Tumor necrosis factor-alpha levels in the synovial fluid of patients with temporomandibular joint internal derangement

Purpose: The purpose of this study was to investigate the level of tumor necrosis factor-alpha (TNF-alpha) in the synovial fluid (SF) of patients with temporomandibular joint (TMJ) internal derangement and to show the relationship between the level of TNF-alpha and the severity of the disease. Materials and methods: Arthrocentesis was performed on 32 female and five male patients (aged between 17 and 45) referred to our clinic with the complaint of TMJ pain and discomfort. TNF-alpha levels were determined in the SF samples obtained during arthrocentesis. As a measure of pain, visual analog scale (VAS) scores were also evaluated. Results: There were statistically significant differences in VAS scores between the stages. VAS scores were found to be elevated as the stage of disease progressed. Increased levels of TNF-alpha were found in progressive stages of internal derangement. Conclusion: In our study, both SF TNF-alpha levels and pain levels (VAS scores) were found to be increased in patients with internal derangement as the stage of the disease progresses. TNF-alpha might contribute to the pathogenesis of synovitis and the degeneration of the TMJ cartilage and bone. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.