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METHOD OF TREATING INFLAMMATORY AND DEGENERATIVE-DYSTROPHIC DISEASES OF TEMPOROMANDIBULAR JOINT
METHOD OF TREATING INFLAMMATORY AND DEGENERATIVE-DYSTROPHIC DISEASES OF TEMPOROMANDIBULAR JOINT
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机译：治疗颞下颌关节炎性和退化性营养不良的方法
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摘要
FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to surgical dentistry and maxillofacial surgery, and can be used in treating inflammatory and degenerative-dystrophic diseases of temporomandibular joint. That is ensured by administering non-steroidal anti-inflammatory drugs in the presence of severe pain syndrome. Performing preoperative pre-medication. Marking of needle insertion points is applied onto skin, followed by intraarticular injection of the preparation. Intra-articular injection of the preparation is performed in the position of the patient lying on his/her back on a couch or sitting in a dental chair with a head tucked back resting on the headrest. Contours of the temporomandibular joint are palpated to determine the position of the articular condyle of the lower jaw, wherein the patient performs lower jaw movements – backward and forward, left and right, and opens and closes the mouth. It is followed with antiseptic treatment of the skin of the parotid masticatory region and auricle region and applied on the skin of the needle insertion point. First point is applied in a projection of the articular muscle of a mandibular process of the lower jaw of the temporomandibular joint at distance of 15 mm from a goat point along a line extending from it to a lower-external angle of the eye, and 2 mm below this line. Artho-centric needles for anesthesia and intra-articular introduction of the preparation are receded from the first point towards auricle at 3 mm, towards eye at 7 mm, in the caudal direction by 5 mm, in the capillary direction by 5 mm. Four points serve to introduce the preparation into paraarticular tissues around the articular head. Arthrocenesis needle is pricked into the first point in the projection of the articular muscle of the mandibular process of the lower jaw of the temporomandibular joint until it stops in the articular head. When the arthocenesis needle is immersed, mixture of 2.0 ml of 2 % lidocaine hydrochloride and 0.5 ml of 0.1 % adrenaline is continuously injected. When the end of the arthrocentosis needle of the articular head touches, the anesthetic delivery is terminated and the syringe with the needle is pulled by 2 mm towards itself. Exposition after anesthesia is 2 minutes. Anesthetic syringe is then detached from the arthrotcentric needle; a syringe is inserted into the needle for the intra-articular injection of the synovial fluid implant with 2 % hyaluronic acid to be injected in amount of 1.0–1.5 ml for 15 seconds. In 10–20 minutes in para-articular tissues around the articular muscle of the mandibular process of the lower jaw of the temporomandibular joint in four points is administered an autoblood preparation, which is prepared by preliminary sampling from the vein of patient 10 min before the operation of autoblood 18–20 ml, which is centrifuged at 3,600 rpm for 8 minutes with isolation of the supernatant in the form of plasma enriched with thrombocytes containing growth factors. 2.0 ml is taken from the lower half of the volume of the supernatant, which is introduced paraarticularly in 0.5 ml into each of four points; a pressure bandage is applied for up to 4 hours from the moment of intervention.;EFFECT: method provides effective treatment of the given pathology ensured by regeneration of the intrinsic layer of synoviocytes of the temporomandibular joint caused by synergetic action of hyaluronic acid and plasma enriched with thrombocytes, minimizing the risk of joint cavity infection due to one puncture of the joint cavity.;1 cl, 2 dwg, 2 ex
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