| description: |
Temporomandibular joint (TMJ) disorders are a major cause of patient pain and dysfunction and need an important focus of attention by health care providers. The main aims and research hypothesis of the project are as follows: 1) To estimate the role of cytokines (TNF alfa, interleukin 1 alfa and beta, matrix metalloproteinase-3 (MMP-3) in the pathogenesis of temporomandibular joint arthritis to find out wether cytokines enhance the production of MMP-3 in the synovial fluid of TMJ. 2) To find out the role of inflammatory mediators prostaglandin E2, leukotrien B4 and serotonin (5-HT) in the pathogenesis of TMJ arthritis. 3) To investigate the relation between the inflammatory mediators and cytokines versus TMJ radiographic changes in patient with TMJ disorders. 4)On the basis of the results the evidence based treatment of TMJ arthritis using conservative or surgical treatment by means of arthcentesis or arthoscopy is performed. The level of the above mentioned cytokines and mediators in synovial fluid will be determined before treatment and 6-12 months after treatment. The study group will be 40 patients with TMJ arthritis and 15-20 healty subjects. The relation between the inflammatory mediators and cytokines versus TMJ radiographic changes in patients with TMJ disorders is to be investigated. Computerized image analysis system worked out by us (Leibur etal. 1995; 1997) will be used for estimation of bone changes. The effect of granisetron (5-HT3) antagonist (Voog et al. 2000) and Clotam (acidum tolphenamicum), ihibits the synthesis of PGE2 and LkB4, will be estimated in the treatment of TMJ arthritis. For arthroscopy for diagnostic and treatment purposes the scoring intensity of synovitis is estimated by McCain et al. (1991) scoring system. The results of this research will be inroduced for the evidence based treatment of TMJ arthritis using conservative or surgical teratment by means of arthcentesis or arthroscopy. |