Pathophysiology
The study demonstrated that local use of U50,488, a specific kappa opioid receptor agonist, reduced key inflammatory markers such as plasma extravasation and neutrophil migration in the temporomandibular joint [PMID:21484425].
Management
In a study following 21 patients with 26 affected joints for up to 34.1 months, DO combined with gap arthroplasty significantly enhanced maximal mouth opening [PMID:32209271].
Administration of the kappa opioid receptor agonist U50,488 into the temporomandibular joint decreased formalin-induced plasma extravasation and neutrophil migration in a dose-dependent manner [PMID:21484425].
Complications
Post-operative follow-up revealed a high resorption rate of up to 59.4% in mandibular ramus height and 6.2 mm in Go-FN distance [PMID:32209271].
By targeting kappa opioid receptors locally, there is a possibility to mitigate inflammatory complications associated with temporomandibular joint disorders without the central side effects typical of systemic opioids [PMID:21484425].
Prognosis & Follow-up
During a mean follow-up period of 34.1 months, one patient (4.8%) experienced re-ankylosis, and five patients (23.8%) developed anterior open bite [PMID:32209271].
References
1 Xia L, Zhang Y, An J, Chen S, He Y. Evaluating the remodeling of condyles reconstructed by transport distraction osteogenesis in the treatment of temporomandibular joint ankylosis. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 2020. link 2 Chicre-Alcântara TC, Torres-Chávez KE, Fischer L, Clemente-Napimoga JT, Melo V, Parada CA et al.. Local kappa opioid receptor activation decreases temporomandibular joint inflammation. Inflammation 2012. link
2 papers cited of 3 indexed.