Effectiveness of Intra-Articular Injections of Sodium Hyaluronate, Corticosteroids, Platelet-Rich Plasma on Temporomandibular Joint Osteoarthritis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Xie, Yuan; Zhao, Kun; Ye, Guanchen; Yao, Xudong; Yu, Mengfei; Hongwei, Ouyang

doi:10.1016/j.jebdp.2022.101720

Cited by 15 publications

(37 citation statements)

References 53 publications

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“…In the group of pharmaceuticals, hyaluronic acid (HA), corticosteroids, hypertonic dextrose, and anesthetics are applicable [ 30 , 31 , 32 , 33 , 34 , 35 ]. The significance of the type of injectable used is still debated, prompting the assessment of the importance of other factors, such as the specific injection site [ 27 , 28 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

Chęciński¹,

Chęcińska

Turosz

et al. 2023

JCM

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This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the Helkimo index, and abolishing mandibular mobility limitation were included. Medical databases covered by the Bielefeld Academic Search Engine, Google Scholar, PubMed, ResearchGate, and Scopus engines were searched. The risk of bias was assessed using dedicated Cochrane tools (RoB2, ROBINS-I). The results were visualized with tables, charts, and a funnel plot. Six reports describing five studies with a total of 342 patients were identified. Of these, four trials on a total of 337 patients were qualified for quantitative synthesis. Each eligible report was at moderate risk of bias. From 19% to 51% improvement in articular pain, 12–20% lower Helkimo index, and 5–17% higher maximum mouth opening were observed. The evidence was limited by the small number of eligible studies, discrepancies regarding the substances used, possible biases, and the differences in observation times and scheduled follow-up visits. Despite the above, the advantage of inferior over superior compartment temporomandibular joint intra-articular injections is unequivocal and encourages further research in this direction.

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Section: Introductionmentioning

confidence: 99%

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

Chęciński¹,

Chęcińska

Turosz

et al. 2023

JCM

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“…Publication date of the included studies ranged between 2010 and 2022, and interesting to note, 13 systematic reviews or meta-analyses were published in the last 5 years. Thirteen studies [28][29][30][33][34][35][36][37][38][39][40][41][42] included only randomized controlled clinical trials (RCTs) and eight systematic reviews 28,34,36,38,39,[43][44][45] also performed a meta-analysis on the data of the included studies. All articles but one 44 performed a systematic search on at least two databases.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Two studies 42,47 focused both on IA injections of CS and HA. Five studies 28,29,33,38,39 considered multiple comparisons between different therapies (IA injections of HA included). One study 37 mainly focused on arthroscopy plus interventions, and HA injections were considered as combined with this surgical technique.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Interventions including arthrocentesis have been considered by 14 articles. [28][29][30]35,36,[38][39][40][41][43][44][45][46][47] Only one study 42 2.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…On the contrary, in patients with disc displacement, arthrocentesis plus HA injection seemed to be more effective, mainly in chewing efficiency and quality of life. 26 Also, the results of recent systematic reviews were not in agreement, and authors concluded that IA pharmacological injections of CS, HA and PRP had no effect on TMJ pain and functional outcomes compared with placebo injection, 27,28 whereas other recent metaanalysis reported the efficacy of HA injections in TMJ. 29,30 Therefore, the objective of this umbrella review was to evaluate the available scientific evidence on the effects of IA injections of HA on pain relief and improvement of jaw function in patients affected by TMD.…”

Section: Introductionmentioning

confidence: 98%

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Hyaluronic acid injections for pain relief and functional improvement in patients with temporomandibular disorders: An umbrella review of systematic reviews

Agostini,

Ferrillo,

Bernetti

et al. 2023

J of Oral Rehabilitation

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BackgroundTemporomandibular disorders (TMD) are the main cause of chronic facial pain, and intra‐articular (IA) injections of hyaluronic acid (HA) are commonly performed.ObjectivesThis umbrella review of systematic reviews aimed at analysing the effectiveness of HA injections on pain and functional outcomes in patients affected by TMD.MethodsPubMed, Cochrane Library and PEDro were systematically searched from inception until 17 January 2023 to identify systematic reviews evaluating the effects on pain and functional outcomes of HA IA injections. PROSPERO registration number: CRD42022382586.ResultsOut of 316 papers suitable for title/abstract screening, 18 articles were included in the umbrella review. Thirteen studies included only randomized controlled clinical trials (RCTs). The included systematic reviews reported no statistically significant differences between HA and corticosteroids, whereas platelet derivates seem to have good results in pain relief. The literature did not show severe adverse events, except for mild pain in the site of injection. Concerning the quality assessment of the 18 systematic reviews, 2 (11.11%) had a high quality, 3 (16.67%) a moderate quality, 7 (38.89%) a low quality and 6 (33.33%) a critically low quality.ConclusionsTaken together, findings of this umbrella review showed intriguing effects of IA HA injections in terms of reduction of pain intensity and improvement of functioning in patients affected by TMD. Furthermore, there is no agreement on the effectiveness of a combination of arthrocentesis or arthroscopy with IA HA injections. Although the literature showed these positive results after IA HA injections, the overlapping of primary studies in the systematic reviews included might have affect our results, such as the very low quality of the papers. Thus, further RCTs are needed to confirm the efficacy of IA injections of HA on pain relief in patients with TMD.

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Effects of botulinum toxin type A in patients with painful temporomandibular joint disorders: A systematic review and meta-analysis

Zhu,

Huang,

Wang

et al. 2024

Annals of Medicine &Amp; Surgery

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Objective: To assess the therapeutic efficacy of botulinum toxin type A (BTX-A) for managing myofascial pain related to temporomandibular disorders (TMDs). Methods: This study was conducted according to the PRISMA 2020 statement guidelines. The PubMed, Embase, and Cochrane Library databases were searched. Only randomized controlled trials (RCTs) were included. The primary outcome was pain score on the visual analogue scale (VAS), and the secondary outcomes were maximum mouth opening (MMO) and adverse effects. The Cochrane risk of bias tool was used to assess risk bias. A meta-analysis of studies with the same interventions, controls, assessment methods and follow-up durations was performed. Results: A total of 519 studies were retrieved, of which 20 RCTs were included in the qualitative analysis and 6 were included in the meta-analysis. The results showed that, compared with placebo, BTX-A injection was more effective at relieving myofascial pain, and its effect was similar to that of conventional methods. However, there was no difference in MMO between the two groups. After study assessment with the RoB 2.0 tool, six studies showed a low risk of bias, 13 studies showed some concerns regarding the reported results, and only one study showed a high risk of bias. Adverse effects of BTX-A injection were observed in four studies. Conclusions: In conclusion, BTX-A is effective at relieving pain in TMD patients but does not improve mouth opening. To minimize adverse effects, we recommend a low dose of BTX-A for TMD patients who do not experience complete pain relief from conservative treatments.

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Effectiveness of Intra-Articular Injections of Sodium Hyaluronate, Corticosteroids, Platelet-Rich Plasma on Temporomandibular Joint Osteoarthritis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Cited by 15 publications

References 53 publications

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

Hyaluronic acid injections for pain relief and functional improvement in patients with temporomandibular disorders: An umbrella review of systematic reviews

Effects of botulinum toxin type A in patients with painful temporomandibular joint disorders: A systematic review and meta-analysis

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