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Prevalência e perfil de cefaleia em estudantes adolescentes de 10 a 19 anos na cidade de Benin: um estudo transversal
No full textIntroductionAdolescent headaches significantly impact their daily functioning, academic performance, and quality of life. The occurrence of headaches is influenced by genetics, psychological stressors, and environmental exposures. Understanding these influences is crucial for effective management strategies.AimTo determine the prevalence, characteristics, and associated factors of headaches among school-going adolescents in Benin City, Nigeria.MethodsThis was a descriptive cross-sectional study among secondary school students. Using a structured questionnaire, data on sociodemographics, headache characteristics, triggers, and impacts were collected. The chi-square test was used to assess the association between the presence of headaches and categorical covariates. All analyses used a significance level of p<0.05.ResultOf the 486 respondents 235 (48.4%) were boys and 251 (48.3%) were girls with a M:F ratio of 1:1.07. The mean age of the study participant was 13.7 (+ 1.78) years. The one-year prevalence of headache was 84%. 92 (18.9%) of those reporting headaches met the diagnostic criteria for chronic daily headache. The most common impact of headache was poor concentration (110; 22.6%). Psychological stress (55.3%) and poor sleep (26.1%) were the most commonly reported headache triggers.ConclusionMore than four in five school-going adolescents have headache at one time in the past year. Reading and concentration problems are the most common adverse effect of headache in adolescents.IntroduçãoAs dores de cabeça em adolescentes afetam significativamente seu funcionamento diário, desempenho acadêmico e qualidade de vida. A ocorrência de dores de cabeça é influenciada por fatores genéticos, estressores psicológicos e exposições ambientais. Compreender essas influências é crucial para estratégias de manejo eficazes.ObjetivoDeterminar a prevalência, características e fatores associados às dores de cabeça entre adolescentes que frequentam a escola em Benin City, Nigéria.MétodoEste foi um estudo descritivo transversal entre estudantes do ensino secundário. Utilizando um questionário estruturado, foram coletados dados sociodemográficos, características das dores de cabeça, gatilhos e impactos. O teste qui-quadrado foi usado para avaliar a associação entre a presença de dores de cabeça e covariáveis categóricas. Todas as análises utilizaram um nível de significância de p<0,05.ResultadoDos 486 respondentes, 235 (48,4%) eram meninos e 251 (51,6%) eram meninas, com uma razão M de 1:1,07. A idade média dos participantes do estudo foi de 13,7 (+ 1,78) anos. A prevalência de um ano de dor de cabeça foi de 84%. 92 (18,9%) daqueles que relataram dores de cabeça atenderam aos critérios diagnósticos para dor de cabeça crônica diária. O impacto mais comum da dor de cabeça foi a falta de concentração (110; 22,6%). Estresse psicológico (55,3%) e sono inadequado (26,1%) foram os gatilhos de dor de cabeça mais comumente relatados.Conclusão Mais de quatro em cada cinco adolescentes que frequentam a escola tiveram dor de cabeça em algum momento no ano passado. Problemas de leitura e concentração são os efeitos adversos mais comuns da dor de cabeça em adolescentes
Questionnaires used to assess the quality of life of patients with migraine and other headache disorders: an integrative review
No full textIntroductionAccording to the World Health Organization (WHO), quality of life is an individual\u27s perception of their position in life in the context of the culture and value system in which they live and in relation to their goals, expectations, standards and concerns. Despite the subjectivity, quality of life may be measured through some assessment instruments in various diseases, including migraine and other headache disorders. Objective: This study aimed to review the main instruments used to assess the quality of life of patients with migraine and/or other headache disorders. MethodThis was an integrative literature review using articles with historical data on the main instruments used to assess the quality of life of patients with migraine or other headache disorders. ResultsSeven instruments for assessing the quality of life in patients with headache and other disorders were described. They were: Migraine Disability Assessment Scale (MIDAS), Headache Impact Test (HIT-6), Headache Disability Index (HDI), Short Form Health Survey (SF 36), Migraine Specific Quality of Life Questionnaire (MSQ), Migraine Severity (MIGSEV), and Migraine Functional Impact Questionnaire (MFIQ). ConclusionThe quality of life of patients with headache may be compromised, but despite its subjectivity, it can be measured through assessment instruments.Introdução: Segundo a Organização Mundial da Saúde (OMS), qualidade de vida é a percepção do indivíduo sobre sua posição na vida no contexto da cultura e sistema de valores em que vive e em relação aos seus objetivos, expectativas, padrões e preocupações. Apesar da subjetividade, a qualidade de vida pode ser mensurada por meio de alguns instrumentos de avaliação em diversas doenças, incluindo enxaqueca e outros transtornos de cefaleia. Objetivo: Este estudo teve como objetivo revisar os principais instrumentos utilizados para avaliar a qualidade de vida de pacientes com enxaqueca e/ou outros transtornos de cefaleia. Método: Trata-se de uma revisão integrativa da literatura utilizando artigos com dados históricos sobre os principais instrumentos utilizados para avaliar a qualidade de vida de pacientes com enxaqueca ou outros transtornos de cefaleia. Resultados: Foram descritos sete instrumentos para avaliação da qualidade de vida em pacientes com cefaleia e outros transtornos de cefaleia. Foram eles: Migraine Disability Assessment Scale (MIDAS), Headache Impact Test (HIT-6), Headache Disability Index (HDI), Short Form Health Survey (SF 36), Migraine Specific Quality of Life Questionnaire (MSQ), Migraine Severity (MIGSEV) e Migraine Functional Impact Questionnaire (MFIQ). Conclusão: A qualidade de vida de pacientes com cefaleia pode estar comprometida, mas apesar de sua subjetividade, ela pode ser mensurada por meio de instrumentos de avaliação
Local anesthetic infiltration and its points of application in the treatment of nummular headache: Case Report
Full text linkIntroduction
Nummular headache is a rare condition, and it is often difficult to control with therapies used to manage pain. It is known that the use of local anesthetic is a possibility as prophylaxis, but, until now, there is no description of which points should be infiltrated in the affected region.
Objective
In this case report we describe, for the first time, a possible technique to be used in the application of local anesthetic in patients with nummular headache, in the painful area.
Case Report
A 73-year-old woman came for evaluation due to a headache that had started four months ago. The pain was acute, of strong intensity, located in the right parieto-occipital region, rounded in shape and measuring 1,9685 inches in diameter. The attacks were interspersed with asymptomatic periods, lasted an average of 5 minutes, and were described as a burning sensation and shock, followed by pre-syncope or even syncope after intense pain. During physical examination, the patient reported a burning sensation when touched in the area of pain (dysesthesia), without other changes. Laboratory tests, cerebral magnetic resonance imaging and intracranial arterial angiography were requested, all with results within normal limits. After attempts to use gabapentin and indomethacin, drugs not tolerated by the patient even in subdoses due to adverse effects, blockage of greater and lesser occipital nerves ipsilateral to the pain, associated with the application of bupivacaine without vasoconstrictor (0.5 ml/point) in the affected region were done. The technique used in the coin-shaped area was carried out using five infiltration points, one in the central region and the others distributed in the periphery. The patient reported having no headaches at the first reassessment (carried out 2 weeks after the procedure), and remained headache-free for the 6-month period during which she was monitored.
Conclusion
Local anesthetic infiltration should be considered in patients with nummular headache. The technique described above is easily applicable, has a lower cost, as well as low potential for side effects
Magnitude of the founder effect for migraine in exomes of the Mennonite population
Full text linkThe Mennonite population has been genetically isolated for about 500 years since the Anabaptist movement. Due to political-religious conflicts, the population has experienced three significant reductions in size (bottleneck events), leading to increased inbreeding, a small number of couples contributing to the next generation (founder effect), and susceptibility to chronic diseases such as migraine. In this study, we screened 325 exomes of South Brazilian Mennonites (SBM: 131 from Curitiba - PR and 194 from Colônia Nova - RS) for variants previously associated with migraine in genome-wide association studies (GWAS database). Among 244 headache-associated variants, we found 9 in SBM. We further compared their frequencies with those of the non-Finnish European population (EURO, N=589,961), the Amish (N=456), and the Brazilian population (BR, N=1,171), using the gnomAD v4.1.0 and ABraOM databases, correcting p-values for multiple testing using the False Discovery Rate method and evaluating possible associations with gene expression using GTEx portal. The nine variants occur in the HJURP, ANAPC4, IRAG1, CHRM4, and AMN genes, with four occurring in the RNF213 gene. The frequencies of three polymorphisms differed between SBM vs. EURO (founder effect), eight between SBM and Amish (genetic drift effect), and seven between SBM and BR (possible epidemiological relevance). The only protective variant was a benign aminoacid substitution (p.Arg465Gln), associated with lower expression of the ANAPC4 gene in several brain regions. Three RNF213 variants form a susceptibility haplotype, found more frequently in SBM than in Amish and BR (p=0.045). The benign p.Ser2383Asn (rs9674961) variant is among them, being also associated with lower RNF213 expression in the frontal cortex (p=0,03). Mutations in this gene further cause progressive cerebral angiopathy in the Moyamoya syndrome. In conclusion, we observed a founder and genetic drift effect for headache-associated variants among the Mennonite population. Further studies are needed to validate these genes\u27 actions and the potential impact of these variants on migraine development. A população menonita foi geneticamente isolada por cerca de 500 anos, desde o movimento anabatista. Devido a conflitos político-religiosos, a população experimentou três reduções significativas de tamanho (eventos de gargalo), levando ao aumento da endogamia, um pequeno número de casais contribuindo para a próxima geração (efeito fundador) e suscetibilidade a doenças crônicas, como a enxaqueca. Neste estudo, rastreamos 325 exomas de menonitas do sul do Brasil (SBM: 131 de Curitiba - PR e 194 de Colônia Nova - RS) para variantes previamente associadas à enxaqueca em estudos de associação genômica ampla (banco de dados GWAS). Entre 244 variantes associadas à cefaleia, encontramos 9 na SBM. Além disso, comparamos suas frequências com as da população europeia não finlandesa (EURO, N=589.961), da população Amish (N=456) e da população brasileira (BR, N=1.171), usando as bases de dados gnomAD v4.1.0 e ABraOM, corrigindo os valores de p para testes múltiplos usando o método False Discovery Rate e avaliando possíveis associações com a expressão gênica usando o portal GTEx. As nove variantes ocorrem nos genes HJURP, ANAPC4, IRAG1, CHRM4 e AMN, sendo que quatro ocorrem no gene RNF213. As frequências de três polimorfismos diferiram entre SBM vs. EURO (efeito fundador), oito entre SBM e Amish (efeito deriva genética) e sete entre SBM e BR (possível relevância epidemiológica). A única variante protetora foi a substituição benigna de aminoácidos (p.Arg465Gln), associada à menor expressão do gene ANAPC4 em várias regiões cerebrais. Três variantes do RNF213 formam um haplótipo de suscetibilidade, encontrado mais frequentemente em SBM do que em Amish e BR (p=0,045). O p. benigno.A variante Ser2383Asn (rs9674961) está entre elas, estando também associada à menor expressão de RNF213 no córtex frontal (p=0,03). Mutações nesse gene causam angiopatia cerebral progressiva na síndrome de Moyamoya. Em conclusão, observamos um efeito fundador e de deriva genética para variantes associadas à cefaleia entre a população menonita. Mais estudos são necessários para validar as ações desses genes e o potencial impacto dessas variantes no desenvolvimento da enxaqueca
Cefaleia Associada à DTM: Análise de Fatores de Risco e Implicações Clínicas
No full textThe term temporomandibular disorder (TMD) encompasses a set of conditions affecting the masticatory muscles, the temporomandibular joint (TMJ), and associated structures. Headache often appears as a painful comorbidity in patients with TMD. Headaches are categorized as primary and secondary, the latter being when there is a known disorder that can trigger the headache, and primary when no underlying disease is identified. Frequently, patients with TMD report headaches, and these should be properly diagnosed to avoid treatment failure. Thus, the aim of this study was to assess the risk factors associated with the presence of headache attributed to TMD in individuals with different subtypes of TMD. Sixty-eight individuals with TMD were evaluated, of whom 55 reported “pain in the temples,” but only 28 were diagnosed with headache attributed to TMD according to DC/TMD criteria. Two groups of TMD patients were formed: with (n=28) and without (n=40) headache attributed to TMD. There was no significant difference in age or gender between the groups studied. The presence of the complaint of "pain in the temples" increased the likelihood of a diagnosis of headache attributed to TMD by 27.98%. Oral behaviors, such as awake bruxism and hypertrophy of the temporal muscle, were associated with the presence of this headache. No significant associations were found between other specific TMD diagnoses and headache attributed to TMD (p>0.05). A higher average of oral behaviors in general (p=0.008) and non-functional oral behaviors (p=0.02) were observed in individuals with headache attributed to TMD. Regression analysis showed that the presence of non-functional oral behaviors and hypertrophy of the temporal muscle significantly impacted the probability of an individual having a headache attributed to TMD (x2= 9.76, p=0.007; R2N=0.183). These findings highlight the importance of properly evaluating the presence of oral behaviors and their clinical signs, as their presence negatively impacts the occurrence of headache attributed to TMD and represents a risk factor for its development.O termo disfunção temporomandibular (DTM) abrange um conjunto de condições que afetam os músculos mastigatórios, a articulação temporomandibular (ATM) e estruturas associadas. A cefaleia frequentemente aparece como uma comorbidade dolorosa em pacientes com DTM. As cefaleias são categorizadas em primárias e secundárias, com as últimas sendo quando há um distúrbio conhecido que pode desencadear a cefaleia, e primárias, quando não há uma doença subjacente identificável. Frequentemente, pacientes com DTM apresentam queixas de dor de cabeça e esta deve ser devidamente diagnosticada para que não haja falha no tratamento. Assim, o objetivo deste estudo foi avaliar os fatores de risco associados à presença de cefaleia atribuída à DTM em indivíduos com diferentes subtipos de DTM. Foram avaliados 68 indivíduos com DTM, dos quais 55 relataram “dor nas têmporas”, mas apenas 28 foram diagnosticados com cefaleia atribuída à DTM de acordo com os critérios do DC/TMD. Foram formados dois grupos de pacientes com DTM: com (n=28) e sem (n=40) cefaleia atribuída à DTM. Não houve diferença significativa de idade ou sexo entre os grupos estudados. A presença de queixa de "dor nas têmporas" aumentou em 27,98% a chance de diagnóstico de cefaleia atribuída à DTM. Comportamentos orais, como bruxismo em vigília, e hipertrofia do músculo temporal foram associados à presença dessa cefaleia. Não foram encontradas associações significativas entre outros diagnósticos específicos de DTM e a cefaleia atribuída à DTM (p>0,05). Observou-se uma média maior de comportamentos orais em geral (p=0,008) e de comportamentos orais não funcionais (p=0,02) em indivíduos com cefaleia atribuída a DTM. A análise de regressão mostrou que a presença de comportamentos orais não funcionais e de hipertrofia do músculo temporal, impactam significativamente na probabilidade de o indivíduo apresentar cefaleia atribuída à DTM (x2= 9,76, p=0,007; R2N=0,183). Esses achados apontam a importância de avaliar corretamente a presença de comportamentos orais e seus sinais clínicos, pois sua presença impacta negativamente na presença da cefaleia atribuída a DTM e representa um fator de risco para seu desenvolvimento
Inglês
No full textIntroduction:
Acetazolamide is a carbonic anhydrase inhibitor widely used in the treatment of idiopathic intracranial hypertension (IIH), a condition characterized by increased intracranial pressure without detectable apparent cause, often resulting in symptoms such as headache, papilledema, and transient visual loss. The efficacy of acetazolamide in managing IIH has been demonstrated in various clinical studies, notably improving patients\u27 symptoms and playing a crucial role in preventing long-term visual complications. The therapeutic approach with acetazolamide is generally well-tolerated, although side effects such as paresthesia, fatigue, and changes in taste may occur.
Objective:
In the present study we aimed to assess the results with Acetazolamide in a real-life cohort of Brazilian patients
Methods:
The data of IIH patients treated at Santa Casa since 2019 were evaluated, with information obtained during consultations and from medical records. Sociodemographic and clinical data were collected. The outcomes assessed were headache attributed to HII, pulsatile tinnitus, reduced visual acuity, diplopia, and papilledema before and after treatment with acetazolamide. Comparisons were made using the chi-square test.
Results:
Forty patients were included, all of them were female. The mean age was 33.9±11.5 years. Twenty-two patients were obese, 10 were overweight, and in 8 this information was not obtained. The mean BMI was 33,5±4,3. The mean follow-up time was 55.4±48.4 days. The mean Acetazolamide dose was 972.2±523.6. Six patients reported side effects (paresthesias=6 and dizziness and tinnitus=1) with four of them discontinuing acetazolamide, which was replaced by topiramate.
The frequencies of observed evaluated outcomes were: headache (90%x0%, P<0.0001); low visual acuity (75% x 50%, P=0.02); papilledema (75.7% x 54.5%, P=0.001); diplopia (33.3% x 25%, P=0.006); and tinnitus (27.8% x 0%, P=0.0007).
Conclusion:
The data confirm the good tolerability and efficacy of acetazolamide, which was discontinued in only 10% of cases. All patients who continued the medication had a satisfactory response, with resolution of headache and tinnitus. Regarding neuro-ophthalmological outcomes, there was significant improvement in all evaluated parameters. Our data support that this medication should be promptly introduced in patients diagnosed with IIH
Anormalidades na ressonância magnética na hipertensão intracraniana idiopática: um estudo com 40 pacientes do sexo feminino
No full textIntroduction
Idiopathic intracranial hypertension (IIH) is a condition characterized by increased intracranial pressure with no detectable cause. MRI is an importat tool in diagnosing and understanding IIH, providing insights into the anatomical changes associated with this condition. This study aims to describe the MRI findings in a cohort of 40 female patients diagnosed with IIH.
Objective
To evaluate the frequency and type of abnormalities detected on MRI in female patients with IIH.
Methods
We conducted a retrospective analysis of MRI findings in 40 female patients diagnosed with IIH. The average age of the patients was 33.9 years (standard deviation of 11.5 years). The MRI abnormalities evaluated included sella turcica deformities, optic nerve abnormalities (including optic nerve tortuosity, distended optic nerve sheath, and optic nerve head protrusion), globe flattening, and transverse sinus stenosis. The data were analyzed to determine the prevalence of each abnormality. All the patients were evaluated at the Headache Outpatient Clinic of Santa Casa de Misericórdia de São Paulo.
Results
The analysis revealed the following abnormalities:
Sella turcica deformities in 14 patients (35%)
Optic nerve abnormalities in 35 patients (87.5%)
Globe flattening in 8 patients (20%)
Transverse sinus stenosis in 14 patients (35%)
Conclusion
Our study demonstrates that optic nerve abnormalities are the most frequent MRI finding in female patients with IIH, observed in 87.5% of cases. This is a higher frequency compared to sella turcica deformities, which were present in 35% of the patients. These findings differ from other series in the literature, where sella turcica abnormalities are often reported as more common. This highlights the variability in anatomical manifestations of IIH and underscores the importance of comprehensive MRI evaluation in these patients
Characterization of adult patients with a diagnosis of migraine and osmophobia: the osmograine study
Full text linkIntroductionOsmophobia is associated with a greater intensity of the headache, a more significant presence of affective symptoms, and the appearance of cutaneous allodynia.ObjectivesTo determine the sociodemographic and clinical characteristics of patients with episodic and chronic migraine associated with osmophobia.MethodsA cross-sectional analytical observational study, 100 patients were included.Results65% of the patients presented osmophobia, 64.6% of patients with osmophobia had chronic migraine, and 35.4% had episodic migraine without statistically significant differences p=0.120. Regarding the clinical characteristics, pulsatile pain was the most frequent in 49%, and severe intensity was present in 81%. Statistically significantrelationships were found between osmophobia and photophobia [(95.4 vs 77.1]; p=0.005), phonophobia ([96.9 vs 74.3); p=0.001) and allodynia ([75.4 vs 45.7); p=0.002). The that become chronic factors were more frequent in the group with osmophobia, in which an association with the excessive use of analgesics ([43.8%vs. 22.9%]; p=0.029) and a history of anxiety and depression ([32.8% vs. 14.3%]; p=0.045). In the multivariate model, the variables associated with osmophobia with statistically significant differences were photophobia, allodynia, and botulinum toxin application.ConclusionsIn this first study of osmophobia in migraine in Colombia, osmophobia is a frequent symptom in patients with chronic migraine; it has related to markers of central sensitization; it is also related to that become chronic factors and the use of botulinum toxin. Therefore, it is likely that osmophobia can predict the risk of that factor, causing the disease to become chronic.Introducción: La osmofobia está asociada a una mayor intensidad de cefalea, presencia más significativa de síntomas afetivos y aparición de alodinia cutánea.
Objetivos: Determinar las características sociodemográficas y clínicas de pacientes con enfermedad episódica y crónica asociada a osmofobia.
Métodos: estudio observacional analítico transversal, foro incluido 100 pacientes.
Resultados: 65% de los pacientes presentaban osmofobia, 64,6% de los pacientes con osmofobia presentaban encefalitis crónica y 35,4% presentaban encefalitis episódica sin diferencias estadísticamente significativas p=0,120. En cuanto a las características clínicas, el dolor pulsátil fue más frecuente en un 49%, mientras que la intensidad intensa estuvo presente en un 81%. Se encontraron relaciones estadísticamente significativas entre osmofobia y fotofobia [(95,4 vs 77,1]; p=0,005), fonofobia ([96,9 vs 74,3); p=0,001) y alodinia ([75,4 vs 45,7); p=0,002). Los factores que se vuelven crónicos son más frecuentes en el grupo con osmofobia, en el que se observó una asociación con el uso excesivo de analgésicos ([43,8% vs. 22,9%]; p=0,029) y antecedentes de ansiedad y depresión ([ 32,8% vs. 14,3%]; En el modelo multivariado, las variables asociadas a la osmofobia con diferencias estadísticamente significativas fueron fotofobia, alodinia y aplicación de toxina botulínica.
Conclusiones: En el primer estudio sobre la osmofobia a la enjaqueca en Colombia, la osmofobia es un síntoma frecuente en pacientes con enjaqueca crónica; relacionaros con marcadores de sensibilización central; También está relacionado con factores crónicos y el uso de toxina botulínica. Por lo tanto, es demostrable que la osmofobia puede prevenir el riesgo de este factor, haciendo que la enfermedad se vuelva crónica
Epidemiological analysis of hospitalizations for headache in women at menacme in Brazil, between 2019 and 2023
Full text linkIntroduction: Headache is considered the second most frequent type of pain worldwide, generating high costs for patients and health services as a whole. According to the Brazilian Academy of Neurology, women are more likely to develop headache compared to men, a reason attributed to hormonal cycles. Objectives: To describe the number of hospitalizations due to headaches in women at menacme in Brazil between 2019 and 2023. Method: This is a descriptive cross-sectional study, using data collection from the SUS Hospital Information System (SIH/SUS), linked to the Department of Informatics of the Unified Health System (DATASUS) in may 2024. The numbers of hospital admissions for migraine and other cephalic pain syndromes in women at menacme in the 2019-2023 period were analyzed. The variables used were: Age group, gender, year of hospitalization, race/color, average value of hospitalizations, and federation unit/region. Results: During this period, 22,649 hospitalizations for headaches were recorded in women at menacme. Of this total, the Southeast region concentrated the highest number of hospitalizations (32.3%, 7,333), and the state of São Paulo accounted for 61.9% of the cases. The year 2019 had the highest number of records (5,333), followed by 2023, with 4,975 cases. It was observed that headaches predominated in brown races/skin color in the North, Northeast and Midwest regions, which corresponded to 43% of the cases in Brazil. The predominant age group was 30-39 years (28.7%, 6,504). The South region had the highest average hospitalization value (465.72 reais). Conclusion: In view of the analysis, there was a drop in hospitalizations from 2019 onwards, with a new increase in 2023. It was observed that the highest epidemiological profile is related to the Southeast region, especially the state of São Paulo, with brown skin color and age group between 30 and 39 years. The South region was responsible for the highest average number of hospitalizations. Therefore, this conclusion will be valid for the creation of public policies aimed at the prevention and treatment of headache in women at menacme
The Comparative effectiveness of double-puncture versus single-puncture type 2 arthrocentesis in long-term management of tmj disc displacement without reduction
Full text linkIntroduction:Temporomandibular joint (TMJ) disc displacement without reduction (DDWOR) is a prevalent condition causing significant pain and functional impairment. Arthrocentesis is a minimally invasive procedure frequently employed to manage this condition. This study aims to compare the clinical effectiveness of conventional double-puncture versus single-puncture type 2 arthrocentesis for the management of TMJ DDWOR after 3 years of follow-up.
Objective: To evaluate and compare the long-term outcomes of TMJ arthrocentesis using conventional double-puncture versus single-puncture type 2 techniques in patients with DDWOR.
Methods: A total of 26 patients diagnosed with DDWOR were randomly and blindly allocated into two treatment groups (n = 13 each). Group 1 underwent conventional double-puncture arthrocentesis, while Group 2 received single-puncture type 2 arthrocentesis. Data on gender, side of painful joint complaint, age (years), duration of joint pain (months), maximum interincisal distance (MID, mm), and pain intensity (self-reported using a 0–10 visual analog scale [VAS]) were collected. VAS scores and MID were measured before (baseline) and 3 years after (final) the arthrocentesis.
Results: Twenty-three patients completed the study (Group 1, n = 11; Group 2, n = 12). Both techniques resulted in significantly reduced VAS scores and increased MID (P = .001) after the 3 years of follow-up. However, there were no statistically significant differences between the two techniques (P > 0.05).
Conclusion: The findings indicate that both conventional double-puncture and single-puncture type 2 arthrocentesis are effective in reducing pain (as measured by VAS scores) and improving mouth opening (as measured by MID) in patients with TMJ DDWOR. Despite the lack of significant differences between the two techniques, both methods provided substantial clinical benefits over the 3-year follow-up period. This suggests that either technique can be successfully utilized for the long-term management of TMJ DDWOR, offering clinicians flexibility in treatment choices based on patient needs and clinical circumstances.