The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction

Temporomandibular joint injection with corticosteroid and local anesthetic for limited mouth opening

“…Most practitioners have preferred hyaluronic acid to intraarticular corticosteroids due to the reported adverse effects of corticosteroid injections in the knee joint, which include septic arthritis, postinjection "flare", local tissue atrophy, tendon rupture, cartilage damage, flushing, and increased blood glucose level (18). These adverse effects are relatively uncommon in the TMJ (11,13,14,19,20), and we did not observe any of the above adverse effects in our patient sample. Also, a recent systematic review showed that hyaluronic acid and glucocorticoids had the same short-term and long- term effects on improvement of symptoms, clinical signs, and overall condition of TMJ disorders (21).…”

“…Hyaluronic acid, a viscous polysaccharide and a major component of synovial fluid, has been widely studied in the management of DDWOR and arthritis of the TMJ and has been shown to be safe for intraarticular use in the TMJ (2,(12)(13)(14)17). Most practitioners have preferred hyaluronic acid to intraarticular corticosteroids due to the reported adverse effects of corticosteroid injections in the knee joint, which include septic arthritis, postinjection "flare", local tissue atrophy, tendon rupture, cartilage damage, flushing, and increased blood glucose level (18).…”

“…Studies of TMJ injections have focused on decreased pain after injection in patients with both pain and limited mouth opening secondary to inflammatory disorders of the joint, such as arthritis and capsulitis (9)(10)(11)(12)(13)(14)(15)(16). One study focused on improvement in mouth opening after TMJ injection with hyaluronic acid in patients with DDWOR (17).…”

O uso do hialuronato de sódio no tratamento das disfunções temporomandibulares articulares

“…Considering HA properties, viscosuplementation with HA has been used in different joint TMDs, such as reducing and nonreducing disc displacement, osteoarthritis and degenerative joint disease 16,17,20,21,23,[34][35][36][37][38] . A multicenter study 16 involved a sample of 121 participants divided in two parallel groups, who were followed up for six months.…”

“…These studies positively point to the association of HA with arthroscopy and arthrocentesis, showing better results both in the evaluation of intra-articular bone changes and the evaluation of subjective clinical symptoms. Some studies 35,36 have compared HA to the use of corticosteroids (CS). Short term effect (1 month) of intra-articular infiltration of SH or corticosteroids (betamethasone) was compared to a sample 35 of 33 patients with TMJ pain and sensitivity to palpation for at least six months and who had not responded to conservative treatment.…”