Effects of glucosamine supplements on painful temporomandibular joint osteoarthritis: A systematic review

Abstract

The purpose of this study was to systematically review the literature for studies that assessed the effects of glucosamine supplements (GS) on pain and maximum mouth opening (MMO) restriction compared to other therapies, placebo or no intervention on painful temporomandibular joint osteoarthritis (TMJ OA). Randomised controlled trials were selected in a two-phase process. Seven electronic databases, in addition to three grey literature databases, were searched. Risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Twelve potentially eligible studies were identified, from which three were finally included. Furthermore, two were categorised at low risk and one at high risk of bias. Intervention groups were treated with glucosamine-sulphate, while controls were treated with placebo or ibuprofen. In two studies, GS were equally effective regarding pain reduction and mouth opening improvement compared to ibuprofen taken two or three times a day over 12 weeks; however, one study did not find significant differences in follow-up evaluations concerning these clinical variables in both glucosamine and placebo groups administered over six weeks. There is very low evidence regarding GS therapeutic effects on TMJ OA. Considering a follow-up of 12 weeks, GS were as effective as ibuprofen taken two or three times a day. However, over six weeks of medication intake, GS were not superior to placebo. Still, included studies presented major drawbacks, and therefore, conclusions must be interpreted with caution.

Glucosamine sulphate: an umbrella review of health outcomes

“…46 On the contrary, when people suffering from spine or temporomandibular joint OA were included no significant effect of GS on physical function or pain was observed. 44,48…”

“…After removing the duplicates, study selection commenced and 140 papers were evaluated, with 47 assessed as full text. As shown in the PRISMA flowchart (Figure 1), 11 articles were finally inclu ded, 21,[41][42][43][44][45][46][47][48][49][50] that is, 3 systematic reviews without meta-analysis, 1 network meta-analysis reporting narrative data on GS and 7 meta-analyses, for a total of 21 independent outcomes, as fully reported in Table 1. No systematic review or meta-analysis regarding observational studies was included, that is, no observational studies met the inclusion/exclusion criteria.…”

“…46 On the contrary, when people suffering from spine or temporomandibular joint OA were included no significant effect of GS on physical function or pain was observed. 44,48 Quality assessment The assessment of the risk of bias in the metaanalyses included is fully reported in Supplemental Table 3. Four systematic reviews/meta-analyses were adjudicated as having high (i.e.…”

Polyphenols as Potential Agents in the Management of Temporomandibular Disorders

“…Currently, conventional pharmacologic interventions, such as non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, are considered the primary management for painful TMJOA, reducing TMJ-related pain and inflammatory states [13]. Generally, applied pharmacologic therapy shows efficacy in pain relief but their long-term use is frequently associated with adverse effects, such as gastrointestinal and renal toxicity, related to prolonged use [10,14].…”

Short term histopathological effects of GaAlAs laser on experimentally induced TMJ osteoarthritis in rabbits

“…Conservative procedures include recommendations to avoid forced movements of the mandible, prescription of analgesic and antiinflammatory drugs, splint therapy, thermal therapy, or minimally invasive methods. 10,11 Radical treatment procedures ranging from open joint surgery (arthroplasty) to TMJ replacement can be performed in patients in whom medications and conservative treatment options have failed. 10 However, since radical treatments are associated with the risk of intraoperative and postoperative complications, it is necessary to develop alternative conservative treatment modalities.…”