Diagnostic value of the temporomandibular joint tissue destruction predictors in traumatic mandibular condyle fractures

Abstract

Summary. Traumatic injuries of the mandible, in particular fractures, contusions directly affect the condition of its articular surfaces, structural elements and can cause persistent functional disorders. Timely diagnosis of damage to the temporomandibular joints, and especially their cartilage, is a necessary condition for successful treatment and helps to improve the prognosis in patients with joint diseases of various etiologies.

The aim of the study – to analize early diagnosis of damage to cartilaginous and bone components of the TMJ in traumatic fractures of the articular process of the mandible and to study the correlation of MRI results and biochemical parameters in the dynamics.

Materials and Methods. To study the degree of bone and cartilage damage of the TMJ, the level of pyridinoline (PID) and deoxypyridolin (DPID) was determined by enzyme-linked immunosorbent assay (ELISA) in urine samples of patients before treatment and for 21, 30 and 180 days after immobilization. MRI results of condylar fractures reliably indicate organic changes in the structural elements of the TMJ, both bone and soft tissue, but can only visualize their actual damage.

Results and Discussion. The results of biochemical parameters showed an increase in PID and DPID, confirming the destruction of both bone tissue and degradation of articular cartilage in traumatic fractures of the articular process of the mandible at the stage of pre-radiation diagnosis, at the stage of disease preceding focal changes.

Conclusions. The lack of complete and timely normalization of PID and DPID indicates the need to develop new treatment regimens for TMJ injuries in order to prevent the occurrence of post-traumatic osteoarthritis and ankylosis of the TMJ.