This journal club presentation compared the effects of intra-articular injections of injectable platelet-rich fibrin (i-PRF) versus platelet-rich plasma (PRP) in the management of temporomandibular joint disorders (TMDs). A randomized controlled study of 14 patients with internal derangement received injections of either i-PRF or PRP. Both groups showed improvements in pain, maximal mouth opening, and joint sounds over 6 months of follow-up, with greater improvements observed in the i-PRF group. The results suggest i-PRF injections may be more effective than PRP injections for treating TMDs due to i-PRF's ability to induce lavage of the synovial
Short Term Analysis of Clinical, Functional Radiological Outcome of Total Kne...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Mahendra Azad et al. GAINT ODONTOGENIC KERATOCYST OF MANDIBLE OPERATED UNDER LOCAL ANESTHESIA- A CASE REPORT. JOURNAL OF DENTAL HEALTH & RESEARCH (VOL. 1, ISSUE 2, JUL - DEC 2020): 24-2
Short Term Analysis of Clinical, Functional Radiological Outcome of Total Kne...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Mahendra Azad et al. GAINT ODONTOGENIC KERATOCYST OF MANDIBLE OPERATED UNDER LOCAL ANESTHESIA- A CASE REPORT. JOURNAL OF DENTAL HEALTH & RESEARCH (VOL. 1, ISSUE 2, JUL - DEC 2020): 24-2
A comparative study on the clinical and functional outcome of limb salvage su...NAAR Journal
The aim of this study was to analyze the survival, recurrence, complications as well as the quality of life (QOL) in tibial osteosarcoma (OSA) patients managed by limb salvage surgery (LSS), either by a prosthesis, resection or graft or by amputation. 106 tibial osteosarcoma patients were enrolled where 39 had custom-designed endoprosthetic arthroplasty (LSS1), 36 underwent resection and bone graft (LSS2) while only 31 underwent amputation. A Comparison was done based on post-operative survival rates, postoperative recurrence, and complications. The impact of the patient’s QOL was also evaluated.
44.Rohini Kanitkar Kamat et al. A Comparative Assessment of the Efficiency of ThreeDimensional plates over single Superior Border Plating in the management of Mandibular Angle Fractures. J Res Adv Dent 2020;10:3s:17-22.
Open debridement and radiocapitellar replacement in primary and post-traumati...Alberto Mantovani
Background: Postmortem and clinical studies have shown an early and prevalent involvement of the radiohumeral
joint in primary and secondary arthritis of the elbow. The lateral resurfacing elbow (LRE) prosthesis
has recently been developed for the treatment of lateral elbow arthritis. However, few data have been
published on LRE results.
Materials and methods: A prospective multicenter study was designed to assess LRE preliminary results.
There were 20 patients (average age, 55 years). Preoperative diagnosis were primary osteoarthritis in 11
and post-traumatic osteoarthritis in 9. All patients underwent open debridement and LRE prosthesis.
Patients were evaluated preoperatively and postoperatively with the Mayo Elbow Performance Score
(MEPS), modified American Shoulder Elbow Surgeons (m-ASES) elbow assessment, and the Quick
Disabilities of the Arm, Shoulder and Hand (Quick-DASH). Mean follow-up was 22.6 months.
Results: At the last follow-up, the mean improvement of MEPS and m-ASES was 35 (P ¼ .001) and 34
(P ¼ .001) respectively; the average Quick DASH decreased by 29 (P ¼ .001). Average range of motion
was improved by 35 (P ¼.001). MEPI results were excellent in 12 patients, good in 2, and fair and poor in
3 each. Mild overstuffing was observed in 5 patients, and an implant malpositioning in 3. The implant
survival rate was 100%.
Conclusion: LRE showed promising results in this prospective investigation. Most patients had an
uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional
recovery at short-term follow-up. Further studies with longer follow-up are warranted.
omfs journal club ppt on bone ridge augmentationAkhil Sankar
This is a journal club to start with for new omfs pgs . This is correctly criticized and cross-checked ppt. Also, it is a relevant topic in day to day preactise
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
Comparison of postoperative complications in benign thyroid disorders: subtot...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A comparative study on the clinical and functional outcome of limb salvage su...NAAR Journal
The aim of this study was to analyze the survival, recurrence, complications as well as the quality of life (QOL) in tibial osteosarcoma (OSA) patients managed by limb salvage surgery (LSS), either by a prosthesis, resection or graft or by amputation. 106 tibial osteosarcoma patients were enrolled where 39 had custom-designed endoprosthetic arthroplasty (LSS1), 36 underwent resection and bone graft (LSS2) while only 31 underwent amputation. A Comparison was done based on post-operative survival rates, postoperative recurrence, and complications. The impact of the patient’s QOL was also evaluated.
44.Rohini Kanitkar Kamat et al. A Comparative Assessment of the Efficiency of ThreeDimensional plates over single Superior Border Plating in the management of Mandibular Angle Fractures. J Res Adv Dent 2020;10:3s:17-22.
Open debridement and radiocapitellar replacement in primary and post-traumati...Alberto Mantovani
Background: Postmortem and clinical studies have shown an early and prevalent involvement of the radiohumeral
joint in primary and secondary arthritis of the elbow. The lateral resurfacing elbow (LRE) prosthesis
has recently been developed for the treatment of lateral elbow arthritis. However, few data have been
published on LRE results.
Materials and methods: A prospective multicenter study was designed to assess LRE preliminary results.
There were 20 patients (average age, 55 years). Preoperative diagnosis were primary osteoarthritis in 11
and post-traumatic osteoarthritis in 9. All patients underwent open debridement and LRE prosthesis.
Patients were evaluated preoperatively and postoperatively with the Mayo Elbow Performance Score
(MEPS), modified American Shoulder Elbow Surgeons (m-ASES) elbow assessment, and the Quick
Disabilities of the Arm, Shoulder and Hand (Quick-DASH). Mean follow-up was 22.6 months.
Results: At the last follow-up, the mean improvement of MEPS and m-ASES was 35 (P ¼ .001) and 34
(P ¼ .001) respectively; the average Quick DASH decreased by 29 (P ¼ .001). Average range of motion
was improved by 35 (P ¼.001). MEPI results were excellent in 12 patients, good in 2, and fair and poor in
3 each. Mild overstuffing was observed in 5 patients, and an implant malpositioning in 3. The implant
survival rate was 100%.
Conclusion: LRE showed promising results in this prospective investigation. Most patients had an
uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional
recovery at short-term follow-up. Further studies with longer follow-up are warranted.
omfs journal club ppt on bone ridge augmentationAkhil Sankar
This is a journal club to start with for new omfs pgs . This is correctly criticized and cross-checked ppt. Also, it is a relevant topic in day to day preactise
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
Comparison of postoperative complications in benign thyroid disorders: subtot...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. National Journal of Maxillofacial Surgery /
Volume 14 / Issue 2 / May-August 2023
3. INTRODUCTION
The term “temporomandibular disorders(TMDs)” represents
pain and dysfunction conditions in the masticatory system.
Various noninvasive management and invasive management
of TMDs have been advocated in the literature.
Newer methods for stimulating repair or replacing damaged
cartilage, such as matrix metalloproteinase inhibitor,
cytokine inhibitor, artificial cartilage substitute, and growth
factors are being researched extensively.
4. HUMAN PLATELET CONCENTARTES
Platelet concentrates comprise high quantities of key growth factors, which
have the capacity to stimulate cell proliferation, matrix remodeling, and
angiogenesis.
Abdulgani Azzaldeen, Abdulgani Mai, Abu-
Hussein Muhamad. Platelet-rich fibrin (PRF) in
dentistry. Int J Appl Dent Sci 2019;5(4):01-08.
5. Abdulgani Azzaldeen, Abdulgani Mai, Abu-Hussein Muhamad. Platelet-rich fibrin (PRF)
in dentistry. Int J Appl Dent Sci 2019;5(4):01-08.
6. Intra-articular injections of PRP/i-PRF are
minimally invasive and thus have a higher
patient acceptance rate and is the cost-effective
procedure.
In this study, It was hypothesized that i-PRF is
better than PRP in terms of improving the
symptoms and function of patients affected by
TMDs.
7. AIM
To compare the effect of intra-articular injections
of injectable PRF versus PRP in the management
of TMDs.
8. MATERIAL AND METHOD
Randomized control study was conducted in the Department of
Oral and Maxillofacial Surgery, Saraswati dental college and
hospital, Lucknow, UP, India.
14 patients (N = 28 joints) within the age group of 20–50 years
diagnosed with internal derangement between December 2018
and January 2021.
Patients were randomly divided into GROUP I (PRP) and
GROUP II (i-PRF) with seven patients (N = 14 joints) in each.
9. Inclusion criteria
Patients were classified under the
Wilkes classification of internal
derangement (stages I–V) based on
clinical and radiographic evaluation and
willingness to participate in the study.
10. Procedure
The preoperative phase
Detailed case history, clinical TMJ examination,
and magnetic resonance imaging (MRI) (at three
positions: close mouth, open mouth, and 25 mm
mouth opening position) were taken. Patient
education and occlusion rehabilitation (if
required) followed by an occlusal splint were
given to all patients.
11. The operative phase
Following strict aseptic
protocol, an
auriculotemporal nerve
block (2% lidocaine with
1:200000 adrenaline) was
administered. TMJ
arthrocentesis with 200 ml
ringer lactate solution was
performed using a
2-needle technique
14. INJECTION OF PRP OR i-
PRF
Using a 26-gauge needle,
the intra-articular injection
of 2 ml PRP/i–PRF was
injected in the superior
joint space following the
Holmlund–Hellsing line, at
a distance of 10 mm from
the tragus and 2 mm
inferior to it.
15. The Postoperative phase
Patients were advised to take a soft diet with
restricted jaw movements for one week.
No anti-inflammatory drugs were given to
assess the accurate pain response of the
patients after the operative phase.
16. Postoperative evaluation parameters
Clinical evaluation
It was carried out preoperative and 1 week postoperatively every
month till the end of the treatment (6 months) and final follow-up
at 9 months.
1. Evaluation of Pain
It was evaluated by recording on the visual analog scale (VAS) in
which 0 being no/absence of pain and 10 being worst/unbearable
pain on either side.
17. Evaluation of maximal mouth
opening (MMO)
Using a More Rao Scale, the
distance between the two points
marked in between the incisal
edges of maxillary and mandibular
central incisors was recorded as
mouth opening in mm.
18. Evaluation of lateral and protrusive
movement
On the two previously marked points, the
More Rao Scale was stabilized at the point
marked on the maxillary central incisor
patient was asked to deviate the
mandible on one side and the distance
between the two points was measured
and recorded.
The protrusive movement was recorded
in mm between the incisal edges by
asking the patient to protrude the
mandible forward.
19. Evaluation of TMJ sounds
Patients were asked to do a full range of mandibular
movements vertically and horizontally, and the absence or
presence of joint sounds was recorded on both sides by
auscultation and palpation.
Radiographical evaluation
Evaluation based on MRI was carried out preoperatively
and postoperatively at 9months(3months after completion
of the operative phase).
20. Evaluation of disc position
Sagittal and coronal MRI sections in close and open mouth
positions were viewed, and the position of the meniscus was
evaluated as normal, disc displacement with early reduction
(DDWER), disc displacement with late reduction (DDWLR),
and disc displacement without reduction (DDWR).
Evaluation of joint effusion (JE)
T2-weighted MRI images were evaluated for the absence and
presence of JE where hyperintensity suggested the presence
of fluid, which was interpreted as the presence of JE.
26. DISCUSSION
The therapeutic management of degenerative disorders of
the TMJ is focused on a minimally invasive treatment
modality for relieving the functional pain and establishing
a normal range of mandibular motion in these patients.
Since the pathogenic pathways are imprecise, noninvasive
methods are preferred as the first-line treatment
modality, and if they are not efficacious, then surgical
treatment is desirable.
27. Conservative therapy includes occlusal splint
therapy, which eliminates mechanical stress, and
physical therapies that relieve pain.
Minimally invasive modalities such as lavage and
intra-articular injection techniques to remove
pain and inflammatory mediators of TMD have
been described extensively in the literature.
28. SUPPORTING STUDIES
Hegab et al. in 2015 (PRP v/s hyaluronic acid (HA) in
TMJ osteoarthritis) revealed significant
improvements over time in terms of pain, MMO,
and joint sounds with better results in PRP than the
HA group where pain began to increase
postoperatively.
Albilia et al. (2018) (i-PRF in internal derangement)
reported a statistically significant reduction in pain
and an increase in MMO, which was comparable to
PRP.
29. Yuce et al. (2020)(arthrocentesis vs arthrocentesis plus HA
vs arthrocentesis plus i-PRF) reported a statistically
significant decrease in pain scores (VAS) and a significant
increase in MMO in all three groups throughout the
follow-up and concluded that the arthrocentesis plus i-PRF
group was superior among these three groups.
Teama et al. (2020)[12] (i-PRF vs arthrocentesis in internal
derangement) reported a significant reduction in pain
intensity and a significant increase in MMO in both groups
with better results in i-PRF cases compared with
arthrocentesis. There was also significant improvement in
TMJ clicking 2 weeks posttreatment that was sustained
thereafter.
30. To restore normal structure and function of TMJ beyond symptomatic relief,
regenerative therapeutics involve bio-supplementation of the joint with
platelet concentrates.
The biochemistry of the pathophysiology of arthralgia and joint
inflammation has been attributed to vasodilation, extravasation, activation
of immune cell communication, differentiation, chemotaxis, and activation
of nociceptive neurons, which is caused due to lack of waste removal and
decreased blood supply, thereby generating higher concentration of pain
mediators such as substance P, serotonin, bradykinin, leukotriene B4, and
prostaglandin E2 and pro-inflammatory cytokines such as interleukins and
tumor necrosis factor-α within the synovial fluid.
The chronic presence of these mediators results in bone remodeling and
degradation of joint morphology.
31. The intra-articular injections of platelet concentrates
possess cellular, biochemical, and angiogenic
characteristics.
i-PRF intra-articular injections in particular, cause a
mechanical tear of adhesions via a mechanism of
hydraulic distension and expansion of the superior joint
space, thereby eradicating the vacuum effect present in
osteoarthritis (OA).
The liquid formulation of PRF spontaneously Polymerize
at approximately ± 15 min.
32. Platelet concentrates release cytokines and
various growth factors, which play an important
role in providing a supportive environment for
debridement by circulating macrophages and
type A synoviocytes, consequent renovation by
chondrocytes, and type B synoviocytes.
33. The outcome of i-PRF was better than PRP in the study.
i-PRF induces an organic lavage of synovial fluid by prompt
delivery of immune cells for debridement and repair following the
restoration of the synovium’s capillary network.
The clinical symptoms of all patients improved, and no
complications were observed
The combination of injectable therapeutics together with adjunct
therapy was found to provide improved benefits, the synergy of
which requires further in-depth research.
Conclusion
34. CRITICAL APPRAISAL
Merits
PRP, and i-PRF injections is regarded as simple and safe
method with potential beneficial effects.
cost-effective.
Comparative study.
Aim of the study well defined.
Randomized control trial.
Statistically significant results.
35. Demerits
Smaller sample size.
Inclusion and exclusion criteria not
well defined
Observer bias- not blinded.
Procedure of arthrocentesis not
explained.
Procedure of prp or prf preparation-
standardized(?)
36. CROSS REFERENCES
Diab NAF, Ibrahim AM, Abdallah AM. Fluid Platelet-Rich Fibrin (PRF) Versus Platelet-Rich
Plasma (PRP) in the Treatment of Atrophic Acne Scars: A Comparative Study. Arch Dermatol
Res. 2023 Jul;315(5):1249-1255.
Manafikhi M, Ataya J, Heshmeh O. Evaluation of the efficacy of platelet rich fibrin (I-PRF)
intra-articular injections in the management of internal derangements of temporomandibular
joints - a controlled preliminary prospective clinical study. BMC Musculoskelet Disord. 2022
May 14;23(1):454.
Albilia J DMD, MSc, Herrera-Vizcaíno C DDS, Weisleder H BSc, Choukroun J MD, Ghanaati S
MD, DMD, PhD. Liquid platelet-rich fibrin injections as a treatment adjunct for painful
temporomandibular joints: preliminary results. Cranio. 2020 Sep;38(5):292-304.
Young AL. Internal derangements of the temporomandibular joint: A review of the anatomy,
diagnosis, and management. J Indian Prosthodont Soc. 2015 Jan-Mar;15(1):2-7.
Soni A. Arthrocentesis of Temporomandibular Joint- Bridging the Gap Between Non-Surgical
and Surgical Treatment. Ann Maxillofac Surg. 2019 Jan-Jun;9(1):158-167.
‑PRF preserves its cell content and growth factors in the articular space for an extended duration, thereby prolonging its release and restoration of the TMJ bioenvironment.