SERRATIOPEPTIDASE IN THE COMPLEX TREATMENT AT PATIENTS WITH TEMPOROMANDIBULAR JOINT DISEASES
DOI:
https://doi.org/10.35220/2078-8916-2019-34-4-50-56Keywords:
temporomandibular joint, pain, serratiopeptidaseAbstract
The purpose of the study. To evaluate the clinical effica-cy and safety of use of the serratiopeptidase at patients with temporomandibular joint (TMJ) diseases.
Materials and methods. The study involved 36 patients (m-11, w-25) with diseases of the temporomandibular joint (TMJ), the average age of which was 45.2±7.3 years, who were treated at the Dental Medical Center of Bogomolets NMU.
The patients were divided into 2 groups: main – 18 people, comparison – 18 people. Patients received NSAIDs, chondroprotectors, combination of preparations of the calcium and vitamin D3. Patients in the main group additionally took serratiopeptidase 10 mg 1 tablet 3 times a day for 30 days.
Examination of patients was performed according to the classical method of examination of patients with diseases of the TMJ. The dynamics of clinical manifestations in patients were evaluated at 7, 21, 30 days of treatment.
The degree of mouth opening, the volume of movement of the mandible, noted the presence of sounds (noises) in the joint were took into account during objective examination. The presence, severity of pain in the TMJ were determined by the verbal scale of pain intensity assessment – Verbal Descriptor Scale (VDS).
The obtained laboratory data were referenced in the International System of Units and processed by variational statistics using MedStat and EZR v.1.35 (Saitama Medical Center, Jichi Medical University, Saitama, Japan, 2017), which is a graphical interface to RFSC (The R Foundation for Statistical Computing, Vienna, Austria).
Results. There was a decrease of the pain both at rest and during chewing at all (100 %) patients in both groups after 7 days of treatment, respectively 2.1±1.1 and 4.3±0.9 points. Patients from both groups during follow-up visits had an increase in mouth opening up to 3.7±0.7 cm, improved jaw movements, decreased crunching and crepitus in the joint.
Patients from the main group at follow-up visits after 1 month of the observation had significantly better rates of pain reduction at rest and during chewing: 0.6±0.4 and 2.1±1.1 points, respectively (p<0,05) – resting state; 1.6±1.1 and 3.3±1.0 points (p<0.05) – during active jaw movements. The same pattern was observed in the improvement of the jaw movements and mouth opening in the patients of the main group, compared with the comparison group, respectively 4.4±1.0 cm and 3.9±0.8 cm (p<0.05).
Conclusions. The use of serratiopeptidase in complex treatment of patients with diseases of the TMJ reduces the pain in the joint both at rest and during active movements of the mandible, allows to improve the volume of movements in the TMJ and the degree of mouth opening to 4.4±1.0 cm, compared to the comparison group (p<0.05). Significant gradual reduction of pain, improvement of mouth opening, reduction of crunchiness and crepitus in the TMJ in both groups were found throughout the study (p<0.05).
References
Воловар О.С. Діагностика та лікування захворю-вань скронево-нижньощелепного суглоба на фоні соматич-них захворювань: автореф. дис. на здобуття наук.ступеня д-ра мед. наук: спец. 14.01.22 «Стоматологія» / Воловар Ок-сана Степанівна. – Київ, 2013. – 40 с.
Liu F. Epidemiology, Diagnosis, and Treatment of Temporomandibular Disorders / F. Liu, A. Steinkeler // Dental Clinics of North America. – 2013, Jul. – Vol. 3 (57). – P. 465–479.
Temporomandibular Joint Disorders in Older Adults. / S. Yadav, Y. Yang, E.H. Dutra [et al.] // J Am Geriatr Soc. – 2018. – 66 (6). – Р. 1213–17.
Консервативное лечение артроза височно-нижнечелюстного сустава / И.В. Тарасов, А.А. Никитин, Н.В. Перова [и др.] // Вестник современной клинической медицины. – 2016. – №4(9). – С. 66–71.
Поворознюк В.В. Застосування препаратів Мо-векс® і Мовіназа® в комплексному лікуванні хворих стар-ших вікових груп з остеоартрозом великих суглобів / В.В. Поворознюк, Т.В. Орлик, М.А. Бистрицька // Здоров’я України. – 2013. – 22(323). – С. 16–18.
Chantaracherd P. Temporomandibular joint disorders' impact on pain, function, and disability. / P. Chantaracherd, M.T. John, J.S. Hodges, E.L. Schiffman // Journal of dental research. – 2015. – 94(3 Suppl). – Р.79S–86S.
Хірургічна стоматологія та щелепно-лицева хірур-гія: підручник; у 2 т. – Т.1 / [Маланчук В.О., Воловар О.С., Гарляускайте І.Ю. та ін..] – К.: ЛОГОС, 2011. – 672 с.
Murphy M.K. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies / M.K. Murphy, R.F. MacBarb, M.E. Wong, K.A.
Athanasiou // Int J Oral Maxillofac Implants. – 2013. – 28(6). – Р. e393–414.
Шуба В.Й. Остеоартроз: рання діагностика та лі-кування / В.Й. Шуба // Укр. мед. Часопис. – 2016. –1 (111). – С. 59–65.
Al-Moraissi E.A. The hierarchy of different treatments for arthrogenous temporomandibular disorders: A network meta-analysis of randomized clinical trials / E.A. Al-Moraissi, L.M. Wolford, E. III. Ellis, A. Neff // J Craniomaxillofac Surg. – 2019 Nov. –5(19). –S1010–5182. doi.org/10.1016/j.jcms.2019.10.004
Sustained inflammation induces degeneration of the temporomandibular joint / X.D. Wang, X.X. Kou, J.J. Mao [et al.] // Journal of Dental Research. – 2012. – Vol. 91(5). – P.499–505.
An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin. / O. Bruyère, C. Cooper, J.P. Pelletier [et al.] // Arthritis Rheum. – 2019. – 49(3). – P.337–350.
Meszaros E. Prospects for treating osteoarthritis: enzyme–protein interactions regulating matrix metalloproteinase activity / E. Meszaros, C.J. Malemud // Ther Adv Chronic Dis. – 2012. – 3(5). – P. 219–229.
Tiwari M. The role of serratiopeptidase in the resolution of inflammation / M. Tiwari // Asian journal of pharmaceutical sciences. – 2017/ – 12. – P. 209–215.
Bhagat S. Serratiopeptidase: A systematic review of the existing evidence / S. Bhagat, M. Agarwal, V. Roy // Int J Surg. – 2013. – 11(3). – P. 209–17.
Santhoshkumar M. The emerging role of serratiopeptidase in oral surgery: literature update / M. Santhoshkumar // Asian journal of pharmaceutical sciences. – 2018. – 11(3). – P. 19–23.
Посібник з біостатистики. Аналіз результатів ме-дичних досліджень у пакеті EZR (R-statistics): [навч. посіб.] / В.Г. Гур’янов, Ю.Є. Лях, В.Д. Парій, О.В. Короткий, О.В. Чалий – Київ. – 2018. – 207 с.
