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PhD ceremony Mr. L.M. Vos: Arthrocentesis and viscosupplementation as treatment modalities for arthralgia of the temporomandibular joint

When:Mo 20-01-2014 at 16:15
Where:Academiegebouw, Broerstraat 5, Groningen

PhD ceremony: Mr. L.M. Vos

Disertation: Arthrocentesis and viscosupplementation as treatment modalities for arthralgia of the temporomandibular joint

Promotor(s): prof. B. Stegenga, prof. S.K. Bulstra

Faculty: Medical Sciences

Arthralgia of the temporomandibular joint (TMJ) is often associated with a chronic degenerative process and may have considerable impact on normal daily life. In order to minimize the effects of this process on the quality of life or even preventing it from becoming chronic, adequate intervention is essential. Initial treatment usually consists of explaining the nature and expected course of the disorder, and prescription of a soft diet and home exercises. If indicated, physical therapy and splint therapy can be applied. Usually, when this conventional therapy fails, arthrocentesis is the next step.

The general aim of this thesis was to investigate the clinical and cost effectiveness of arthrocentesis as initial treatment and explore the applicability in the TMJ of a related therapeutic treatment modality that proved to be successful in treating arthralgia of the knee joint, i.e. viscosupplementation.

From this thesis it can be concluded that a more prominent place of arthrocentesis in the treatment TMJ arthralgia seems justified. The indication of arthrocentesis as initial treatment results in better health outcomes, especially with regard to pain reduction, and also may contribute to the reduction of healthcare costs. However, modification of existing treatment modalities or development of novel therapeutic options is still necessary to increase the clinical effectiveness. Hereby treatment options that have been tested in larger synovial joints may serve as a starting point. However, thoroughly testing of these treatment modalities in the TMJ itself remains needed, because differences in pathophysiology between the TMJ and other joints may influence the clinical results.