EVALUATION OF INFLUENCE OF GENETIC PAIN SENSITIVITY ON THE SUCCESS OF ARTHROCENTESIS FOR TREATMENT OF NON-REDUCING DISC DISPLACEMENT OF TMJ

Abstract

EVALUATION OF INFLUENCE OF GENETIC PAIN SENSITIVITY ON THE SUCCESS OF ARTHROCENTESIS FOR TREATMENT OF NON-REDUCING DISC DISPLACEMENT OF TMJT. Can1 , S. Cinar2 , M. Poda3 , S. Bekpinar4 , S. Cakarer1 , C. Keskin11 Department of Oral and Maxillofacial Surgery, Istanbul University Faculty of Dentistry, Istanbul, Turkey 2 Department of Immunology, Istanbul University Instıtute of Experimental Medicine, Istanbul, Turkey 3 Department of Genetics, stanbul University Instıtute of Experimental Medicine, Istanbul, Turkey 4 Department of Biochemistry, stanbul University Istanbul Medical Faculty, Istanbul, Turkey Objective: The aim of the study is to find out the role of pain sensitivity on clinical success of TMJ arthrocentesis for treatment of Non-reducing Disc Placement. Methods: The study group comprised 31 patients (25 females, 6 males; mean age 36.00±13.84, range 18-60 diagnosed as having non-reducing disc displacement both clinically and radiographically. Synovial fluid samples were obtained before and 3 months after arthrocentesis. Maximum mouth opening and VAS pain scores were recorded during control examinations before arthrocentesis and 1 week, 1 month and 3 months after arthrocentesis. The pain sensitivity of all patients were determined after DNA isolation from blood samples according to the variations of the gene encoding the enzyme KOMT and the patients were divided into 2 groups (1. Group high pain sensitivity + average pain sensitivity and 2. group: low pain sensitivity). IL-1β, IL-2, IL- 6, IL-8, IL-10, and TNF-α concentrations and total activity of matrix metalloproteinases -1, -2, -3 and -9 in the synovial fluid samples were measured by using specific kits. Results: In each group, maximum mouth opening was increased and VAS pain scores were decreased. The success rate of 1. group was 57.1 and of 2. group was %58.8. No correlation was observed between the clinical parameters and cytokin levels and MMP activity in the synovial fluid. No statistical difference was recorded between the success rates of the two groups created according to the genetic pain sensitivity. No correlation was observed also between the change of clinical parameters and change of cytokin levels and MMP activity in the synovial fluid obtained before and 3 months after arthrocentesis. The decrease in MMP activity in synovial fluids of successfully treated patients was statistically significant but there wasn’ t any statistically significant difference in synovial fluids of the patients who’s treatments are unsuccessful. Conclusions: TMJ arthrocentesis is a safe and successful method to treat Non-reducing Disc Placement. We couldn’t determine any effect of genetic pain sensitivity on the clinical success of TMJ arthrocentesis for treatment of patients in our study.