Analysis of synovial fluid of temporomandibular joint for IL-1 beta cytokine levels in patients with mandibular fractures

Background and objectives: Facial trauma has been suggested as a possible aetiologic factor of temporomandibular disorders (TMD). Trauma occurring in TMJ can be classified as macrotrauma and microtrauma by the degree of intensity. Facial trauma with mandibular fractures in specific is the main type of TMJ macrotrauma and parafunctional habits being microtrauma. In this prospective study we aim to evaluate mandibular trauma as a potential aetiologic factor for TMJ disorders. The study hypothesizes the role of mandibular fractures as a causative factor for pathogenesis of TMD.

Material and methods: A total of 16 cases (32 TM joints) of mandibular fractures were selected and analyzed for the study with specific armamentarium for arthrocentesis and IL-1 beta estimation. All cases underwent open reduction and internal fixation under general anaesthesia for mandibular fractures. The cases were divided in two groups A and B with unilateral fracture and bilateral fractures, respectively. Study findings were analyzed using Unpaired Student’s t -test and Lagranges Interpolation Equation.

Results: All the cases on fractured and non-fractured side had statistically significant amount of IL-1 beta concentrates but more in former as compared to latter with p = 0.0030. In bilateral fracture cases concentration of IL-1 beta was higher in the right side (9–28 pg/ml) as compared to left (0–9 pg/ml) suggesting greater propensity of mechanical stress on right side.

Conclusion: The inflammatory and degenerative changes of TMJ can develop following macrotrauma to mandible. IL-1 beta, which is a possible marker to assess early micro environmental inflammation or cartilage degradation in TMJ, is increased in our evaluation. This study suggests that long term follow up and evaluation of the TMJ in mandibular fracture cases for any changes can be diagnosed at earliest and appropriate intervention can be provided.

Key words: temporomandibular disorders; IL-1 beta; arthrocentesis; mandible trauma

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Analysis of synovial fluid of temporomandibular joint for IL-1 beta cytokine levels in patients with mandibular fractures
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