Pain relief following a single‐dose intra‐articular injection of methylprednisolone in the temporomandibular joint arthralgia—A multicentre randomised controlled trial

Abstract

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. SummaryBackground: Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation. Objective:The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain.Methods: This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population. Results:In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812).Treatment-related adverse events were doubled in the methylprednisolone group. Conclusion:Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia. K E Y W O R D Sarthralgia, corticosteroids, injection, intra-articular, pain management, temporomandibular joint

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

“…HA, CS and PRP may be injected intraarticularly independently as sole, less invasive, surgical procedures or may be injected at the end of other surgical procedures, including arthrocentesis or arthroscopy [ 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ].…”

“…Isacsson et al [ 75 ] determined the efficacy of a single-dose intraarticular injection of methylprednisolone (CS) and the efficacy of a single-dose intraarticular injection of sodium chloride. There were no statistically significant differences between the examined groups regarding the pain reduction and the function of the mandible.…”

Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis

“…Nonsurgical methods include anti-inflammatory drugs, occlusal splints, physiotherapy, laser application, and acupuncture. Injection of anti-inflammatory drugs (i.e., corticosteroids) or lubricating materials (i.e., hyaluronic acid [HA]) with or without arthrocentesis or arthroscopic surgeries have been found to reduce pain and to enhance masticatory function in TMD patients (Korkmaz et al 2016; Bouchard et al 2017; Candirli et al 2017; Isacsson et al 2019). Surgical treatment protocols such as arthrocentesis, arthroscopy, disc surgeries, arthroplasty, and even total joint replacement are used in patients who do not respond to nonsurgical therapies.…”

Ultrasensitive separation of methylprednisolone acetate using a photoresponsive molecularly imprinted polymer incorporated polyester dendrimer based on magnetic nanoparticles

“…Glucocorticoids are strong anti-inflammatories that are widely used for the treatment of pain and swelling in arthritic Article Related Abbreviations: AGE, allyl glycidyl ether; BMZ, betamethasone; DMZ, dexamethasone; EDS, energy dispersive spectroscopy; EGDMA, ethylene glycol dimethacrylate; MAPDHA, 5-[(4, 3-(methacryloyloxy) phenyl) diazenyl] dihydroxy aniline; MIP, molecularly imprinted polymer; MPA, methylprednisolone acetate; PMIP, photo-responsive molecular imprinting polymer; TCL, triamcinolone; TGA, thermogravimetric analysis and rheumatologic cases [1,2]. They have fewer side effects than the systemic corticosteroid treatment and do not appear to cause long-time effects on gristle [3,4]. Methylprednisolone acetate (MPA), is a synthetic water-insoluble glucocorticoid with a potent and prolonged anti-inflammatory, immunosuppressive, and anti-allergic activity.…”

“…Glucocorticoids are strong anti‐inflammatories that are widely used for the treatment of pain and swelling in arthritic and rheumatologic cases . They have fewer side effects than the systemic corticosteroid treatment and do not appear to cause long‐time effects on gristle . Methylprednisolone acetate (MPA), is a synthetic water‐insoluble glucocorticoid with a potent and prolonged anti‐inflammatory, immunosuppressive, and anti‐allergic activity.…”