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Effect of Auriculotemporal Nerve Block Anesthesia on Manual Reduction of Disc Displacement without Reduction of the Temporomandibular Joint

악관절의 비정복성관절원판변위의 수조작 정복에 대한 이개측두신경 전달마취의 효과

  • Kim, Sook-Young (School of Dentistry, Chonnam National University) ;
  • Kim, Ji-Yeon (Department of Dentistry, Seoul Veterans Hospital) ;
  • Hong, Su-Min (Department of Dental Hygiene, Baekseok University) ;
  • Kim, Byung-Gook (Department of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Park, Byung-Ju (Department of Oral Biochemistry, School of Dentistry, Chonnam National University) ;
  • Im, Yeong-Gwan (Department of Oral Medicine, Chonnam National University Hospital)
  • 김숙영 (전남대학교 치의학전문대학원) ;
  • 김지연 (서울보훈병원 치과) ;
  • 홍수민 (백석대학교 치위생학과) ;
  • 김병국 (전남대학교 치의학전문대학원 구강내과학교실) ;
  • 박병주 (전남대학교 치의학전문대학원 구강생화학교실) ;
  • 임영관 (전남대학교치과병원 구강내과)
  • Received : 2011.02.05
  • Accepted : 2011.03.03
  • Published : 2011.03.30

Abstract

Aim: Disc displacement without reduction of the temporomandibular joint (TMJ) has been managed by mandibular manipulation to reduce the displaced disc but with a low success rate. The purpose of this study was to determine whether auriculotemporal nerve block anesthesia had an effect on the reduction of the displaced disc and to analyze the factors that influenced the result. Methods: 112 patients were diagnosed with disc displacement without reduction and treated by mandibular manipulation. Disc was recaptured in 35 patients. Among the 77 patients with whom disc recapture had failed, the auriculotemporal nerve was blocked with a local anesthetic in the 49 patients (mean $age \;{\pm}\; SD\; =\; 34.4\;{\pm}\; 15.1$; male 24, female 25) and then mandibular manipulation was performed again. Factors including age, elapsed time from the onset, and opening amount were analyzed in association with disc reduction rate with the auriculotemporal nerve block. Results: Among 49 patients who did not respond to manipulation only, manual reduction with auriculotemporal nerve block anesthesia was successful in 19 patients (38.8%). Maximum unassisted opening amount significantly increased in the 19 patients with successful recapture of the disc ($mean \;{\pm}\; SD\; =\; 46.1 \;{\pm}\; 4.5\; mm$), in contrast to the limited opening amount of the 49 patients before local anesthesia of the auriculotemporal nerve ($mean \;{\pm}\; SD\; =\; 25.7 \;{\pm}\; 6.0\; mm$). Age, elapsed time after the onset, and preoperative opening amount were not associated with the reduction rate. Conclusion: The results of this study suggest that auriculotemporal nerve block anesthesia increases the reduction rate of the disc displacement without reduction of the TMJ when combined with mandibular manipulation, and such anesthesia should be applied at the first stage of manual treatment of disc displacement without reduction.

Acknowledgement

Supported by : 전남대학교병원

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