Efficacy of Temporomandibular Joint Arthrocentesis with Sodium Hyaluronate in the Management of Temporomandibular Joint Disorders: A Prospective Randomized Control Trial

Gorrela, Harsha; Prameela, J; Srinivas, G; Reddy, B Vijay Baskar; Sudhir, M; Arakeri, Gururaj

doi:10.1007/s12663-016-0955-x

Cited by 26 publications

(23 citation statements)

References 13 publications

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“…The authors concluded that the type of medicament used during arthrocentesis had no impact on the final outcome. Contrary to those results, Gorrela et al [83] found that the intensity of pain was significantly decreased in the group with sodium hyaluronate injection compared to the group with arthrocentesis alone. However, it should be noted that the authors analyzed the results after a shorter period of time (6 months).…”

Section: Arthrocentesis With Hyaluronic Acidmentioning

confidence: 67%

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

2020

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Background and objectives: There is an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. Materials and Methods: PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Results and Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.

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Section: Arthrocentesis With Hyaluronic Acidmentioning

confidence: 67%

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

2020

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“…Treatment with arthrocentesis is very effective and the results are comparable to arthroscopy or arthrotomy. The success of arthrocentesis is indicated in 70-80 % of cases, which is comparable to arthroscopy (more than an 80 % success rate) (9,11,15,25,27).…”

Section: Discussionmentioning

confidence: 87%

Therapeutic effects of arthrocentesis in treatment of temporomandibular joint disorders

Malachovsky¹,

Statelová²,

Staško³

et al. 2019

BLL

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OBJECTIVE: Analyse, compare and evaluate the effects of the treatment arthrocentesis with a control group of non-steroid drugs treated patients. MATERIAL AND METHODS: 1752 outpatients (1293 females, 459 males) were examined within the years 2013-2017. We evaluated the following criteria: gender, age, visual analog scale for pain (VAS), inter-incisal distance and reducing intake of orally administered analgesics. RESULTS: The pain level of the group of patients with arthrocentesis had stabilized at mark 2.5 on the pain scale, unlike in the control group after treatment with non-steroidal anti-infl ammatory drugs, pain had stabilized at mark 9 on the pain scale. The inter incisal distance amongst the fi rst group was 37 mm and in the control group only 27 mm, after completed treatment. The amount of applied analgesics in the group with arthrocentesis decreased to 100 mg daily, while in the control group, the dose was adjusted to 700 mg daily. CONCLUSION: In the observed study, arthrocentesis was effective in reducing pain, amount of analgesics per day and improving the mobility of temporomandibular joint (TMJ). The results of this study we use in the ongoing project, that focuses on progressive and innovative methodology of endoscopically assisted arthrocentesis.

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“…It was also important that well-defined physical examination techniques such as the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (36) or other validated techniques were used to identify the presence or absence of signs and symptoms that defined the patient sample. In our review of 31 published RCTs, some studies had no inclusion or exclusion criteria (2,14,33) or used a diagnosis of disk displacement with or without reduction as the inclusion criteria without reporting the exclusion of other pain sources such as masticatory muscle myalgia (3)(4)(5)(7)(8)(9)(10)(11)15,17,18,(20)(21)(22)24,(26)(27)(28)(29)(30)(31)(32). Only a few RCTs confirmed the source of pain was from TMJ innervated structures by either the use of a local anesthetic to anesthetize the auriculotemporal nerve and eliminating the TMJ pain (6) or by selectively loading the TMJ by contralateral biting and duplicating the intracapsular source of pain within the joint (19).…”

Section: Identifying the Appropriate Patient To Test Tmj Arthrocentesis Efficacymentioning

confidence: 99%

“…Another important inclusion criterion that was used in some RCTs of TMJ arthrocentesis was unilateral TMJ pain (3,14,16,18,19,22,23,25,29,31,32). Since all of the studies used pain as one of the primary or secondary outcome measures, the inclusion of bilateral TMJ pain would have been problematic if the treatment was only applied to the joint with the highest level of pain and residual pain continued in the opposite joint or if both TMJs were treated and only one was successfully managed.…”

Section: Identifying the Appropriate Patient To Test Tmj Arthrocentesis Efficacymentioning

confidence: 99%

“…arthrocentesis without the addition of medications or growth factors can be effective to reduce pain and improve mandibular mobility over time (2,3,8,9,(11)(12)(13)(14)16,17,(19)(20)(21)(22)24,26,27,29,32). However, the effectiveness of additional supplements infused into the superior joint space of the TMJ has not been clearly established.…”

Section: T H a S B E E N W E L L -E S T A B L I S H E D I N R C Ts T H A T T M Jmentioning

confidence: 99%

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Temporomandibular joint arthrocentesis: an evidence-based review

Dolwick¹,

Widmer²

2020

Front Oral Maxillofac Med

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Temporomandibular joint (TMJ) intracapsular pain can sometimes persist after pursuing reversible techniques. TMJ pain reduction may require a more focused treatment approach such as arthrocentesis to remove intracapsular inflammatory mediators. Evidence of efficacy for treating TMJ pain and mandibular mobility using TMJ arthrocentesis is available from a small number of high-quality evidence randomized controlled trials (RCTs). However, there still remains a lack of high-quality evidence to test the efficacy of various supplements that have been proposed to further enhance the outcomes after arthrocentesis. The purpose of this review was to examine published RCTs to determine the efficacy of TMJ arthrocentesis alone and with supplementation by steroids, hyaluronic acid and platelet-rich plasma growth factors. Thirty-one RCTs were identified from the literature with most of the studies having low to medium quality evidence. Most of the RCTs suffered from a lack of controlling experimental bias, lack of inclusion and exclusion criteria, lack of pain source validation, lack of stratification by sex and inclusion of bilateral TMJ arthrocentesis procedures that can confound the interpretation of the results of the procedure. Some RCTs were single or double blind studies, but the majority did not use a blinded experimental design.Low to medium quality evidence RCTs that focused on a comparison of TMJ arthrocentesis alone to postarthrocentesis supplementation found no differences in resting pain intensity or mandibular mobility.However, one high-quality evidence RCT that evaluated steroid supplementation (triamcinolone acetonide) found a significant improvement and normalization of chewing pain and the normalization of mandibular mobility at 12 weeks post-arthrocentesis compared to the control group. Hyaluronic acid has been evaluated by medium quality evidence RCTs and these studies did not find differences between supplementation and control groups for pain or mandibular mobility. Finally, platelet-rich plasma has been used as a supplement and one study with medium quality evidence found significant differences between groups for pain, mandibular mobility and chewing efficiency. The paucity of high-quality evidence RCTs has not allowed a consensus for the efficacy of TMJ post-arthrocentesis supplements and further studies are required to guide the practicing clinician on their use.

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Efficacy of Temporomandibular Joint Arthrocentesis with Sodium Hyaluronate in the Management of Temporomandibular Joint Disorders: A Prospective Randomized Control Trial

Abstract: Although patients benefitted from both techniques, arthrocentesis with injection of SH seemed to be superior to arthrocentesis alone.

Cited by 26 publications

References 13 publications

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

Therapeutic effects of arthrocentesis in treatment of temporomandibular joint disorders

Temporomandibular joint arthrocentesis: an evidence-based review

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