint with internal derangementsand osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2002;94(4):515-521.
20. Matsumoto K, Honda K, Ohshima M et al. Cytokine profile insynovial fluid from patients with internal derangement of thetemporomandibular joint: a preliminary study. DentomaxillofacRadiol. 2006;35(6):432-441.
21. Nishimura M, Segami N, Kaneyama K, Suzuki T, MiyamaruM. Proinflammatory cytokines and arthroscopic findingsof patients with internal derangement and osteoarthritisof the temporomandibular joint. Br J Oral Maxillofac Surg.2002;40(1):68-71.
22. Ulmner M, Sugars R, Naimi-Akbar A et al. Synovial tissuecytokine profile in disc displacement of the temporomandibularjoint. J Oral Rehabil. 2020;47(10):1202-1211.
23. Gulen H, Ataoglu H, Haliloglu S, Isik K. Proinflammatorycytokines in temporomandibular joint synovial fluid before andafter arthrocentesis. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2009;107(5):1-4.
24. Kellesarian SV, Al-Kheraif AA, Vohra F, et al. Cytokine profilein the synovial fluid of patients with temporomandibular jointdisorders: A systematic review. Cytokine. 2016;77:98-106.
25. Kawashima M, Ogura N, Akutsu M, Ito K, Kondoh T. The anti-inflammatory effect of cyclooxygenase inhibitors in fibroblast-like synoviocytes from the human temporomandibular jointresults from the suppression of PGE2 production. J Oral PatholMed. 2013;42(6):499-506
Article available in :
Volume 4, Issue 4, 2023
Page : 345-349
https://doi.org/10.47582/jompac.1333161
Article Information
Received : 26 Tem 2023
Accepted : 26 Ağu 2023
Published : 30 Ağu 2023
Corresponding Author :

Canay Asan Yılmaz: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey

[email protected]
Citation : Yılmaz Asan C, Bayındır Ş, Demirbaş AE, Barlak Keti D, Kütük N. Investigation of the synovial fluid pro-inflammatory cytokines and clinical findings in disc displacements of TMJ. J Med Palliat Care. 2023;4(4):345-349.

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