Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial

Dasukil, Saubhik; Arora, Geetanjali; Boyina, Kiran Kumar; Jena, Ashok Kumar; Jose, Anson; Das, Snigdho

doi:10.1016/j.jcms.2022.10.002

Cited by 18 publications

(13 citation statements)

References 26 publications

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“…The first-line treatment for TMDs includes physiotherapy, behavioral therapy, occlusal splints, and lasers [9][10][11]. TMJ arthrocentesis has also emerged as an effective procedure and alternative to surgical intervention [12,13]. The upper joint space is cleaned using Ringer's lactate to remove inflammatory mediators in this procedure.…”

Section: Introductionmentioning

confidence: 99%

“…The upper joint space is cleaned using Ringer's lactate to remove inflammatory mediators in this procedure. Various therapeutic agents, such as Ringer's lactate, steroids, platelet-rich plasma (PRP), and hyaluronic acid (HA), have been successfully injected into the TMJ space to alleviate pain and improve quality [9,[12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Better results for pain relief were found for five weekly injections than for a single injection [20]. In the literature, HA injections have shown greater efficacy in pain reduction compared to corticosteroids (CS) and lower or similar effectiveness when compared to platelet-rich plasma (PRP) [12,[20][21][22][23][24]. Ozone therapy is another technique used to manage TMD.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis

Saini,

Ali Abdullah Almoyad,

Binduhayyim

et al. 2024

PLoS ONE

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Objective The current body of research on utilizing botulinum toxin (BTX) to manage temporomandibular disorders (TMDs) has not yet yielded definitive conclusions. The primary objective of this study was to determine the effectiveness of BTX in pain reduction for TMDs compared to placebo and other treatments. The secondary outcomes evaluated were adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. Materials and methods A literature search was performed on PubMed, Dimension Publication, Scopus, and Google Scholar. The RoB 2 tool was used for quality assessment. The mean differences in pain scores were estimated to measure the effect of BTX on pain reduction. For adverse events, the risk ratio for the incidence of side effects was calculated. Results Two hundred and sixty non-duplicate articles were identified; however, only 14 RCTS were included in this review. The total study population included 395 patients. The overall risk of bias showed a low to moderate quality of evidence. Results from 6 studies were reported only narratively; four studies were used for meta-analysis on pain reduction, and five were used for meta-analysis on adverse events. The control used in the meta-analysis was placebo injections. Results of the meta-analysis for pain reduction were statistically insignificant for the BTX group with mean differences at MD = −1.71 (95% CI, −2.87 to −0.5) at one month, -1.53 (95% CI, −2.80 to −0.27) at three months, and -1.33 (95% CI, −2.74 to 0.77) at six months. This showed that BTX treatment was not significantly better than placebo for a reduction in pain scores at 1, 3, and 6 months. Regarding safety, the placebo group showed a relative risk of 1.34 (95%CI, 0.48–6.78) and 1.17 (95%CI, 0.54–3.88) at 1 and 3 months respectively. However, the risks were not statistically significant. There was also no difference in the effectiveness of BTX compared to placebo and other treatments for maximum mouth opening, bruxism events, and maximum occlusal force. Conclusion BTX was not associated with better outcomes in terms of pain reduction, adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. More high-quality RCTs are needed to better understand this topic.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis

Saini,

Ali Abdullah Almoyad,

Binduhayyim

et al. 2024

PLoS ONE

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“…[11][12][13] Among the minimally invasive techniques, intra-articular (IA) injections of sodium hyaluronate, including hyaluronic acid (HA), have gained attention as a potentially effective approach, also in combination with joint arthrocentesis and lavage. [14][15][16] HA is a linear polysaccharide physiologically found in synovium, vitrous humour and connective tissue. 17,18 The rationale for HA viscosupplementation lies in HA action as chondroprotective drug for anti-inflammatory and lubrication purposes, able to decrease mechanical wear, promote the tissue repair process in the cartilage and to induce an endogenous synthesis of acid by the synovial cells.…”

Section: Introductionmentioning

confidence: 99%

“…Among the minimally invasive techniques, intra‐articular (IA) injections of sodium hyaluronate, including hyaluronic acid (HA), have gained attention as a potentially effective approach, also in combination with joint arthrocentesis and lavage 14–16 . HA is a linear polysaccharide physiologically found in synovium, vitrous humour and connective tissue 17,18 .…”

Section: Introductionmentioning

confidence: 99%

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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Ultrasound‐Guided Vs Non‐Guided Prolotherapy for Internal Derangement of Temporomandibular Joint. A Randomized Clinical Trial

Alhaj Kheder,

Kandil,

El‐Ghareeb

et al. 2024

J of Ultrasound Medicine

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ObjectivesThis randomized clinical trial study aims to compare ultrasound‐guided versus non‐guided Dextrose 10% injections in patients suffering from internal derangement in the temporomandibular joint (TMJ).Material and MethodsThe study population included 22 patients and 43 TMJs suffering from unilateral or bilateral TMJ painful clicking, magnetic resonance imaging (MRI) proved disc displacement with reduction (DDWR), refractory to or failed conservative treatment. The patients were divided randomly into two groups (non‐guided and ultrasound (US)‐guided groups). The procedure involved injection of 2 mL solution of a mixture of 0.75 mL 0.9% normal saline solution, 0.3 mL 2% lidocaine and 0.75 mL dextrose 10% using a 25G needle in the joint and 1 mL intramuscular injection to the masseter muscle at the most tender point. The Visual Analogue Score (VAS) was used to compare joint pain intensity over four different periods, beginning with pre‐injection, 1‐, 2‐, and 6‐months postinjection.ResultsTwenty‐two patients 5 males (n = 5/22, 22.7%) and 17 females (n = 17/22, 77.2%) were included in this study. The mean age was 27.3 ± 7.4 years (30.2 ± 7.0) for the non‐guided group and 24.3 ± 6.9 for the US‐guided group. The dextrose injection reduced intensity over time in both groups with statistically significant improvement (P value <.05) at 2 and 6 months in both groups. There was no statistically significant difference in VAS assessment between both groups.ConclusionIntra‐articular injection of dextrose 10% for patients with painful clicking and DDWR resulted in reduced pain intensity in both US‐guided and non‐guided groups with significant symptomatic improvement over time in both groups. US guidance allowed accurate anatomical localization and safe procedure with a single joint puncture.

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Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial

Cited by 18 publications

References 26 publications

The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis

The effectiveness of botulinum toxin for temporomandibular disorders: 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

Ultrasound‐Guided Vs Non‐Guided Prolotherapy for Internal Derangement of Temporomandibular Joint. A Randomized Clinical Trial

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