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.

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Objective To describe the morphological characteristics and asymmetries between the left and right mandibular condyles in Brazilian cadaveric specimens. Material and Methods Thirty-two jaws were placed on a rigid support for image acquisition of the frontal and lateral views. The shapes of the mandibular condyles were classified, and measurements of the distance between the anatomical landmarks in the lateral and frontal views were performed. Results Mandibular length and width were not different between the right and left sides. Regarding the shapes of the mandibular condyles, the rounded type was the most frequent, followed by marked medial slope; flattened; overhanging lateral and medial slopes; downward flattening of both slopes and their merger in a single, extensive surface; and deformity and marked lateral slope with flaring and flattening. Asymmetry between the left and right mandibular condyles was present in 40% of the specimens. Conclusion The anatomy of mandibular condyles varies greatly, and this knowledge can avoid misdiagnosis by image examination of the anatomic variations.

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