Effects of Glucosamine and Chondroitine Sulphate combination and Tramadol on IL?1ß, IL?6, TNF? ve PGE2 levels in synovial fluid in TMJ internal disorders

Temporomandibular joint internal disorders are global common diseases and new treatment modalities are still beeing searched. The aim of this study is to investigate the effects of glocosamine/chondroitine combination and tramadol clinically and biochemically in temporomandibular joint internal derangement.A single-blind, randomized, prospective clinical study was designed. 30 healthy patients with disk displacement and degenerative changes, maximum inerincisal opening (MIO) less than 35 mm and, pain at palpation of temporomandibular joint were included. Patients? MIO and pain scores at palpation (NS) were recorded. Temporomandibular joint synovial fluid samples were taken under local anaesthesia and conscious sedation from each patient. The samples stored at -40°C. Patients are divided into two groups randomly. 1500 mg glucosamine and 1200 mg chondroitine sulphate were prescribed to one group and tramadol 50 mg to the other one. At the end of two months clinically findings were recorded and synovial fluid samples were taken with the same procedure. IL?1ß, IL?6, TNF-? ve PGE2 levels of synovial fluid before and after medication were compaired.The lower jaw movements in the glucosamine/chondroitine group were increased significantly. The change of jaw movements in tramadol group was not statistically significant. The pain scores at palpation of the temporomandibular joint were improved significantly in both groups. A significantly decrease was detected at IL?1ß and PGE2 levels but not at IL?6 and TNF-? levels.