Ultrasound Guided Autologous Blood Injection in Temporomandibular Joint Dislocation

Not Applicable

Recruiting

Interventions: Procedure: ultrasound guided autologous blood injection
Procedure: non guided autologous blood injection

Brief Summary: The aim of this study is To compare the accuracy and effectiveness of ultrasound (US) guided autologous blood injection (ABI) versus non- guided technique for the treatment of chronic recurrent temporomandibular joint dislocation

Detailed Description: All patients involved in this study will be divided randomly to two different groups and injected with autologous blood into joint space and pericapsular tissue.

Study group (group A) will be injected with autologous blood with ultrasound guidance.

control group (group B) will be injected with autologous blood without US guidance. Anatomical landmarks and tactical sense will be followed only.

The operation will be done under local anesthesia ( Auriculotemporal nerve block ) the skin overlying the temporomandibular joint will be scrubbed by an antiseptic solution and the area will be isolated with sterile towels. External auditory canal will be blocked with cotton.

About 3 ml of blood will be withdrawn from patient's antecubital fossa, of which 2 ml injected intra-articular and 1 ml in the pericapsular tissue (PT) The procedure should be repeated on the opposite side in case of bilateral involvement.

Recruitment & Eligibility

Inclusion Criteria

Patient with at least 3 episodes of temporomandibular joint dislocation in the past 6 months.
Necessitating a visit to the emergency room or trained professional to reduce the dislocation.
Radiological evidence of displacement of condylar head beyond the articular eminence on wide mouth opening.
Maximum mouth opening (MMO) more than 40 mm.
Unilateral or bilateral.
Over 18 years of age.
Both gender Males or females.

Exclusion Criteria

Patient having inflammatory temporomandibular joint disease like tuberculous arthritis, rheumatoid arthritis.
Patients with bleeding disorders, pregnancy or bony pathology of temporomandibular joint .
Allergy to local anesthetic.
Severe epilepsy or Parkinson's disease.
Patient on anti-depressants or anti-psychotics.
Inability to follow-up the patient during the entire follow-up period.
Patients who had recent fracture at temporomandibular joint level or who had previous surgical interference to temporomandibular joint .
Refused to sign the written informed consent were also excluded.
Dystonia

Arm && Interventions

Group	Intervention	Description
Study group (group A) will be injected with ultrasound guidance in temporomandibular joint .	ultrasound guided autologous blood injection	uses of ultrasound as a guiding tool for temporomandibular joint injection
control group(group B) conventional non guided injection in temporomandibular joint	non guided autologous blood injection	without ultrasound guidance only anatomical landmark will be followed during injection

Primary Outcome Measures

Name	Time	Method
maximum mouth opening	at 2weeks, 3months and 6 months post-operative	change in Maximum mouth opening (MMO): It's measured (in millimeter) from incisal edge of 11 to 41, in maximum mouth open position using caliper

Secondary Outcome Measures

Name	Time	Method
Frequency of temporomandibular joint dislocation:	2weeks, 3 months and 6 months post-operatively	number of dislocation per week
change of pain	2weeks, 3 months and 6 months post-operatively	measuring pain using visual analogue scale(0-10),higher scores mean worse outcome.

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