1
|
Kukreja P, Kukreja BJ, Marrapodi MM, Ronsivalle V, Cicciù M, Minervini G. Efficacy of hyaluronic acid in temporomandibular disorders evaluated with diagnostic criteria for temporomandibular disorders (DC/TMD). J Oral Rehabil 2024. [PMID: 39210692 DOI: 10.1111/joor.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/27/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The study aimed to retrospectively assess the efficacy of hyaluronic acid (HA) in managing temporomandibular disorders (TMD) using the diagnostic criteria for temporomandibular disorders (DC/TMD). There has been an ongoing debate regarding the effectiveness of HA as a treatment option for TMD, which necessitated a thorough evaluation. METHODS The review adhered to PRISMA guidelines conducted across eight different databases, including PubMed, Embase, Web of Science, Cochrane Library, Scopus, ScienceDirect, PsycINFO and CINAHL. The selection criteria included studies that evaluated the efficacy of HA in TMD patients, utilised DC/TMD, and were published in English. Data extraction and quality assessment were performed independently by two reviewers. ROB-2 tool was employed to assess methodological quality of the assessed studies. RESULTS A total of 10 studies met the inclusion criteria. They demonstrated that HA was effective in improving various symptoms of TMD, such as pain, mouth opening and joint sounds over control group. But on the other end, platelet-rich plasma (PRP) was found to be better than HA intervention in alleviation of TMD symptoms. However, the degree of improvement varied across the studies. Some studies reported adverse effects, but these were typically minor and transient. Risk of bias assessment was low in all the included studies. CONCLUSION The findings suggest that HA can be an effective treatment for TMD when evaluated with DC/TMD. However, the variation in effectiveness across studies indicates the need for individualised treatment planning and careful monitoring of adverse effects. Further research is needed to refine the treatment protocols and understand the long-term effectiveness and safety of HA in TMD management.
Collapse
Affiliation(s)
- Pankaj Kukreja
- Department of Biomedical and Dental Sciences, Faculty of Dentistry, Al-Baha University, Al-Baha, Kingdom of Saudi Arabia
| | - Bhavna Jha Kukreja
- Assistant Professor, Periodontology, College of Dentistry Preventive Dental Sciences, Ajman, United Arab Emirates
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Caserta, Italy
| |
Collapse
|
2
|
Sàbado-Bundó H, Sánchez-Garcés M, Camps-Font O, Gay-Escoda C. Intraarticular injections of hyaluronic acid in arthrocentesis and arthroscopy as a treatment of temporomandibular joint disorders: A systematic review. Cranio 2024; 42:122-131. [PMID: 34027829 DOI: 10.1080/08869634.2021.1925029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the benefits of hyaluronic acid intraarticular injection (HA IAI), in conjunction with minimally invasive surgery (arthrocentesis or arthroscopy), as a therapeutic option for temporomandibular joint disorders. METHODS An electronic search in PubMed, Cochrane Library, and Scopus databases was conducted in order to answer the following PICOS question: "In clinical trials with patients treated with arthroscopy or arthrocentesis, did the subsequent use of HA IAI provide a better control of postoperative pain and temporomandibular joint function compared to those patients who did not receive it?" RESULTS Following PRISMA criteria, six randomized controlled clinical trials were selected. HA IAI showed significant differences in terms of pain reduction in three of them and improvement of mandibular function in two, compared to the control group. CONCLUSION Based on scientific evidence, the level of recommendation found regarding this type of intervention is type B (recommendation based on inconsistent or limited-quality patient-oriented evidence).
Collapse
Affiliation(s)
- Helena Sàbado-Bundó
- Department of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - MaÁngeles Sánchez-Garcés
- Master's Degree Program in Oral Surgery and Implantology, University of Barcelona, Barcelona, Spain
- Researcher of the IDIBELL Institute, Barcelona, Spain
| | - Octavi Camps-Font
- Department of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Researcher of the IDIBELL Institute, Barcelona, Spain
| | - Cosme Gay-Escoda
- Oral and Maxillofacial Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Oral Surgery and Implantology, FUCSO, Implantology and Maxillofacial Surgery Department, EFHRE International University, Teknon Medical Center, Barcelona, Spain
| |
Collapse
|
3
|
Raveggi E, Ramieri G, Bosco GF, Zavattero E. Temporomandibular joint arthrocentesis: a single-center experience and review of the literature. Minerva Dent Oral Sci 2023; 72:69-76. [PMID: 37052194 DOI: 10.23736/s2724-6329.22.04653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND The aim of this paper was to report our experience and to review the literature of arthrocentesis focusing on protocols and results. METHODS Arthrocentesis with supplemental hyaluronic acid was performed in patients with TMDs between January 2017 and December 2020 at the Division of Maxillofacial Surgery. The maximum interincisal opening (MIO) and pain score were recorded preoperatively (T0), 2 months postoperatively (T1), and 6 months postoperatively (T2). A literature search was performed to analyze the same parameters in patients with TMDs. Patient demographic, characteristics and treatment protocols used were also recorded. RESULTS This retrospective analysis enrolled 45 patients. Twenty-two patients (20 females, 2 males) with mean age of 37.13 years with internal derangement were included in study group A. Study group B included 23 patients with degenerative joint disease (19 females and 4 males) with mean age of 55.73 years. The outcomes trend of MIO and pain during the follow-up period showed a gradual improvement. Fifty articles meeting the proposed scientific criteria were selected for the literature revision. A range of clinical and procedural variables were analyzed by grouping the studies into two broad categories based on the diagnosis of TMD. CONCLUSIONS Based on our experience and on the basis of the most accredited scientific studies in the literature, intra-articular injections of HA are beneficial for the improvement of the pain and/or functional symptoms of TMDs.
Collapse
Affiliation(s)
- Elisa Raveggi
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Giovanni F Bosco
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Emanuele Zavattero
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy -
| |
Collapse
|
4
|
Jacob SM, Bandyopadhyay TK, Chattopadhyay PK, Parihar VS. Efficacy of Platelet-Rich Plasma Versus Hyaluronic Acid Following Arthrocentesis for Temporomandibular Joint Disc Disorders: A Randomized Controlled Trial. J Maxillofac Oral Surg 2022; 21:1199-1204. [PMID: 36896087 PMCID: PMC9989114 DOI: 10.1007/s12663-021-01519-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 01/22/2021] [Indexed: 10/22/2022] Open
Abstract
Purpose Injection of intra-articular medicaments is an accepted therapy for temporomandibular joint disorders (TMDs). This study compares the efficacy of arthrocentesis followed by platelet-rich plasma (PRP) as compared to hyaluronic acid (HA) injections for TMDs unresponsive to conservative therapy. PRP injection following arthrocentesis was hypothesized to be better compared to arthrocentesis alone or when combined with HA injection. Methods Forty-seven patients with TMDs enrolled in an RCT were randomly assigned to three groups: Group A-PRP, Group B-HA or Group C-control group of arthrocentesis alone. Pre-operative evaluation and post-operative changes at 1-, 3-, 6-month intervals were assessed for improvement in pain, maximum mouth opening, joint sounds and excursive movements. Statistical significance was set at P value < 0.05. Results Post-operative joint sounds were present in three out of 16 patients in Group A; six out of 15 patients in Group B and eight out of 16 patients in Group C at 6-month follow-up. For the remaining outcome variables, no statistical difference between groups was observed. Conclusion Both medicaments produced significant clinical improvements when compared to the control group. When comparing PRP against HA, none showed superiority over the other.Clinical trial registration number: CTRI/2019/01/017076.
Collapse
Affiliation(s)
- Shiju Mathew Jacob
- Department of Oral and Maxillofacial Surgery, Army Dental Center (Research & Referral), C/O Army Hospital (Research & Referral), Delhi Cantt, New Delhi, India
- Present Address: Department of Oral and Maxillofacial Surgery, Military Dental Center, Meerut, 250001 India
| | - Tapas Kumar Bandyopadhyay
- Department of Oral and Maxillofacial Surgery, Army Dental Center (Research & Referral), C/O Army Hospital (Research & Referral), Delhi Cantt, New Delhi, India
| | - Prabodh Kumar Chattopadhyay
- Department of Oral and Maxillofacial Surgery, Army Dental Center (Research & Referral), C/O Army Hospital (Research & Referral), Delhi Cantt, New Delhi, India
| | - Vinay Singh Parihar
- Department of Oral and Maxillofacial Surgery, Army Dental Center (Research & Referral), C/O Army Hospital (Research & Referral), Delhi Cantt, New Delhi, India
- Department of Oral and Maxillofacial Surgery, 3 Corps Dental Unit, C/O 99 APO, 903503 India
| |
Collapse
|
5
|
Hyder A, Tawfik BE, Elmohandes W. Efficacy of computer-guided versus conventional sodium hyaluronate injection in superior joint space in treatment of temporomandibular joint (TMJ) internal derangement: Comparative randomized controlled trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e321-e326. [PMID: 35545190 DOI: 10.1016/j.jormas.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES evaluate the feasibility and clinical outcomes of computer-guided sodium hyaluronate injection in superior joint space compared to conventional injection for the treatment of TMJ Internal Derangement (TMJ-ID). PATIENTS AND METHODS Randomized controlled trial conducted on 40 patients diagnosed with bilateral TMJ-ID divided into two groups. Group A treated with four computer-guided sodium hyaluronate injections in superior TMJ space with one-week intervals. Group B received similar injections but with the conventional method. The intraoperative assessment included total procedural time and patient convenience during the injection. The postoperative evaluation included maximum unassisted mouth opening (MUMO), modified Helkimo's clinical dysfunction index, and pain intensity on a visual analog scale (VAS). RESULTS Group A showed better improvement in maximum mouth opening and pain intensity than group B after a week of the second, third and fourth injection. At the six months, group A continued to show better improvement regarding maximum mouth opening, while improvement in pain and TMJ dysfunction was similar in both groups. There were differences between both groups regarding procedural time and patient convenience across the study except the time of the first injection, which was similar in both groups CONCLUSION: Using the virtual planning and injection guide for intra-articular TMJ injection is considered promising to increase the accuracy and efficacy of injectable material securing faster results besides rendering the procedure easily reproducible and simpler to both clinicians and patients. However, the authors could not ensure the long-term superiority of the computer-guided injection technique over the conventional one in light of the results of this study.
Collapse
Affiliation(s)
- AbdElKader Hyder
- Assistant Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Al-Azhar University, 11884, ElNasr Road, Nasr City, Cairo, Egypt.
| | - Bahaa Eldin Tawfik
- Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Al-Azhar University, Cairo, Egypt
| | - Wael Elmohandes
- Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Al-Azhar University, Cairo, Egypt
| |
Collapse
|
6
|
Işık G, Kenç S, Özveri Koyuncu B, Günbay S, Günbay T. Injectable platelet-rich fibrin as treatment for temporomandibular joint osteoarthritis: A randomized controlled clinical trial. J Craniomaxillofac Surg 2022; 50:576-582. [PMID: 35798596 DOI: 10.1016/j.jcms.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/02/2022] [Accepted: 06/25/2022] [Indexed: 12/23/2022] Open
Abstract
The purpose of this study was to assess the treatment outcomes of intraarticular injection of injectable platelet-rich fibrin (i-PRF) after arthrocentesis in patients with temporomandibular joint osteoarthritis (TMJ-OA). Patients were randomly assigned to one of two treatment groups: those who received intraarticular injection of i-PRF after arthrocentesis procedure - the i-PRF group; and those who underwent the arthrocentesis procedure alone - the control group. The primary outcome variable was pain, the level of which was measured preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. The secondary outcome variables included maximum mouth opening (MMO), and lateral and protrusive movements. Of the total of 36 patients, 18 were analyzed in the i-PRF group and 18 in the control group. There were significant differences between the groups in terms of pain levels and measurements of MMO, lateral movement, and protrusive movement over the 12 months of follow-up (p < 0.001). Significant increases in pain levels and decreases in measurements of MMO, lateral movement, and protrusive movement were observed in the control group from the 6th to 12th month postoperatively (p < 0.001). In contrast, no significant differences were found in both pain levels and measurements of MMO, lateral, and protrusive movements for the i-PRF group from the 2nd to the 12th month postoperatively. Within the limitations of the study it seems that intraarticular injection of i-PRF after arthrocentesis should be preferred whenever appropriate because when reducing pain intensity and improving functional jaw movement is the priority.
Collapse
Affiliation(s)
- Gözde Işık
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey.
| | - Selin Kenç
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey
| | - Banu Özveri Koyuncu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey
| | - Sevtap Günbay
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey
| | - Tayfun Günbay
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey
| |
Collapse
|
7
|
Memiş S. Evaluation of the effects of temporomandibular joint arthrocentesis with hyaluronic acid injection on mandibular condyles using fractal dimension analysis: A retrospective study. J Craniomaxillofac Surg 2022; 50:643-650. [DOI: 10.1016/j.jcms.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/15/2022] [Accepted: 07/02/2022] [Indexed: 12/01/2022] Open
|
8
|
Measuring Changes in Jaw Opening Forces to Assess the Degree of Improvement in Patients with Temporomandibular Disorders. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background: Currently, the degree of improvement in patients with TMDs is measured through subjective questionnaires and clinical examination This study aimed to investigate the properties of an objective quantitative measure of jaw-opening forces to assess clinical improvement in temporomandibular disorder (TMD) patients following treatment. Methods: Baseline jaw-opening forces were recorded for TMD-patients (n = 62) and a comparison group of TMD-free participants (n = 56), using a jaw-opening forces measuring device. TMD patients were divided into three subcategories (myofascial pain, disc-displacement, and myofascial pain and disc-displacement combined) and received a combination of treatment for six months; meanwhile, TMD-free participants did not receive treatment. Jaw-opening forces for each participant in both groups were measured at their six-month review appointment. Results: Jaw-opening forces were reliable at baseline (single measure ICC 0.98, 95% CI 0.97–0.98, ICC ≥ 0.94 for all groups and subcategories). Jaw-opening forces increased in the TMD group following treatment at six-months (18.6 N at baseline and 32.4 N at six-months, p < 0.001) and did not change significantly in the TMD-free group (49 N at baseline and 48.3 N at six-months). There was a small improvement in the disc displacement group (27.8% higher forces, p = 0.002). However, the myofascial-pain and myofascial-pain-and-disc-displacement groups showed significant improvement following treatment (93.5% higher forces, p < 0.001; 91.1% higher forces, p < 0.001; respectively). Conclusion: This study demonstrated that the measurement of jaw-opening forces could potentially be used to assess the clinical improvement in TMD patients following diagnosis and treatment.
Collapse
|
9
|
Does glucosamine, chondroitin sulfate, and methylsulfonylmethane supplementation improve the outcome of temporomandibular joint osteoarthritis management with arthrocentesis plus intraarticular hyaluronic acid injection. A randomized clinical trial. J Craniomaxillofac Surg 2021; 49:711-718. [PMID: 33685850 DOI: 10.1016/j.jcms.2021.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/03/2020] [Accepted: 02/16/2021] [Indexed: 01/13/2023] Open
Abstract
The purpose of this study was to compare clinical outcomes obtained with the use of glucosamine, chondroitin sulfate, and methylsulfonylmethane (GCM) supplementation after arthrocentesis plus intraarticular hyaluronic acid (HA) injection. A randomized clinical trial was implemented with adult participants with TMJ-OA who were referred to the author's clinic between February 2014 and May 2015. The sample was entirely composed of patients with TMJ-OA who were treated randomly with a one-session arthrocentesis plus intraarticular HA injection only (control group), or an initial one-session arthrocentesis plus intraarticular HA injection followed by 3 months of GCM supplementation (study group). The predictor variable was management (treatment) technique. The outcome variables were visual analog scale evaluations (masticatory efficiency, pain complaint, joint sound) and mandibular mobility (maximal interincisal opening [MIO], and lateral and protrusive motions of the mandible). The outcome variables were recorded preoperatively and 12 months postoperatively. Thirty-one participants were enrolled in the study. Five were lost during follow-up. The final study sample consisted of 26 participants (age 28.35 ± 10.85 y): 14 in the control group (age 28.71 ± 10.94 y); and 12 in the study group (age 27.92 ± 11.20 y). Pain complaints (p < 0.001) and joint sounds (p = 0.030 for the control group; p = 0.023 for the study group) showed statistically significant decreases. Masticatory efficiency (p < 0.001 for the control group; p = 0.040 for the study group) and lateral mandibular motion (p = 0.040 for the control group; p = 0.004 for study group) showed statistically significant increases in both groups, whereas MIO and protrusive mandibular motion showed no significant changes in either group (p > 0.05). After estimating the differences between the follow-up and baseline outcomes, the mean changes in the primary outcome variables (VAS scores, MIO, and mandibular motion) showed no statistically significant differences between the two groups (p > 0.05). Progressions (reparative remodeling) of hard-tissue TMJ structures were observed on CBCT scans of some participants in both groups. These findings suggested that the use of GCM supplementation after arthrocentesis plus intraarticular HA injection produced no additional clinical benefits or improvements for patients with TMJ-OA compared with arthrocentesis plus intraarticular HA injection alone.
Collapse
|
10
|
Köhnke R, Ahlers MO, Birkelbach MA, Ewald F, Krueger M, Fiedler I, Busse B, Heiland M, Vollkommer T, Gosau M, Smeets R, Rutkowski R. Temporomandibular Joint Osteoarthritis: Regenerative Treatment by a Stem Cell Containing Advanced Therapy Medicinal Product (ATMP)-An In Vivo Animal Trial. Int J Mol Sci 2021; 22:E443. [PMID: 33466246 PMCID: PMC7795212 DOI: 10.3390/ijms22010443] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/19/2022] Open
Abstract
Temporomandibular joint osteoarthritis (TMJ-OA) is a chronic degenerative disease that is often characterized by progressive impairment of the temporomandibular functional unit. The aim of this randomized controlled animal trial was a comparative analysis regarding the chondroregenerative potency of intra-articular stem/stromal cell therapy. Four weeks after combined mechanical and biochemical osteoarthritis induction in 28 rabbits, therapy was initiated by a single intra-articular injection, randomized into the following groups: Group 1: AB Serum (ABS); Group 2: Hyaluronic acid (HA); Group 3: Mesenchymal stromal cells (STx.); Group 4: Mesenchymal stromal cells in hyaluronic acid (HA + STx.). After another 4 weeks, the animals were euthanized, followed by histological examination of the removed joints. The histological analysis showed a significant increase in cartilage thickness in the stromal cell treated groups (HA + STx. vs. ABS, p = 0.028; HA + ST.x vs. HA, p = 0.042; STx. vs. ABS, p = 0.036). Scanning electron microscopy detected a similar heterogeneity of mineralization and tissue porosity in the subchondral zone in all groups. The single intra-articular injection of a stem cell containing, GMP-compliant advanced therapy medicinal product for the treatment of iatrogen induced osteoarthritis of the temporomandibular joint shows a chondroregenerative effect.
Collapse
Affiliation(s)
- Robert Köhnke
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.K.); (M.A.B.); (T.V.); (M.G.); (R.S.)
| | - Marcus Oliver Ahlers
- Department of Prosthetic Dentistry School of Dental Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
- CMD-Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Moritz Alexander Birkelbach
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.K.); (M.A.B.); (T.V.); (M.G.); (R.S.)
| | - Florian Ewald
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany;
| | | | - Imke Fiedler
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (I.F.); (B.B.)
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (I.F.); (B.B.)
| | - Max Heiland
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, 14197 Berlin, Germany;
| | - Tobias Vollkommer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.K.); (M.A.B.); (T.V.); (M.G.); (R.S.)
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.K.); (M.A.B.); (T.V.); (M.G.); (R.S.)
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.K.); (M.A.B.); (T.V.); (M.G.); (R.S.)
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.K.); (M.A.B.); (T.V.); (M.G.); (R.S.)
| |
Collapse
|
11
|
Rossini R, Grossmann E, Poluha RL, Setogutti ÊT, Dos Santos MF. Double-Needle Arthrocentesis with Viscosupplementation in Patients with Temporomandibular Joint Disc Displacement without Reduction. Clinics (Sao Paulo) 2021; 76:e2840. [PMID: 33909828 PMCID: PMC8050596 DOI: 10.6061/clinics/2021/e2840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/16/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Arthrocentesis is the simplest surgical intervention for the temporomandibular joint (TMJ). It can be performed on an outpatient basis at a low cost and with low morbidity. The objective is to release the articular disc by disrupting the adhesion formed between its surfaces and the mandibular fossa through hydraulic pressure generated by irrigation of the upper compartment of the TMJ. Viscosupplementation with hyaluronic acid during or after arthrocentesis improves clinical outcomes, increases mouth opening, and reduces pain levels. The aim of this study was to evaluate the efficiency of arthrocentesis plus hyaluronic acid viscosupplementation through clinical examination and preoperative magnetic resonance imaging in patients with unilateral disc displacement without reduction (DDwoR). METHODS This analytical retrospective cross-sectional study clinically and radiologically evaluated 72 patients of both sexes with unilateral DDwoR. The following data were collected: sex, pain, age, duration of pain, maximum mouth opening, and patient pain perception on a visual analog scale. TMJ arthrocentesis was performed only once for each of the indicated joints. Data were collected before arthrocentesis (baseline) and at 7, 14, 30, 60, 90, and 180 days after the procedure (final evaluation). RESULTS Between the baseline and final evaluation, there was a significant reduction in pain (p=0.001) and restoration of articular function. In addition, there was a significant increase in maximum mouth opening (p=0.001). CONCLUSION Patients with DDwoR undergoing arthrocentesis combined with hyaluronic acid injection showed significant improvement in the perceived pain and maximum mouth opening in the mid-term follow-up periods.
Collapse
Affiliation(s)
- Rafael Rossini
- Pos-Graduacao em Ciencias Cirurgicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR
| | - Eduardo Grossmann
- Departamento de Ciencias Morfologicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR
- *Corresponding author. E-mail:
| | | | | | - Marcos Fabio Dos Santos
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| |
Collapse
|
12
|
Comparison of the Efficiacy of Intra-Articular Injection of Liquid Platelet-Rich Fibrin and Hyaluronic Acid After in Conjunction With Arthrocentesis for the Treatment of Internal Temporomandibular Joint Derangements. J Craniofac Surg 2020; 31:1870-1874. [PMID: 32433129 DOI: 10.1097/scs.0000000000006545] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of intra-articular injection of liquid platelet-rich fibrin (I-PRF) versus hyaluronic acid (HA) following arthrocentesis in patients suffering from temporomandibular joint (TMJ) pain and dysfunction. A total of 69 patients with internal TMJ derangement were enrolled in this retrospective, matched cohort study. A total of 47 included patients (67 joints) were divided into 3 groups as follows: 16 participants in the arthrocentesis-only group; 14 patients in the arthrocentesis plus HA injection group (A+HA); and 17 participants in the arthrocentesis plus I-PRF injection group (A+I-PRF). The 2 outcome variables were TMJ pain and maximal mouth opening (MMO) which were evaluated up to 12 months postoperatively. The data were analyzed using the Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Wilcoxon sign test, Fisher exact test, and the χ test. Statistically significant decreases in pain scores and increases in MMO values were observed in all 3 groups during the 12 months of follow-up. The significant decrease in pain values was shown in the A+I-PRF group as compared with the A+HA group at 9 months postoperatively. MMO values in the A+I-PRF group were significantly higher than in the A+HA group at 9 and 12 months postoperatively. All conventional treatment procedures can provide pain reduction and improvement to MMO. However, intraarticular injections of I-PRF in combination with arthrocentesis showed superior performance in terms of the gradual improvement in pain alleviation and range of mouth opening.
Collapse
|
13
|
Arthrocentesis and Sodium Hyaluronate Infiltration in Temporomandibular Disorders Treatment. Clinical and MRI Evaluation. J Funct Morphol Kinesiol 2020; 5:jfmk5010018. [PMID: 33467234 PMCID: PMC7739436 DOI: 10.3390/jfmk5010018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 11/25/2022] Open
Abstract
Arthrocentesis in temporomandibular joint disorders can be associated with the intra-articular infiltration of various drugs with the objective of increase treatment efficacy. The aim of this study was to evaluate the clinical indexes variation in patients affected by temporomandibular joint disorders treated with arthrocentesis and sodium hyaluronate (SH) injections. A total of 28 patients suffering from temporomandibular joint disorders underwent one cycle of five arthrocentesis and infiltrations of sodium hyaluronate. Spontaneous mouth opening improved from 36.3 ± 7.5 mm to 45.1 ± 1.9 mm at six months follow-up. A significant reduction in the pain at rest and during mastication mean values emerged at follow-up (p < 0.0001). The mean masticatory efficiency, evaluated through a visual analogic scale, showed improvement at the follow-up period, highlighted by the increase of mean value from a baseline of 3.1 ± 1.2 to a mean value of 8.5 ± 1.2 (p < 0.0001). The mean severity of the joint damage at baseline time was 2.4 ± 0.9 and decreased to 0.4 ± 0.3 at the end of the follow-up period. The decrease in values is confirmed by statistical test (p < 0.05). Our data show how arthrocentesis integrated with sodium hyaluronate infiltrations performed under local anesthesia is a valid method of treating temporomandibular joint disorders.
Collapse
|
14
|
De Riu G, Vaira LA, Carta E, Meloni SM, Sembronio S, Robiony M. Bone marrow nucleated cell concentrate autograft in temporomandibular joint degenerative disorders: 1-year results of a randomized clinical trial. J Craniomaxillofac Surg 2019; 47:1728-1738. [DOI: 10.1016/j.jcms.2018.11.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 12/24/2022] Open
|
15
|
Prospective study to evaluate the influence of joint washing and the use of hyaluronic acid on 111 arthrocentesis. Oral Maxillofac Surg 2019; 23:415-421. [PMID: 31264124 DOI: 10.1007/s10006-019-00789-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Temporomandibular dysfunction is a generic term that covers a large number of clinical problems affecting not only temporomandibular joint but also the masticatory musculature and related structures. Arthrocentesis is used in patients with joint pathology in which conservative treatment has failed. METHODS A prospective, observational, analytical cohort study has been carried out to evaluate the results of 111 arthrocentesis. We have performed an inferential statistics study between the variables: improvement of pain and improvement in the oral opening with the variables and access joint, washing joint, hyaluronic acid infiltration, and type of joint pathology. RESULTS Joint washing and intra-articular hyaluronic acid injection significantly improved the pain at 1-week, 1-month, and 3-month postarthrocentesis, although this improvement was limited in time, at 6 months, joint washing and hyaluronic acid infiltration are no longer significant. Only the joint access (p = 0.014) and the type of joint pathology (p = 0.028) are significant. CONCLUSIONS The effectiveness of joint access in the arthrocentesis at 6 months is high, although less than at 1-month and 3-month postarthrocentesis. The type of joint pathology is another important factor. Patients with degenerative pathology worsen the most after 6-month postarthrocentesis. Arthrocentesis could avoid the evolution of acute pathology.
Collapse
|
16
|
Is Repeated Arthrocentesis Beneficial in the Treatment of Temporomandibular Disorders: A Retrospective Study. J Oral Maxillofac Surg 2019; 77:1359-1364. [PMID: 30825439 DOI: 10.1016/j.joms.2019.01.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/20/2019] [Accepted: 01/24/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE Arthrocentesis is an effective, simple, and minimally invasive treatment in patients with temporomandibular joint (TMJ) closed lock (CL). The aim of this study was to compare the effectiveness of 1- versus 2-session arthrocentesis procedures in the management of TMJ CL. MATERIALS AND METHODS A retrospective cohort study was conducted using the files of patients with TMJ CL according to diagnostic criteria for temporomandibular disorders. Patients who underwent 1- or 2-session arthrocentesis were included in the study. The decision of whether to undergo 1- or 2-session arthrocentesis was made by the patients: Those who accepted a second arthrocentesis procedure were assigned to group 1 (repeated arthrocentesis group), and those who did not accept, to group 2 (arthrocentesis group). The primary predictor variable was treatment method. TMJ pain (scored on a visual analog scale) and maximum mouth opening (MMO) were selected as the outcome variables. To evaluate the clinical outcomes of 1- or 2-session arthrocentesis, MMO and pain score (on a visual analog scale) before treatment and at 1, 3, and 6 months' follow-up were analyzed. Descriptive, comparative, correlation, and multivariate analyses were conducted. RESULTS A total of 30 patients (25 female and 5 male patients) with TMJ disc displacement without reduction were enrolled in the study. Each group consisted of 15 patients. Statistically significant decreases in pain scores and increases in MMO values were observed in both treatment groups at 3 and 6 months (P < .05). At 6 months, MMO values were significantly higher and pain levels were significantly lower in patients who received 2 arthrocentesis procedures. CONCLUSIONS Repeated arthrocentesis is more successful at reducing pain and improving MMO than a single intervention in the treatment of TMJ CL.
Collapse
|
17
|
Bergstrand S, Ingstad HK, Møystad A, Bjørnland T. Long-term effectiveness of arthrocentesis with and without hyaluronic acid injection for treatment of temporomandibular joint osteoarthritis. J Oral Sci 2019; 61:82-88. [PMID: 30814387 DOI: 10.2334/josnusd.17-0423] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study evaluated the long-term effectiveness of intra-articular temporomandibular joint arthrocentesis for patients with osteoarthritis and compared arthrocentesis/lavage alone with arthrocentesis/lavage and injected hyaluronic acid. Forty patients met the inclusion criteria, and 37 completed long-term follow-up (approximately 4 years). The patients were randomly allocated to two groups: arthrocentesis with lavage alone (A-group, n = 17) or combined with hyaluronic acid treatment (AS-group, n = 20). Standard two-needle arthrocentesis was performed. Pain and joint sounds were measured at baseline and approximately 4 years after treatment. Reported pain, as indicated by visual analogue scale (VAS) score, significantly decreased from baseline to the final follow-up examination in both groups. Mean VAS score decreased from 64 to 16 (P < 0.001) in the A-group and from 63 to 25 (P < 0.001) in the AS-group. Average maximum incisor opening increased significantly in both groups but did not significantly differ between groups (P = 0.223). Joint sounds did not significantly improve within groups (A-group, P = 0.495; AS-group, P = 0.236). Both methods resulted in significant long-term improvements in pain and jaw function.
Collapse
Affiliation(s)
- Sara Bergstrand
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo
| | - Hanne K Ingstad
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo
| | - Anne Møystad
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo
| | - Tore Bjørnland
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo
| |
Collapse
|
18
|
Sequeira J, Rao BHS, Kedia PR. Efficacy of Sodium Hyaluronate for Temporomandibular Joint Disorder by Single-Puncture Arthrocentesis. J Maxillofac Oral Surg 2019; 18:88-92. [PMID: 30728698 DOI: 10.1007/s12663-018-1093-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 02/07/2018] [Indexed: 11/24/2022] Open
Abstract
Background The term temporomandibular joint internal derangement has characteristic clinical findings such as restricted mouth opening, pain, irregular deviated jaw function and clicking sounds. The technique of TMJ arthrocentesis has gained widespread acceptance as a simple and effective technique for the treatment of acute persistent closed lock of the TMJ. Arthrocentesis is known as the lavage and lysis of upper joint compartment. Purpose To evaluate the efficacy of sodium hyaluronate followed by single-puncture arthrocentesis. Sodium hyaluronate is the sodium salt of hyaluronic acid which is a polysaccharide of the glycosaminoglycans family, found in many extracellular tissues, including synovial fluid and cartilage. Exogenous hyaluronate can stimulate the synthesis of endogenous hyaluronic acid. Methods In our study, a sample of 10 patients (7 females and 3 males) with TMJ disorder was selected. Arthrocentesis was done followed by sodium hyaluronate injection for all the patients. Results On follow-up ranging from 1 to 3 months, pain at rest and pain on mastication had substantially decreased in all patients and mandibular function and mouth opening had significantly improved. Conclusion Our study shows that single-puncture Ringer's lactate arthrocentesis followed by sodium hyaluronate injection is effective in the management of the internal derangement of the temporomandibular joint.
Collapse
Affiliation(s)
- Joyce Sequeira
- 1Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, India
| | - B H Sripathi Rao
- 1Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, India
| | - Pallav Raj Kedia
- 1Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, India.,Gopalganj, Bihar India
| |
Collapse
|
19
|
Champs B, Corre P, Hamel A, Laffite C, Le Goff B. US-guided temporomandibular joint injection: Validation of an in-plane longitudinal approach. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:67-70. [DOI: 10.1016/j.jormas.2018.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/21/2018] [Indexed: 11/30/2022]
|
20
|
Fonseca RMDFB, Januzzi E, Ferreira LA, Grossmann E, Carvalho ACP, de Oliveira PG, Vieira ÉLM, Teixeira AL, Almeida-Leite CM. Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series. Pain Res Manag 2018; 2018:5392538. [PMID: 30154944 PMCID: PMC6091395 DOI: 10.1155/2018/5392538] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/11/2018] [Accepted: 07/09/2018] [Indexed: 12/26/2022]
Abstract
Viscosupplementation is a minimally invasive technique that replaces synovial fluid by intra-articular injection of hyaluronic acid (HA). Although effective in some joints, there is not conclusive evidence regarding temporomandibular disorders. This case series described the efficacy of a viscosupplementation protocol in intra-articular temporomandibular disorders. Ten patients with a diagnosis of disc displacement and/or osteoarthritis by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to four monthly injections of low or medium molecular weight HA. Pain, mandibular function, image analysis by tomography and magnetic resonance, and quality of life were assessed at baseline and follow-ups (1 and 6 months). Pain, jaw range-of-motion, mandibular function, and quality of life improved at follow-up evaluations. Osteoarthritis changes decreased, and 20% of patients improved mandibular head excursion after treatment. Resolution of effusion and improvement in disc morphology were observed for most patients. This viscosupplementation protocol reduced pain and symptoms associated with internal derangement of temporomandibular joint, improved quality of life, and showed benefits from both low and medium molecular weight HA in alternate cycles.
Collapse
Affiliation(s)
| | | | - Luciano Ambrosio Ferreira
- Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- 9 Hospital Maternidade Therezinha de Jesus-HMTJ/JF, Suprema-Faculdade de Ciências Médicas e da Saúde, Juiz de Fora, Brazil
| | - Eduardo Grossmann
- Departamento de Ciências Morfológicas, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Antonio Carlos Pires Carvalho
- Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Antônio Lúcio Teixeira
- Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Belo Horizonte, MG, Brazil
- Department of Psychiatry and Behavioral Sciences, The University of Texas, Houston, TX, USA
| | - Camila Megale Almeida-Leite
- Programa de Pós-Graduação em Patologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Morfologia, Instituto de Ciências Biológicas, UFMG, Belo Horizonte, MG, Brazil
| |
Collapse
|
21
|
Li L, Shi H, Xie H, Wang L. MRI assessment and histopathologic evaluation of subchondral bone remodeling in temporomandibular joint osteoarthritis: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:355-362. [PMID: 30122441 DOI: 10.1016/j.oooo.2018.05.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of the study was to characterize subchondral bone remodeling by using magnetic resonance imaging (MRI) and histopathologic assessment of temporomandibular joint osteoarthritis (TMJOA) and to analyze the correlations between them. STUDY DESIGN The retrospective study was based on 153 joints of 100 patients. These patients had undergone MRI and had been diagnosed with temporomandibular joint internal derangement Wilkes stage IV-V, followed by the failure of conservative or arthroscopic/anchorage treatment. We evaluated and compared 136 joints based on MRI and histopathologic observation. According to the modified Osteoarthritis Research Society International system and the Diagnostic Criteria for Temporomandibular Disorders system, the scores of histopathology and MRI were compared by using kappa categorical agreement analysis. RESULTS MRI showed subchondral bone changes in 153 joints, 136 of which had been subjected to surgical treatment and histopathologic assessment. Statistical tests revealed substantial agreement between MRI and histopathology (κ value: 0.779). CONCLUSIONS MRI is an effective technique to evaluate the pathologic changes of TMJOA. Our histopathologic grading criteria contributed to the clarification of the occurrence and developmental process of TMJOA. Therefore, the evidence of MRI should be seen as a reference standard for the choice of nonsurgical or surgical therapy in the management of TMJOA.
Collapse
Affiliation(s)
- Lingzhi Li
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Huimin Shi
- Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Han Xie
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lizhen Wang
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China.
| |
Collapse
|
22
|
Dashnyam K, Lee JH, Mandakhbayar N, Jin GZ, Lee HH, Kim HW. Intra-articular biomaterials-assisted delivery to treat temporomandibular joint disorders. J Tissue Eng 2018; 9:2041731418776514. [PMID: 29785258 PMCID: PMC5954570 DOI: 10.1177/2041731418776514] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 04/23/2018] [Indexed: 12/19/2022] Open
Abstract
The temporomandibular joint disorder, also known as myofascial pain syndrome, is considered one of the prevalent chronic pain diseases caused by muscle inflammation and cartilage degradation in head and neck, and thus influences even biopsychosocial conditions in a lifetime. There are several current treatment methodologies relieving inflammation and preventing degradation of the joint complex. One of the promising non-surgical treatment methods is an intra-articular injection of drugs such as corticosteroids, analgesics, and anti-depressants. However, the side effects of drugs due to frequent injections and over-doses, including dizziness, dry mouth, and possible drug dependency are considered limitations. Thus, the delivery of therapeutic molecules through the use of nano/microparticles is currently considered as a promising strategy primarily due to the controlled release. This review highlights the nano/microparticle systems for effective intra-articular therapeutics delivery to prevent cartilage degradation and protect subchondral bone in a temporomandibular joint.
Collapse
Affiliation(s)
- Khandmaa Dashnyam
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, South Korea.,Department of Nanobiomedical Science & BK21 PLUS Global Research Center for Regenerative Medicine, Dankook University, Cheonan, South Korea
| | - Jung-Hwan Lee
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, South Korea.,Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan, South Korea
| | - Nandin Mandakhbayar
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, South Korea.,Department of Nanobiomedical Science & BK21 PLUS Global Research Center for Regenerative Medicine, Dankook University, Cheonan, South Korea
| | - Guang-Zhen Jin
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, South Korea.,Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan, South Korea
| | - Hae-Hyoung Lee
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, South Korea.,Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan, South Korea
| | - Hae-Won Kim
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, South Korea.,Department of Nanobiomedical Science & BK21 PLUS Global Research Center for Regenerative Medicine, Dankook University, Cheonan, South Korea.,Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan, South Korea
| |
Collapse
|
23
|
Hossameldin R, McCain J. Outcomes of office-based temporomandibular joint arthroscopy: a 5-year retrospective study. Int J Oral Maxillofac Surg 2018; 47:90-97. [DOI: 10.1016/j.ijom.2017.06.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 05/08/2017] [Accepted: 06/26/2017] [Indexed: 12/11/2022]
|
24
|
Cen X, Liu Y, Wang S, Yang X, Shi Z, Liang X. Glucosamine oral administration as an adjunct to hyaluronic acid injection in treating temporomandibular joint osteoarthritis. Oral Dis 2017; 24:404-411. [PMID: 28862770 DOI: 10.1111/odi.12760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 07/28/2017] [Accepted: 08/10/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the therapeutic effect of oral glucosamine (GS) as an adjunct to hyaluronic acid (HA) injection on patients with temporomandibular joint osteoarthritis (TMJ OA). METHODS In this clinical trial, 136 participants, diagnosed as TMJ OA clinically and radiographically, were enrolled and randomized into two groups (group GS + HA: oral GS + HA injection; group placebo + HA: oral placebo + HA injection). Pain, maximum interincisal mouth opening (MMO), the levels of IL-1β, IL-6, and TGF-β in TMJ synovial were defined as the outcome measurements and conducted before operation, and at 1-month and 1-year follow-up. RESULTS In both groups, pain scores were decreased and MMOs were increased at 1-month and 1-year follow-up, the changes at 1-year follow-up showed statistically significant intergroup differences. At 1-month follow-up, only IL-6 concentration was lower in group GS + HA than that in group placebo + HA. One year later, TGF-β concentration was higher and IL-6 and IL-1β concentrations were lower in group GS + HA than those in group placebo + HA. CONCLUSIONS Both strategies alleviated symptoms in short term, but the patients treated with GS benefited more than those with placebo in long term, which may be due to the suppression of IL-1β and IL-6 and the stimulation of TGF-β.
Collapse
Affiliation(s)
- Xiao Cen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, Sichuan, China.,Department of Oral and Maxillofacial Surgery, West China College of Stomatology (Sichuan University), Chengdu, Sichuan, China
| | - Yan Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, Sichuan, China.,Department of Oral and Maxillofacial Surgery, West China College of Stomatology (Sichuan University), Chengdu, Sichuan, China
| | - Shasha Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, Sichuan, China.,Department of Oral and Maxillofacial Surgery, West China College of Stomatology (Sichuan University), Chengdu, Sichuan, China
| | - Xianrui Yang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, Sichuan, China.,Department of Orthodontics, West China College of Stomatology (Sichuan University), Chengdu, Sichuan, China
| | - Zongdao Shi
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, Sichuan, China.,Department of Oral and Maxillofacial Surgery, West China College of Stomatology (Sichuan University), Chengdu, Sichuan, China
| | - Xinhua Liang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, Sichuan, China.,Department of Oral and Maxillofacial Surgery, West China College of Stomatology (Sichuan University), Chengdu, Sichuan, China
| |
Collapse
|
25
|
Al-Delayme RMA, Alnuamy SH, Hamid FT, Azzamily TJ, Ismaeel SA, Sammir R, Hadeel M, Nabeel J, Shwan R, Alfalahi SJ, Yasin A. The Efficacy of Platelets Rich Plasma Injection in the Superior Joint Space of the Tempromandibular Joint Guided by Ultra Sound in Patients with Non-reducing Disk Displacement. J Maxillofac Oral Surg 2017; 16:43-47. [PMID: 28286383 PMCID: PMC5328864 DOI: 10.1007/s12663-016-0911-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 04/18/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to determine average improvement during the rest and active mouth opening after ultrasound guided platelets rich plasma injection in the tempromandibular superior joint space for the patients complaining from non-reducing disk displacement. PATIENTS AND METHODS Thirty-four patients with non-reducing disk displacement underwent guided ultrasound injection of platelet rich plasma to the upper joint space. The extent of maximal mouth opening, chewing efficiency, sound intensity of the TMJ, and tenderness of the TMJ and the masticatory muscles at rest, motion and mastication were thoroughly assessed at the beginning of the study and scheduled for next follow-up at 1st, 3rd, and 6th months. RESULTS Injection with platelets rich plasma was significantly more effective in improvements of the extent of maximal mouth opening, statistics result demonstrated a significant reduction in the VAS values of pain at rest, motion and mastication compared to the baseline VAS values. CONCLUSION PRP injection to the upper temporomandibular joint space provided improvement in signs and symptoms of patient with non-reducing disk displacement of the temporomandibular joint.
Collapse
Affiliation(s)
- Ra’ed M. Ayoub Al-Delayme
- Faculty of Dentistry, Dijlah University College, Baghdad, Iraq
- Oral and Maxillofacial Surgery Department, AL-Yarmuk Teaching Hospital, Baghdad, Iraq
- Eastman Institute for Oral Health, University of Rochester, New York, USA
| | | | | | | | | | | | | | | | | | | | - Alaa Yasin
- Periodontics Department University of Washington, Washington, USA
| |
Collapse
|
26
|
Gurung T, Singh RK, Mohammad S, Pal US, Mahdi AA, Kumar M. Efficacy of arthrocentesis versus arthrocentesis with sodium hyaluronic acid in temporomandibular joint osteoarthritis: A comparison. Natl J Maxillofac Surg 2017; 8:41-49. [PMID: 28761275 PMCID: PMC5512408 DOI: 10.4103/njms.njms_84_16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease characterized by deterioration of articular tissue with concomitant osseous changes in the condyle and/or articular eminence, joint positive for TMJ noise with jaw movement or function, crepitus detected on palpation on opening, closing, right/left lateral, or protrusive movement. Hyaluronic acid (HA) is a polysaccharide of the family of glycosaminoglycans. HA has been shown to improve and restore normal lubrication in joint, provide nutrition to the avascular articulating disc, and stabilize the joint. MATERIALS AND METHODS Twenty patients with OA of TMJ with age limit between 18 and 60 years of age were enrolled in this study. Patients were randomly divided into two groups, in which one group received arthrocentesis only, and another group received arthrocentesis plus intra-articular injection of sodium HA (0.5 ml) in superior joint space in a cycle of 5 weekly arthrocentesis (one per week). Patients were followed at regular interval of 1st day, 5th day, 7th day, 4 weeks, 6 weeks, and 12 weeks. Assessment of clinical outcome was done in terms of reduction in pain (visual analog scale score), maximum mouth opening (MMO) in millimeters, painful/pain-free lateral or protrusive jaw movement, and clicking/crepitus in joint. RESULTS Significant reduction in pain was observed in both the groups. MMO, lateral and protrusive movements improved significantly in both groups; however, arthrocentesis with sodium HA was superior to arthrocentesis alone. CONCLUSION Combination of arthrocentesis with HA injection showed much better outcome than arthrocentesis alone.
Collapse
Affiliation(s)
- Tikaram Gurung
- Department of Oral and Maxillofacial Surgery, KGMU, Lucknow, Uttar Pradesh, India
| | - R K Singh
- Department of Oral and Maxillofacial Surgery, KGMU, Lucknow, Uttar Pradesh, India
| | - Shadab Mohammad
- Department of Oral and Maxillofacial Surgery, KGMU, Lucknow, Uttar Pradesh, India
| | - U S Pal
- Department of Oral and Maxillofacial Surgery, KGMU, Lucknow, Uttar Pradesh, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, KGMU, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar
- Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
27
|
Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review. Int J Oral Maxillofac Surg 2016; 45:1531-1537. [DOI: 10.1016/j.ijom.2016.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/14/2016] [Accepted: 06/06/2016] [Indexed: 11/19/2022]
|
28
|
Guarda-Nardini L, Cadorin C, Frizziero A, Masiero S, Manfredini D. Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: Effects of intra-articular injection with hyaluronic acid. Cranio 2016; 35:276-282. [PMID: 27638344 DOI: 10.1080/08869634.2016.1232788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis. METHODS Forty-nine patients, (79% females, aged between 43-81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol. RESULTS A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p < 0.001). Most parameters of active cervical range of motion showed an improvement with time. Benefits remained stable throughout six months after the viscosupplementation protocol. CONCLUSIONS A protocol of TMJ intra articular arthrocentesis and viscosupplementation improved cervical function and reduced disability in patients with concurrent cervical spine pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders.
Collapse
Affiliation(s)
- Luca Guarda-Nardini
- a TMD Clinic, Department of Neuroscience , University of Padua , Padova , Italy.,b Section of Dentistry and Maxillofacial Surgery , Hospital of Treviso , Treviso , Italy
| | - Cristina Cadorin
- c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy
| | - Antonio Frizziero
- c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy
| | - Stefano Masiero
- c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy
| | - Daniele Manfredini
- a TMD Clinic, Department of Neuroscience , University of Padua , Padova , Italy.,d School of Dentistry , University of Padova , Padova , Italy
| |
Collapse
|
29
|
Is Hyaluronic Acid Injection Effective for the Treatment of Temporomandibular Joint Disc Displacement With Reduction? J Oral Maxillofac Surg 2016; 74:1728-40. [DOI: 10.1016/j.joms.2016.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/08/2016] [Accepted: 03/08/2016] [Indexed: 11/21/2022]
|
30
|
Marty P, Louvrier A, Weber E, Dubreuil PA, Chatelain B, Meyer C. [Arthrocentesis of the temporomandibular joint and intra-articular injections : An update]. ACTA ACUST UNITED AC 2016; 117:266-72. [PMID: 27554488 DOI: 10.1016/j.revsto.2016.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Arthocentesis of the temporomandibular joint combined with intra-articular washout and, more recently, intra-articular injection of pharmacological agents has been developed from the 1990s and is nowadays extensively in use for the treatment of temporomandibular dysfunctions (TMDs). The goal of our work was to answer 3 questions: 1. Is intra-articular washout effective for the treatment of TMDs ? 2. What kind of pharmacological agents may nowadays be injected in addition to washout and are these injections useful ? 3. What is the place of these treatments in the treatment strategies of TMDs ? MATERIAL AND METHODS A bibliographic research has been carried out in the PubMed database using following keywords arthrocentesis, temporomandibular joint. The 27 articles published between 1991 and 2016, indicating patient's inclusion criterions and objectively evaluating the clinical results (mouth opening, intra-articular noises, pain) were selected. Pharmacological agents were noticed when used. RESULTS 1. All authors concluded to the efficacy of intra-articular washout. No prognostic factor for arthrocentesis efficacy could be identified. 2. Main pharmacological agents used were steroids, hyaluronic acid, morphine-based drugs and platelet rich plasma. Superiority of ith-injection protocols failed to win unanimous support. All authors who compared with- and without-injection protocols concluded to the superiority of with-injection protocols, whatever the agent. DISCUSSION Numerous studies have proven the efficacy of intra-articular washout for the treatment of TMDs resistant to noninvasive treatments. The advantage of any kind of pharmacological agent is not clear. Mechanisms of action are not all elucidated. No pharmacological agent showed any superiority over another. Study methodologies are often defective: imprecise inclusion criterions, short follow-up, confounding variables not taken into account, few comparison between pharmacological agents.
Collapse
Affiliation(s)
- P Marty
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France.
| | - A Louvrier
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - P-A Dubreuil
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - B Chatelain
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, boulevard Fleming, 25030 Besançon cedex, France; Nanomedicine Lab, Imagery and Therapeutics-UFR SMP, 19, rue Ambroise-Paré, 25030 Besançon cedex, France
| |
Collapse
|
31
|
Nitzan DW, Svidovsky J, Zini A, Zadik Y. Effect of Arthrocentesis on Symptomatic Osteoarthritis of the Temporomandibular Joint and Analysis of the Effect of Preoperative Clinical and Radiologic Features. J Oral Maxillofac Surg 2016; 75:260-267. [PMID: 27643632 DOI: 10.1016/j.joms.2016.08.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 08/16/2016] [Accepted: 08/16/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the long-term outcome of arthrocentesis in patients with symptomatic temporomandibular joint (TMJ) osteoarthritis that was unresponsive to nonsurgical interventions. MATERIALS AND METHODS Seventy-nine patients (83 joints) with symptomatic TMJ osteoarthritis that had not responded to nonsurgical interventions and who underwent arthrocentesis were included in this study. Demographic, clinical, and radiologic data, including assessment of pain, dysfunction, improvement, and satisfaction, and maximal mouth opening were analyzed. RESULTS The analysis included 67 female patients (84.8%) and 12 male patients (15.2%), 13 to 70 years old, who were followed for 56.9 ± 6.7 months. Sixty-four (81%) reacted favorably to arthrocentesis. For these patients, maximal mouth opening increased from 26.3 ± 0.8 to 39.24 ± 0.9 mm (P < .001). Pain and dysfunction scores decreased from 6.92 ± 0.2 to 2.36 ± 0.3 (P < .001) and from 7.37 ± 0.2 to 2.24 ± 0.4 (P < .001), respectively. Overall score for patient satisfaction with arthrocentesis was 8.78 ± 0.3. The procedure had no lasting complications. Remarkably, the severity of preoperative pain, dysfunction, and range of motion and of radiographic changes did not correlate with the outcome of arthrocentesis. The severity of preoperative or postoperative signs and symptoms was not correlated with the severity of radiographic changes. CONCLUSIONS For most patients, arthrocentesis offers long-term favorable outcomes for symptomatic TMJ osteoarthritis that has not responded to nonsurgical treatments and otherwise would have required surgical arthroplasty. Severity of preoperative clinical and computerized tomographic findings is not predictive for the success of arthrocentesis. In addition, the lack of correlation between the clinical and radiologic findings negates the commonly used Wilkes classification, which presumes that the clinical signs and symptoms deteriorate together with radiologic changes.
Collapse
Affiliation(s)
- Dorrit W Nitzan
- Professor, Department of Oral and Maxillofacial Surgery, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
| | - Jesica Svidovsky
- Practitioner, Department of Oral Rehabilitation, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Avraham Zini
- Professor, Department of Community Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Yehuda Zadik
- Faculty, Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University, Hadassah School of Dental Medicine, Jerusalem; Head, Department of Oral Medicine, Oral and Maxillofacial Institute, Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| |
Collapse
|
32
|
Bouloux GF, Chou J, Krishnan D, Aghaloo T, Kahenasa N, Smith JA, Giannakopoulos H. Is Hyaluronic Acid or Corticosteroid Superior to Lactated Ringer Solution in the Short Term for Improving Function and Quality of Life After Arthrocentesis? Part 2. J Oral Maxillofac Surg 2016; 75:63-72. [PMID: 27632067 DOI: 10.1016/j.joms.2016.08.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 08/11/2016] [Accepted: 08/11/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE Although arthrocentesis has been used for the management of patients with temporomandibular joint pain, the benefit of hyaluronic acid (HA) or corticosteroid (CS) remains uncertain. The purpose of this study was to assess the efficacy of HA, CS, and lactated Ringer solution (LR; placebo) after arthrocentesis for changes in quality of life (QoL), jaw function (Jaw Function Limitation Scale [JFLS] score), and maximum incisal opening (MIO). MATERIALS AND METHODS This was a prospective multicenter double-blinded randomized clinical trial. Consecutive patients presenting to the oral and maxillofacial departments at Emory University, the University of Pennsylvania, the University of California-Los Angeles, the University of Cincinnati, and the Oregon Health Sciences University were enrolled in the study. Patients were randomized to HA, CS, or LR. All patients underwent arthrocentesis and then instillation of HA, CS, or LR. All patients were evaluated clinically at 1 and 3 months. The outcome variables were QoL, JFLS score, and MIO. Univariate, bivariate, and multivariate statistics were computed, with a P value less than .05 considered significant. RESULTS One hundred two patients were enrolled in the study. Four were lost to follow-up, leaving 98 patients for analysis of data at 1 month. An additional 51 were lost to follow-up at 3 months, leaving 51 patients for data analysis at this time point. There was no difference among groups for QoL Mental Health Composite score at 1 month (P = .70) or 3 months (P = .69). There was no difference among groups for JFLS score at 1 month (P = .71) or 3 months (P = .98). There was no difference among groups for MIO at 1 month (P = .47) or 3 months (P = .31). All groups showed within-group improvements in JFLS score and MIO at 1 and 3 months. CONCLUSION Arthrocentesis alone is as efficacious as arthrocentesis with HA or CS in improving jaw function and MIO at 1 and 3 months. QoL is not improved with arthrocentesis alone or in combination with CS or HA.
Collapse
Affiliation(s)
- Gary F Bouloux
- Associate Professor, Department of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Jolie Chou
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University Buffalo New York, Buffalo, NY; formerly, University of Pennsylvania, Philadelphia, PA
| | - Deepak Krishnan
- Associate Professor, Department of Oral and Maxillofacial Surgery, University of Cincinnati, Cincinnati, OH
| | - Tara Aghaloo
- Professor, Department of Oral and Maxillofacial Surgery, University of California-Los Angeles, Los Angeles, CA
| | - Nora Kahenasa
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, University of California-Los Angeles. Los Angeles, CA
| | - Julie Ann Smith
- Associate Professor, Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR
| | - Helen Giannakopoulos
- Associate Professor, Department of Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
33
|
Bouloux GF, Chou J, Krishnan D, Aghaloo T, Kahenasa N, Smith JA, Giannakopoulos H. Is Hyaluronic Acid or Corticosteroid Superior to Lactated Ringer Solution in the Short-Term Reduction of Temporomandibular Joint Pain After Arthrocentesis? Part 1. J Oral Maxillofac Surg 2016; 75:52-62. [PMID: 27632069 DOI: 10.1016/j.joms.2016.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 07/27/2016] [Accepted: 08/06/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE Arthrocentesis has been used for the management of patients with temporomandibular joint (TMJ) pain, with good success. The additional use of hyaluronic acid (HA) or corticosteroid (CS) remains controversial. The purpose of this study was to compare HA, CS, and lactated Ringer solution (LR; placebo) after arthrocentesis. MATERIALS AND METHODS This was a prospective multicenter double-blinded randomized clinical trial. Consecutive patients presenting to the oral and maxillofacial departments at Emory University, the University of Pennsylvania, the University of California-Los Angeles, the University of Cincinnati, and the Oregon Health Sciences University were enrolled in the study. Patients were randomized to HA, CS, or LR. All patients underwent arthrocentesis and then the instillation of HA, CS, or LR. Patients were evaluated clinically at 1 and 3 months. The primary outcome variable was pain at 1 month (by visual analog scale). Secondary outcome variables were pain at 3 months and analgesic consumption. Univariate, bivariate, and multivariate statistics were computed, with a P value less than .05 considered significant. RESULTS One hundred two patients were enrolled in the study. Four were lost to follow-up, leaving 98 patients for the final analysis. The mean age of patients in the HA, CS, and LR groups was 39.6, 44.3, and 51.8 years, respectively (P = .02). There was no difference among groups in time to follow-up at 1 month (P = .11). The mean decrease in pain in the CS group was 19% for right-side procedures (P = .12) and 36% for left-side procedures (P = .02). The mean decrease in pain in the HA group was 31% for right-side procedures (P = .01) and 34% for left-side procedures (P = .01). The mean decrease in pain in the LR group was 43% for right-side procedures (P < .01) and 37% for left-side procedures (P < .01). There was no difference in pain decrease among groups (P = .55). There was no difference in the use of narcotic (P = .52) or nonsteroidal anti-inflammatory drugs (P = .71) among groups. CONCLUSION Arthrocentesis alone is as efficacious as arthrocentesis with HA or CS in decreasing TMJ pain.
Collapse
Affiliation(s)
- Gary F Bouloux
- Associate Professor, Department of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Jolie Chou
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University Buffalo New York, Buffalo, NY; formerly, University of Pennsylvania, Philadelphia, PA
| | - Deepak Krishnan
- Associate Professor, Department of Oral and Maxillofacial Surgery, University of Cincinnati, Cincinnati, OH
| | - Tara Aghaloo
- Professor, Department of Oral and Maxillofacial Surgery, University of California-Los Angeles, Los Angeles, CA
| | - Nora Kahenasa
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, University of California-Los Angeles, Los Angeles, CA
| | - Julie Ann Smith
- Associate Professor, Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR
| | - Helen Giannakopoulos
- Associate Professor, Department of Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
34
|
Sivri MB, Ozkan Y, Pekiner FN, Gocmen G. Comparison of ultrasound-guided and conventional arthrocentesis of the temporomandibular joint. Br J Oral Maxillofac Surg 2016; 54:677-81. [DOI: 10.1016/j.bjoms.2016.04.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/05/2016] [Indexed: 10/21/2022]
|
35
|
Cömert Kiliç S, Güngörmüş M. Is arthrocentesis plus platelet-rich plasma superior to arthrocentesis plus hyaluronic acid for the treatment of temporomandibular joint osteoarthritis: a randomized clinical trial. Int J Oral Maxillofac Surg 2016; 45:1538-1544. [PMID: 27364372 DOI: 10.1016/j.ijom.2016.06.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/23/2016] [Accepted: 06/13/2016] [Indexed: 01/26/2023]
Abstract
A randomized clinical trial was implemented in adult patients with temporomandibular joint osteoarthritis (TMJ OA). The sample comprised 49 osteoarthritic joints in 31 consecutive patients. Patients were divided randomly into two groups according to the treatment technique applied: the platelet-rich plasma (PRP) group patients underwent initial arthrocentesis plus PRP injection and then four consecutive PRP injections; the hyaluronic acid (HA) group patients underwent one session of arthrocentesis plus HA injection. The predictor variable was the treatment technique. The outcome variables included visual analogue scale (VAS) evaluations and maximum inter-incisal opening (MIO) measurements. Outcome variables were recorded preoperatively and at 12 months postoperative. Descriptive and bivariate statistics were computed and significance was set at P<0.05. The PRP group included 32 joints in 18 subjects, and the HA group included 17 joints in 13 subjects. No statistically significant difference was observed between the groups for any of the changes in VAS parameters or MIO measurements. Both treatment techniques resulted in significant clinical improvements in all VAS parameters and painless MIO. These findings suggest that arthrocentesis plus PRP injections is not superior to arthrocentesis plus a single HA injection; thus PRP injection should not be considered as the first line treatment. Arthrocentesis plus HA injection would appear to be more acceptable for patients.
Collapse
Affiliation(s)
- S Cömert Kiliç
- Ministry of Health, Department of Oral and Maxillofacial Surgery, Centre for Oral and Dental Health, Erzurum, Turkey.
| | - M Güngörmüş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
| |
Collapse
|
36
|
Long-Term Outcome of Arthrocentesis Plus Hyaluronic Acid Injection in Patients With Wilkes Stage II and III Temporomandibular Joint Internal Derangement. J Craniofac Surg 2016; 26:2104-8. [PMID: 26468791 DOI: 10.1097/scs.0000000000002078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Arthrocentesis is a minimally invasive procedure used to manage temporomandibular joint (TMJ) internal derangement (ID). This study evaluated the outcome of arthrocentesis in patients with Wilkes stage II and III TMJ ID. PATIENTS AND METHODS This retrospective study enrolled 50 patients who underwent arthrocentesis in 2011 and 2012 at the Karadeniz Technical University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Turkey. In total, 43 patients underwent unilateral arthrocentesis, whereas 7 patients had bilateral arthrocentesis. The clinical parameters recorded were pain (visual analogue scale [VAS] 0-100 mm during movement), chewing function efficacy (VAS 0-100), clicking sounds, and mandibular movements, including maximum interincisal opening (MIO), lateral excursion, and protrusion. All the parameters were recorded preoperatively, and 1, 3, 6, and 24 months after treatment. RESULTS The MIO, lateral excursion, and protrusion were significantly greater than preoperatively in all the patients. Pain declined significantly postoperatively. The patients in Wilkes III group had greater improvement in mandibular movement and pain than the patients in Wilkes II group. CONCLUSION Arthrocentesis was reliable for treating both Wilkes II and III TMJ ID, and the treatment results were better in Wilkes III patients.
Collapse
|
37
|
Zhao N, Wang X, Qin L, Zhai M, Yuan J, Chen J, Li D. Effect of hyaluronic acid in bone formation and its applications in dentistry. J Biomed Mater Res A 2016; 104:1560-9. [PMID: 27007721 DOI: 10.1002/jbm.a.35681] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Ningbo Zhao
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Xin Wang
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Lei Qin
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Min Zhai
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Jing Yuan
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Ji Chen
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Dehua Li
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| |
Collapse
|
38
|
Temporomandibular joint disorders treated with articular injection: the effectiveness of plasma rich in growth factors-Endoret. J Craniofac Surg 2016; 26:709-13. [PMID: 25974777 DOI: 10.1097/scs.0000000000001534] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The objective of this study was to evaluate the effectiveness of the temporomandibular joint (TMJ) osteoarthritis treatment through articular injections of plasma rich in growth factors (PGRF)-Endoret. Thirteen patients (median age, 47.64 y; SD, 7.51; range, 40-64 y; male-female ratio, 2:11) with osteoarthritis of TMJ associated to chronic pain have been selected. They were treated with articular injections of PRGF-Endoret, measuring the maximum mouth opening and pain level before the first injection (t0), 30 days after just before the second (t1), and after 6 months (t2). Data were analyzed using the paired Student's t-test data. The visual analogue scale score at t0 is 7.69 (range, 4-10; SD, 1.9), whereas that at t1 is 1.54 (range, 0-5; SD, 1.74) and that at t2 is 0.23 (range, 0-2; SD, 0.65). These differences in the results are statistically highly significant (P < 0.0001 comparison t0-t1 and t0-t2 and P < 0.01 comparison t1-t2). In terms of maximum mouth opening, it reduced from 30.15 mm at t0 (range, 26-40 mm; SD, 4.44) to 37.54 mm at t1 (range, 31-51 mm; SD, 5.10), with an increase of 7.38 mm (range, 4-11 mm; SD, 2.02) and a highly significant difference (P < 0.0001). At t2, it was 39.54 mm (range, 34-51; SD, 4.55) with an increase of 9.38 mm (range, 5-12 mm; SD, 2.21) compared with t0 and that of 2.00 mm compared with t1. Both differences in the results are statistically significant (P < 0.0001 and P < 0.01, respectively). The articular injections of PRGF-Endoret represent a very efficient method to control pain and to improve the TMJ mobility.
Collapse
|
39
|
Abstract
TMDs are a group of conditions affecting the joint and or the muscles of mastication.TMDs consist of three main groups of conditions: myofascial pain; disc disorders; TMJ arthritides.The gold standard diagnostic criteria for research involving TMDs are the Research Diagnostic Criteria for TMDs (RDC/TMD). A pragmatic clinically applicable alternative is the Clinical examination protocol for TMDs (CEP-TMD).Signs and symptoms can include: pain in masticatory musculature and or the joint; noises associated with joint movements; locking; headache; otalgia.TMDs' aetiology is multifactorial and biopsychosocial in nature.Reversible conservative management as defined by the American Association of Dental Research is the initial management of choice for all subgroups of TMDs.
Collapse
Affiliation(s)
- J Durham
- NIHR Academic Clinical Lecturer in Oral Surgery
| | - R W Wassell
- Senior Lecturer/Hon Consultant in Restorative Dentistry School of Dental Sciences, Newcastle University. United Kingdom
| |
Collapse
|
40
|
Efficacy of hyaluronic acid injections in patients with osteoarthritis of the temporomandibular joint. A comparative study. J Craniofac Surg 2015; 24:2006-9. [PMID: 24220392 DOI: 10.1097/scs.0b013e3182a30566] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of the present study was to report the 1-year therapeutic outcome of intra-articular injections of high-molecular-weight hyaluronic acid (HA) without arthrocentesis in a group of 25 patients with osteoarthritis (OA) of the temporomandibular joint (TMJ). The results were compared with those of a group of 10 patients with OA of the TMJ, treated with nonsteroidal anti-inflammatory drugs.Twenty-five patients (group A) underwent a cycle of 5 injections of HA into the TMJ. Ten patients (group B) underwent a therapy with nonsteroidal anti-inflammatory drugs for 1 month. The follow-up assessments after the end of treatment were at 1, 3, 6, and 12 months.Regarding the first follow-up (1 month), statistical analysis for all clinical parameters showed no significant differences (ie, beneficial effect for 2 groups) between groups A and B (P > 0.001). Significant statistical differences (ie, encouraging effect for group A) for all clinical parameters were recorded 1 year after the end of treatment between groups A and B (P < 0.001).A cycle of 5 intra-articular injections of HA without arthrocentesis for patients with OA of the TMJ is considered successful at 1-year follow-up period.
Collapse
|
41
|
Guarda-Nardini L, Rossi A, Arboretti R, Bonnini S, Stellini E, Manfredini D. Single- or multiple-session viscosupplementation protocols for temporomandibular joint degenerative disorders: a randomized clinical trial. J Oral Rehabil 2015; 42:521-8. [DOI: 10.1111/joor.12282] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- L. Guarda-Nardini
- Department of Maxillofacial Surgery; Temporomandibular Disorders Clinic; University of Padova; Padova Italy
| | - A. Rossi
- Department of Maxillofacial Surgery; Temporomandibular Disorders Clinic; University of Padova; Padova Italy
| | - R. Arboretti
- Department of Land Use and AgriForestal Systems; University of Padova; Padova Italy
| | - S. Bonnini
- Department of Economics and Management; University of Ferrara; Ferrara Italy
| | - E. Stellini
- School of Dentistry; University of Padova; Padova Italy
| | - D. Manfredini
- Department of Maxillofacial Surgery; Temporomandibular Disorders Clinic; University of Padova; Padova Italy
| |
Collapse
|
42
|
Guarda-Nardini L, Rossi A, Ramonda R, Punzi L, Ferronato G, Manfredini D. Effectiveness of treatment with viscosupplementation in temporomandibular joints with or without effusion. Int J Oral Maxillofac Surg 2014; 43:1218-23. [DOI: 10.1016/j.ijom.2014.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 03/01/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022]
|
43
|
Li C, Long X, Deng M, Li J, Cai H, Meng Q. Osteoarthritic changes after superior and inferior joint space injection of hyaluronic acid for the treatment of temporomandibular joint osteoarthritis with anterior disc displacement without reduction: a cone-beam computed tomographic evaluation. J Oral Maxillofac Surg 2014; 73:232-44. [PMID: 25579006 DOI: 10.1016/j.joms.2014.08.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 08/21/2014] [Accepted: 08/25/2014] [Indexed: 12/15/2022]
Abstract
PURPOSE This study compared the effect of superior and inferior joint space injections of hyaluronic acid (HA) and evaluated osteoarthritic changes in patients diagnosed with temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDw/oR) in association with osteoarthritis (OA) by cone-beam computed tomography (CBCT). MATERIALS AND METHODS One hundred forty-one patients with research diagnostic criteria for ADDw/oR in association with TMJ OA were randomly assigned to 1 of 2 study groups that received superior or inferior joint space injection of HA. CBCT and clinical examination were performed before treatment and at 3 and 9 months after treatment. RESULTS One hundred twenty-six patients returned for the 3-month evaluations, and 74 returned for the 9-month evaluations. Condylar remodeling and TMJ function showed improvement in most patients after treatment. At 3 months, remodeling scores in the superior and inferior groups were 2.14 ± 3.16 and 4.08 ± 3.82, respectively, and scores were 4.80 ± 3.36 and 7.47 ± 3.90 at 9 months. There were significant differences between the superior and inferior groups at 3 and 9 months after treatment (3-month, P = .002; 9-month, P = .002). The Helkimo index of the inferior group was significantly lower than that of superior group at 3 and 9 months (3-month, P = .008; 9-month, P = .028). There were no significant differences in maximal mouth opening between the 2 groups at 3 and 9 months (3-month, P = .82; 9-month, P = .20). CONCLUSION Superior and inferior joint space injections of HA are effective methods for the treatment of ADDw/oR in association with TMJ OA. The injection of HA within the inferior joint space appears to result in better condylar reparative remodeling and improvement in jaw function.
Collapse
Affiliation(s)
- Cheng Li
- Resident, Department of Oral and Maxillofacial Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Xing Long
- Professor, Department of Oral and Maxillofacial Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.
| | - Mohong Deng
- Professor, Department of Oral and Maxillofacial Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Jian Li
- Associate Professor, Department of Oral and Maxillofacial Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Hengxing Cai
- Associate Professor, Department of Oral and Maxillofacial Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Qinggong Meng
- Associate Professor, Department of Oral and Maxillofacial Surgery, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
44
|
Cooper BC, Adib F. An assessment of the usefulness of Kinesiograph as an aid in the diagnosis of TMD: a review of Manfredini et al.'s studies. Cranio 2014; 33:46-66. [PMID: 25115950 DOI: 10.1179/2151090314y.0000000010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM Performing a literature review of publications by Dr. Manfredini et al. related to their temporomandibular joint (TMJ) injection therapy outcome with conclusions on the clinical utility of computerized measurement devices used in the management of temporomandibular disorders (TMDs). In addition, reviewing their published opinion on an occlusion: TMD versus a biopsychosocial paradigm for TMD. Manfredini et al. authored an article published in the Journal of the American Dental Association (JADA) 2013, "An Assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders," the most recent of 12 articles. In all studies, subjects received TMJ injections with an objective measurement outcome criterion; increased maximum mouth opening (MMO) and subjective symptom improvement of pain and chewing function. In the 2013 JADA article, the Mandibular Kinesiograph, referred to as KG, measured MMO before and after therapy. In 11 prior articles, all subject groups with limited mouth opening exhibited very significant increased MMO post-treatment, documenting treatment success using the same 2013 protocol. The 2013 study showed a 1·1 mm improved MMO, described as insignificant. The authors did not critique or explain the aberrant, skewed 2013 outcome data contrasted with their prior studies, which showed overwhelmingly significant increased MMO. Instead, they concluded that the MMO recording device was clinically useless. This motivated a literature review of the authors' TMD publications. CONCLUSION The publications by Manfredini et al. recognized proponents of the psychosocial model of TMD, including the 2013 article, appear to be part of a campaign denying an occlusion: TMD relationship and disparaging the specific computerized measurement devices and the dentists using them in the management of their TMD patients using neuromuscular occlusion dental treatment.
Collapse
|
45
|
Manfredini D, Piccotti F, Guarda-Nardini L. Hyaluronic Acid In the Treatment of TMJ Disorders: A Systematic Review of the Literature. Cranio 2014; 28:166-76. [DOI: 10.1179/crn.2010.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
46
|
Januzzi E, Nasri-Heir C, Grossmann E, Gonçalves Leite FM, Heir GM, Melnik T. Combined Palliative and Anti-Inflammatory Medications as Treatment of Temporomandibular Joint Disc Displacement Without Reduction: A Systematic Review. Cranio 2014; 31:211-25. [DOI: 10.1179/crn.2013.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
47
|
Abstract
INTRODUCTION Osteoarthritis (OA) constitutes a growing public health burden and the most common cause of disability in the United States. Non-pharmacologic modalities and conservative pharmacologic therapies are recommended for the initial treatment of OA, including acetaminophen, and topical and oral non-steroidal anti-inflammatory drugs. However, safety concerns continue to mount regarding the use of these treatments and none have been shown to impact disease progression. Viscosupplementation with injections of hyaluronans (HAs) are indicated when non-pharmacologic and simple analgesics have failed to relieve symptoms (e.g., pain, stiffness) associated with knee OA. This review evaluates literature focusing on the efficacy and/or safety of HA injections in treating OA of the knee and in other joints, including the hip, shoulder, and ankle. METHODS Relevant literature on intra-articular (IA) HA injections as a treatment for OA pain in the knee and other joints was identified through PubMed database searches from inception until January 2013. Search terms included "hyaluronic acid" or "hylan", and "osteoarthritis". DISCUSSION Current evidence indicates that HA injections are beneficial and safe for patients with OA of the knee. IA injections of HAs treat the symptoms of knee OA and may also have disease-modifying properties, potentially delaying progression of OA. Although traditionally reserved for second-line treatment, evidence suggests that HAs may have value as a first-line therapy in the treatment of knee OA as they have been shown to be more effective in earlier stages and grades of disease, more recently diagnosed OA, and in less severe radiographic OA. CONCLUSION For primary care physicians who treat and care for patients with OA of the knee, IA injection with HAs constitutes a safe and effective treatment that can be routinely administered in the office setting.
Collapse
Affiliation(s)
- M Carrington Reid
- Weill Cornell Medical College, 1484-1486 1st Avenue, New York, NY, 10075, USA,
| |
Collapse
|
48
|
An assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders. J Am Dent Assoc 2013; 144:397-405. [DOI: 10.14219/jada.archive.2013.0133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
49
|
Manfredini D, Favero L, Del Giudice A, Masiero S, Stellini E, Guarda-Nardini L. Axis II psychosocial findings predict effectiveness of TMJ hyaluronic acid injections. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2012.10.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Lee JY, Kim DJ, Lee SG, Chung JW. A longitudinal study on the osteoarthritic change of the temporomandibular joint based on 1-year follow-up computed tomography. J Craniomaxillofac Surg 2012; 40:e223-8. [DOI: 10.1016/j.jcms.2011.10.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 10/09/2011] [Accepted: 10/11/2011] [Indexed: 11/25/2022] Open
|