Trial Outcomes & Findings for Efficacy of Steroid Supplementation After TMJ Rinsing for Pain Management (NCT NCT01770912)

NCT ID: NCT01770912

Last Updated: 2020-10-08

Results Overview

TMJ loading pain is evaluated using ordinal scale ratings of 0-3 (none, mild, moderate, severe pain intensity).

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

24 participants

Primary outcome timeframe

Baseline and 12 weeks post-treatment

Results posted on

2020-10-08

Participant Flow

Subjects were recruited from 2013-2018 from facial pain referrals to the Oral and Maxillofacial Surgery Clinic.

Participant milestones

Participant milestones
Measure
Lactated Ringers
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Overall Study
STARTED
12
12
Overall Study
COMPLETED
10
12
Overall Study
NOT COMPLETED
2
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Lactated Ringers
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Overall Study
Lost to Follow-up
2
0

Baseline Characteristics

Efficacy of Steroid Supplementation After TMJ Rinsing for Pain Management

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Lactated Ringers
n=12 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Total
n=24 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
11 Participants
n=93 Participants
8 Participants
n=4 Participants
19 Participants
n=27 Participants
Age, Categorical
>=65 years
1 Participants
n=93 Participants
3 Participants
n=4 Participants
4 Participants
n=27 Participants
Age, Continuous
43.3 years
STANDARD_DEVIATION 17.5 • n=93 Participants
52.7 years
STANDARD_DEVIATION 18.1 • n=4 Participants
48.0 years
STANDARD_DEVIATION 18.1 • n=27 Participants
Sex: Female, Male
Female
12 Participants
n=93 Participants
12 Participants
n=4 Participants
24 Participants
n=27 Participants
Sex: Female, Male
Male
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
Race (NIH/OMB)
White
12 Participants
n=93 Participants
11 Participants
n=4 Participants
23 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Region of Enrollment
United States
12 participants
n=93 Participants
12 participants
n=4 Participants
24 participants
n=27 Participants
Temporomandibular Joint Loading Pain
2 units on a scale
n=93 Participants
2 units on a scale
n=4 Participants
2 units on a scale
n=27 Participants

PRIMARY outcome

Timeframe: Baseline and 12 weeks post-treatment

TMJ loading pain is evaluated using ordinal scale ratings of 0-3 (none, mild, moderate, severe pain intensity).

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment in TMJ Loading Pain Rating at 12 Weeks
-1 units on a scale
Interval -2.0 to 0.0
-2 units on a scale
Interval -3.0 to 0.0

SECONDARY outcome

Timeframe: Baseline and 2 weeks post-treatment

TMJ loading pain is evaluated using ordinal scale ratings of 0-3 (none, mild, moderate, severe pain intensity).

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment in TMJ Loading Pain Rating at 2 Weeks
-1 units on a scale
Interval -3.0 to 0.0
-2 units on a scale
Interval -3.0 to 0.0

SECONDARY outcome

Timeframe: Baseline and 6 weeks post-treatment

TMJ loading pain is evaluated using ordinal scale ratings of 0-3 (none, mild, moderate, severe pain intensity).

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment in TMJ Loading Pain Rating at 6 Weeks
-1 units on a scale
Interval -2.0 to 2.0
-2 units on a scale
Interval -3.0 to -1.0

SECONDARY outcome

Timeframe: Baseline and 2 weeks post-treatment

Mandibular range of motion is measured in millimeters (mm) of vertical opening between the upper and lower central incisors plus vertical overlap of the incisors. These measures are made for jaw unassisted opening without pain, maximum unassisted opening and maximum assisted opening. Horizontal mandibular range of motion is measured in millimeters (mm) assessed for maximal right and left mandibular lateral movements and mandibular protrusion. A positive value represents an improvement (or larger range of motion) in mandibular opening/lateral movement.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment in Mandibular Range of Motion Without Pain at 2 Weeks
3.9 mm
Standard Error 2.4
9.7 mm
Standard Error 2.6

SECONDARY outcome

Timeframe: Baseline and 6 weeks post-treatment

Mandibular range of motion is measured in millimeters (mm) of vertical opening between the upper and lower central incisors plus vertical overlap of the incisors. These measures are made for jaw unassisted opening without pain, maximum unassisted opening and maximum assisted opening. Horizontal mandibular range of motion is measured in millimeters (mm) assessed for maximal right and left mandibular lateral movements and mandibular protrusion. A positive value represents an improvement (or larger range of motion) in mandibular opening/lateral movement.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment in Mandibular Range of Motion at 6 Weeks
6.9 mm
Standard Error 2.8
7.4 mm
Standard Error 2.9

SECONDARY outcome

Timeframe: Baseline and 12 weeks post-treatment

Mandibular range of motion is measured in millimeters (mm) of vertical opening between the upper and lower central incisors plus vertical overlap of the incisors. These measures are made for jaw unassisted opening without pain, maximum unassisted opening and maximum assisted opening. Horizontal mandibular range of motion is measured in millimeters (mm) assessed for maximal right and left mandibular lateral movements and mandibular protrusion. A positive value represents an improvement (or larger range of motion) in mandibular opening/lateral movement.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment in Mandibular Range of Pain-Free Motion at 12 Weeks
5.3 mm
Standard Error 2.1
10.0 mm
Standard Error 3.3

SECONDARY outcome

Timeframe: Baseline and 2 weeks post-treatment

Palpable muscle tenderness of masticatory muscles using ordinal ratings of 0-3 (none, mild, moderate, severe pain to palpation) are summed. A standardized muscle palpation pressure is used at specific locations on each side of the face for a total of 20 locations. The range of possible scores is 0-60. The rating of each muscle palpation site is added for a composite muscle tenderness score.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment Palpable Muscle Tenderness at 2 Weeks
-2 units on a scale
Interval -16.0 to 7.0
-1 units on a scale
Interval -5.0 to 2.0

SECONDARY outcome

Timeframe: Baseline and 6 weeks post-treatment

Palpable muscle tenderness of masticatory muscles using ordinal ratings of 0-3 (none, mild, moderate, severe pain to palpation) are summed. A standardized muscle palpation pressure is used at specific locations on each side of the face for a total of 20 locations. The range of possible scores is 0-60. The rating of each muscle palpation site is added for a composite muscle tenderness score.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment Palpable Muscle Tenderness at 6 Weeks
-1 units on a scale
Interval -16.0 to 3.0
-1 units on a scale
Interval -5.0 to 2.0

SECONDARY outcome

Timeframe: Baseline and 12 weeks post-treatment

Palpable muscle tenderness of masticatory muscles using ordinal ratings of 0-3 (none, mild, moderate, severe pain to palpation) are summed. A standardized muscle palpation pressure is used at specific locations on each side of the face for a total of 20 locations. The range of possible scores is 0-60. The rating of each muscle palpation site is added for a composite muscle tenderness score.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment Palpable Muscle Tenderness at 12 Weeks
0 units on a scale
Interval -16.0 to 5.0
-2 units on a scale
Interval -5.0 to 3.0

SECONDARY outcome

Timeframe: Baseline and 2 weeks post-treatment

Opening and closing sounds (click, course crepitus, fine crepitus) detected by palpation on left, right or both sides of face.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Number of Participants With Change From Pre-Treatment Joint Sounds in 2 Weeks
1 Participants
5 Participants

SECONDARY outcome

Timeframe: Baseline and 6 weeks post-treatment

Opening and closing sounds (click, course crepitus, fine crepitus) detected by palpation on left, right or both sides of face.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Number of Participants With Change From Pre-Treatment Joint Sounds in 6 Weeks
3 Participants
6 Participants

SECONDARY outcome

Timeframe: Baseline and 12 weeks post-treatment

Opening and closing sounds (click, course crepitus, fine crepitus) detected by palpation on left, right or both sides of face.

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Number of Participants With Change From Pre-Treatment Joint Sounds in 12 Weeks
4 Participants
5 Participants

SECONDARY outcome

Timeframe: Baseline and 2 weeks post-treatment

Pain is assessed for average chewing pain intensity using a 100 mm visual analog scale with 0 representing "no pain" and 100 representing "the most intense chewing pain imaginable".

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment Functional Pain (Chewing) at 2 Weeks
-30 units on a scale
Standard Error 6.1
-37 units on a scale
Standard Error 7.3

SECONDARY outcome

Timeframe: Baseline and 6 weeks post-treatment

Pain is assessed for average chewing pain intensity using a 100 mm visual analog scale with 0 representing "no pain" and 100 representing "the most intense chewing pain imaginable".

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment Functional Pain (Chewing) at 6 Weeks
-33 units on a scale
Standard Error 7.8
-47 units on a scale
Standard Error 9.2

SECONDARY outcome

Timeframe: Baseline and 12 weeks post-treatment

Pain is assessed for average chewing pain intensity using a 100 mm visual analog scale with 0 representing "no pain" and 100 representing "the most intense chewing pain imaginable".

Outcome measures

Outcome measures
Measure
Lactated Ringers
n=10 Participants
1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure. Lactated Ringers: Solution used for TMJ arthrocentesis procedure. 1 cc of Lactated Ringers solution injected once after the TMJ rinsing procedure.
Triamcinolone Acetonide
n=12 Participants
1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure. Triamcinolone acetonide: 1 cc of triamcinolone acetonide (20 mg) injected once after the TMJ rinsing procedure.
Change From Pre-Treatment Functional Pain (Chewing) at 12 Weeks
-26 units on a scale
Standard Error 9.6
-43 units on a scale
Standard Error 8.7

Adverse Events

Lactated Ringers

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Triamcinolone Acetonide

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Charles G. Widmer, Associate Professor

University of Florida

Phone: 352-273-5696

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place