Auriculotemporal Nerve Block in TMJ Disorders

NCT04827784 | Completed

• 1 other identifier: GaziosmanpasaU2
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

The retrospective study aimed to evaluate the efficacy of the Auriculotemporal Nerve Block (ATNB) in achieving unrestricted mouth opening amount and in reducing the pain scores in those patients diagnosed with disc displacement with (DDWR) and without reduction (DDWOR) according to the Diagnostic Criteria for Temporomandibular Disorders, who could not benefit from noninvasive methods but did not want further invasion.

Conditions

Temporomandibular Joint Disorders; Arthralgia of TMJ

Keywords

Auriculotemporal nerve block; Temporomandibular disorders; Physiotherapy; Anesthesia; Local

Outcome Measures

Primary Outcomes (3)

• Baseline Pain Intensity

  Pain intensity was measured using a 10-point Visual Analog Scale (VAS), in which 0 referred to 'no pain', 5 referred to 'moderate pain,' and 10 referred to 'excruciating pain'. The patients were asked to mark their pain intensities on VAS scale.

  At the initial visit before starting anesthetic administration.

• Post-injection Pain Intensity

  Pain intensity was measured using a 10-point Visual Analog Scale (VAS), in which 0 referred to 'no pain', 5 referred to 'moderate pain,' and 10 referred to 'excruciating pain'. The patients were asked to mark their pain intensities on VAS scale.

  At six months follow-up visit

• Change From Baseline Maximal Mouth Opening on Post-Injection Follow Up Visits

  All patients' maximal mouth opening were measured and recorded as the distance between upper and lower right central incisors.

  At the first week, fourth week and sixth month.

Secondary Outcomes (1)

• Overall Satisfaction With The Applied Treatment

  At the six-month follow-up visit

Study Arms (1)

Auriculotemporal Nerve Block Administration

EXPERIMENTAL

A total of 3 doses of Auriculotemporal Nerve Block (ATNB) were administered to involved participants. Local anesthetic solutions containing Articaine Hydrochloride (80 mg / 2 ml) and epinephrine bitartrate (0.02 mg / 2 ml) were used for ATNB application. The injections were repeated on follow-up visits in the first and fourth weeks. The maximal mouth opening amounts, pain intensity values (via VAS scale), and self-reported outcomes were evaluated at the pre-injection, first week, fourth week, and sixth-month follow-up controls.

Procedure: local anaesthetic injection

Interventions

local anaesthetic injection PROCEDURE

The head and neck of the condyle were detected by palpating the pretragal area. Then, the needle was inserted anterior to the junction of the tragus and the lobule. After 0.5 ml the solution was subcutaneously infiltrated, the needle was protruded until it touched the neck of the condyle. Aspiration was performed to avoid intravenous injections, and the remaining solution was injected thereafter.

Auriculotemporal Nerve Block Administration

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Underwent non-invasive therapies (occlusal stabilization splints, behavioral modifications, physical therapy, pharmacotherapy) but did not benefit from them and volunteered for the ATNB instead of invasive therapies (arthrocentesis, arthroscopy, and discectomy).

You may not qualify if:

• Patients with
• Symptoms of the diseases possibly related to TMD (e.g., fibromyalgia, hypothyroidism, scleroderma, rheumatoid arthritis)
• Orofacial disorders that might have been responsible for the TMD symptoms (e.g., neuralgia, migraine, myositis, trauma, neuropathic pain, infections)
• Complications due to ATNB (e.g., temporary facial nerve palsy, hematoma, positive aspiration)
• History of invasive therapies or TMJ surgeries

Sponsors & Collaborators

• Tokat Gaziosmanpasa University: lead

Study Sites (1)

Tokat Gaziosmanpasa University, Faculty of Dentistry

Tokat Province, 60100, Turkey (Türkiye)

Location

Related Publications (3)

• NASCIMENTO, Mirella Marques Mercês do, et al. Anesthetic blockage of the auriculotemporal nerve and its clinical implications. Odontologia Clínico-Científica (Online), 2011, 10.2: 143-146.

  BACKGROUND

• Ayesh EE, Ernberg M, Svensson P. Effects of local anesthetics on somatosensory function in the temporomandibular joint area. Exp Brain Res. 2007 Jul;180(4):715-25. doi: 10.1007/s00221-007-0893-4. Epub 2007 Feb 15.

  PMID: 17588187 BACKGROUND

• Nascimento MM, Vasconcelos BC, Porto GG, Ferdinanda G, Nogueira CM, Raimundo RD. Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial. Med Oral Patol Oral Cir Bucal. 2013 Jan 1;18(1):e81-5. doi: 10.4317/medoral.17491.

  PMID: 23229236 RESULT

MeSH Terms

Conditions

Temporomandibular Joint Disorders

Interventions

Anesthesia, Local

Condition Hierarchy (Ancestors)

Craniomandibular Disorders; Mandibular Diseases; Jaw Diseases; Musculoskeletal Diseases; Joint Diseases; Muscular Diseases; Stomatognathic Diseases

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia

Study Officials

• Mehmet K. Tümer, AssocProfDr

  Alanya Alaaddin Keykubat University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Oral and Maxillofacial Surgeon

Model Details: Participants whose Temporomandibular disorders (TMD)-related complaints continued despite occlusal stabilization splint, NSAIDs and centrally acting muscle relaxant treatments were administered a total of 3 doses of Auriculotemporal Nerve Block (ATNB).

Study Record Dates

• First Submitted: March 27, 2021
• First Posted: April 1, 2021
• Study Start: January 15, 2020
• Primary Completion: September 23, 2020
• Study Completion: December 7, 2020
• Last Updated: April 1, 2021

Record last verified: 2021-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)