TEMPOROMANDIBULAR DISORDERS - CLINICAL AND LABORATORY ANALYSES FOR RISK ASSESSMENT OF CRITERIA FOR SURGICAL THERAPY, A PILOT-STUDY

Temporomandibular disorder (TMD) is a broad category involving dysfunc tion of the skeletomuscular structures of the head and neck, and the t emporomandibular joint (TMJ), A total of 66 patients, 54 with TMD, par ticipated in this study, Group 1 (G1) had 31 patients suffering from e arly to intermediate stage disease, and no prior surgeries. G1 patient s had arthrotomy/meniscectomy performed on the diseased joint(s). Grou p 2 (G2) consisted of 23 patients with late stage disease, All G2 pati ents had previously had unsuccessful TMJ surgery and were treated with either a partial or total joint prosthesis. Group 3 (G3) consisted of 12 patients who were clinically and radiographically asymptomatic, Me dical histories including inflammatory bowel disease, headaches, verti go, tinnitus and anemia, as well as surgical tonsillectomies, appendec tomies and cholecystectomies, were significantly greater in G1 and G2 when compared to G3, Serological testing included HLA subtype, positiv e (ANA) antinuclear antibody, erythrocyte sedimentation rate (ESR), an emia profile, hormonal levels of prolactin and estradiol, and rheumato id factor (RF), HLA frequencies, as well as some serological analyses, were significantly different among the three groups, These findings s uggest that surgical failure may be secondary to autoimmune dysfunctio n with a predisposition to multisystem disease, The utilization of gen etic markers, serological testing, and thorough medical and surgical h istories should allow the clinician to determine which patients are po tentially better surgical risk candidates for treatment of TMD.