A comparative study of the effect of transcutaneous electrical nerve stimulation(TENS) and Arthrocentesis methods in the treatment of TMJ joint disorders after orthognathic treatment in patients with dentofacial disorders

Comparing the effect of two treatment methods, Arthrocentesis and electrical stimulation of nerves through the skin (TENS), on the complications caused by temporomandibular joint disorders in patients who have already undergone orthognathic treatment

Clinical trial, parallel groups, double-blind, randomized, on 30 patients. The rand function of Excel software was used for randomization

This clinical trial study is conducted on patients who refer to the maxillofacial surgery department of Taleghani Hospital. Informed consent will be obtained from all patients. Demographic information of patients will be recorded. The patient and the examiner will be blinded. For the first group, arthrocentesis is performed with the help of two angiokets in the upper joint space with normal saline and corticosteroids, and for the second group (TENS)is performed. the factors of pain level, maximum mouth opening, latrusive and protrusive movements are recorded immediately, after 2weeks and1month by a blind examiner and the results are compared blindly.

Inclusion criteria: male and female patients aged 17 to 40 who have undergone orthognathic surgery and have symptoms in the Temporomandibular joint including pain, restriction in mouth opening and joint noises. Exclusion criteria: systemic musculoskeletal disease; fibromyalgia; previous or current history of cancer; pregnancy; history of radiotherapy and chemotherapy; use of partial and complete prosthesis; history of psychosomatic problems.

For the first group, Arthrocentesis is performed with normal saline and corticosteroids, and for the second group,(TENS) is performed with the help of a device.

The intensity of pain measured by using (VAS), maximum opening of the mouth, the amount of latrusive and protrusive movements

First, people are randomly divided into two groups with the help of software (OpenClinicaRandomize). The randomization method is block type. For all of them, primary conservative methods including warm compress, massage, soft diet and preventing mouth opening have been done. For both groups, the treatment process is explained, and if they accept the treatment, informed consent is obtained from them. For the first group, arthrocentesis treatment by two angiokets with injection of normal saline and corticosteroids is used, and for the second group, transcutaneous electrical nerve stimulation treatment is used through the skin.Factors such as the amount of pain, maximum opening of the mouth, lateral and protrusive movements, as well as the amount of rotation of the occlusal plate in orthognathic treatment, the amount of advancement or setback of the mandible, and the type of orthognathic treatment are recorded for each patient before starting the treatment, and the factor of Pain level, maximum mouth opening and the maximum lateral and protrusive movements are recorded immediately, after 2 weeks and 1 month, and the results are compared blindly

The evaluation of the factors of pain level, maximum opening of the mouth and lateral movements and protrusive movements will be done immediately and after 2 weeks and 1 month by an examiner who is unaware of the study groups and the surgical process of each group.