The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: A retrospective study of 18 cases

Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review

“…Among the eight studies, seven were RCTs 2,7,10,16,24,26,31 and one was a retrospective study. 1 The total number of patients treated was 350, ranging from 16 to 100; 275 were female and 75 were male.…”

“…Temporomandibular joint disorder (TMD) is a widely researched disease in the literature, since it has a high prevalence and is often associated with chronic pain and limited function of the temporomandibular joint (TMJ), resulting in decreased quality of life for the patient. [1][2][3][4][5] The joint disorders include disc displacement and degenerative and/or inflammatory disorders. Due to its complex aetiology and varied classification, different conservative and surgical treatments have been studied in an attempt to improve clinical symptoms and restore function for the affected patients.…”

“…Due to its complex aetiology and varied classification, different conservative and surgical treatments have been studied in an attempt to improve clinical symptoms and restore function for the affected patients. 1,[6][7][8][9][10] Conservative treatments include rest, the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, botulinum toxin injections, bite splints, and physical therapy. 1,8,[11][12][13][14][15][16] Arthrocentesis is among the surgical alternatives performed when there is no effective response to conservative treatment; this is a simple and minimally invasive procedure, commonly used to remove inflammatory mediators associated with nociceptive processes within the synovial fluid.…”

“…1,[6][7][8][9][10] Conservative treatments include rest, the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, botulinum toxin injections, bite splints, and physical therapy. 1,8,[11][12][13][14][15][16] Arthrocentesis is among the surgical alternatives performed when there is no effective response to conservative treatment; this is a simple and minimally invasive procedure, commonly used to remove inflammatory mediators associated with nociceptive processes within the synovial fluid. 2,9,[17][18][19] The procedure can be associated with the injection of various drugs, such as sodium hyaluronate (SH), which can also be used separately, with the aim of increasing the treatment efficacy.…”

“…17,20,21 The use of intra-articular injections of SH (viscosupplementation), which is a viscous, high molecular weight polysaccharide, allows the lubrication and subsequent protection of the joint cartilage. 1,5,7,9,[22][23][24][25][26] This substance consists of a sodium salt of hyaluronic acid (HA), a physiological component of synovial fluid, which is responsible for the lubrication of synovial joints including the TMJs. 2,22,[27][28][29][30] There is still controversy in the literature regarding the benefits of the use of intra-articular HA injections in the treatment of TMD, 1 as well as in establishing an ideal protocol and technique to restore function and promote pain relief for patients.…”