Syftet med denna studie var att jämföra tre års resultat av enbart lokalanestesi jämfört mot lokalanestesi ochspolning i käkledenpå patienter som lider av smärtande diskdisplacering utan reduktionStudien utfördes från 2003 till 2007 och 45 patienter valdes från sammanlagt 55 utvalda patienter för behandling av TMD till avdelningen för Klinisk bettfysiologi, Odontologiska fakulteten, Malmö högskola, Sverige.Frågeformulär och klinisk undersökning enligt Research Diagnostic Criteria(RDC/TMD), panorama röntgenbilder och magnetisk resonanstomografi utfördes vid start av studien. Tre år efter behandling, sändes ett frågeformulär till 37 patienter.Intensiteten av smärta, fysisk funktion, känslomässig funktion och global förbättring utvärderades.Tjugofyra patienter randomiserades till behandling med lokalanestesi och tjugo patienter randomiserades till behandling med lokalanestesi och spolning. Trettiofyra patienter besvarade enkäten vid 3-års uppföljningen. I en intention-to-treat analys visade det huvudsakliga resultatet att 28/45(62%) hade fått 30% smärtlindring vid uppföljningen. Inga signifikanta skillnader fanns mellan grupperna lokalanestesi och lokalanestesi och spolning avseende smärtlindring, fysisk funktion, känslomässig funktion och global förbättring. Det fanns signifikanta förbättringar (P< 0.05) inom båda grupperna avseendesmärtintensitet, fysisk funktion och emotionell funktion och global förändring vid uppföljning jämfört med start av studien.Eftersom det inte fanns någon skillnader mellan grupperna lokalanestesi och spolningoch enbart lokalanestesii käkleden tre år efter behandling av smärtsam diskdisplacering utan återgång, kan spolning av käkleden ifrågasätts. / The aim of this prospective and longitudinal study was to compare three-year outcomes of local anesthetics compared to anesthetics, arthrocentesis and lavage on patients suffering from painful jaw locking in the TMJThe study was performed from 2003 until 2007 and 45 patients were selected from altogether 55 eligible patients referred for the treatment for TMD to the Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Sweden. History questionnaire and clinical examination according toResearch Diagnostic Criteria, panoramic radiographs and Magnetic Resonance Imaging were completed at baseline. A questionnaire was sent three years after treatment to 37 patients. Pain intensity, physical functioning, emotional functioning and global improvement were evaluated.Twenty-five patients were randomised to group anesthetics and 20 patients were randomised to group anesthetics, arthrocentesis and lavage. Thirty-four patients answered the questionnaire at the 3-year follow-up. In an intention-to-treat analysis the primary outcome, showing a ≥30% pain relief, was reported by 28 of 45(62%) patients at the follow-up. No significant differences in improvement were found between group local anesthetics and group anesthetics, arthrocentesis and lavage regarding pain relief, physical functioning, emotional functioning, and global improvement. Significant improvements(P<0.05) were found within both groups regarding pain intensity, physical functioning, emotional functioning and global changes at the follow-up compared to baseline.Since no differences were found between local anesthetics, arthrocentesis and lavage compared to local anesthetics alone of the TMJ three years after treatment of painful disc displacement without reduction, the use of arthrocentesis and lavage can be questioned.

Objective: To study the quality of life, jaw function and aesthetics in patients, at least 10 years after they have completed orthognathic treatment, in comparison with a control group. Material and Methods: The sample was retrieved from a previous study by Abrahamsson et al. The treatment group consisted of 94 consecutive patients (59 women and 35 men) with dentofacial deformities who were referred to Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden for orthognathic surgery. The average age of the treatment group was 22.4 ±7.6 years. The control group consisted of 53 individuals (30 women and 23 men, with mean age 23.4 ± 7.3) and was recruited from the Department of Oral Diagnostics in Dentistry University in Malmö and at the Public Dental Service in Oxie. A questionnaire including Oral health impact profile (OHIP-14), Jaw functional limitation scale (JFLS-8) and Orofacial aesthetic scale (OAS-8) supplemented with two questions directed to the treatment group was sent out to both the treatment and the control group. Result: The response rate was 57% (n=54) in the treatment group and 53% (n=28) in the control group. According to the result from OHIP-14 the quality of life was better in the treatment group in comparison with the control group. However, jaw function and orofacial aesthetics were comparable between the groups according to the results from JFLS-8 and OAS-8. The majority of the patients in this study were very satisfied with the result of orthognathic surgery at 10 years follow-up.Conclusion: Orthognathic treatment has been shown to be a successful treatment not only in term of jaw function and aesthetic but also in enhanced quality of life.