Use of chondroitin sulphate and glucosamine sulphate in degenerative changes in TMJ: a systematic review

Abstract

Introduction: Degenerative changes in Temporomandibular Joint (TMJ) have increased in prevalence and severity over the years. Within this context, it's necessary to obtain safe and effective therapies for control and management of the patient in cases of osteoarthritis and osteoarthrosis of the TMJ. Therapeutic options range from intra-articular infiltration protocols, occlusal splints, pharmacological therapies and physiotherapy and educational measures. The alternative treatment with structure-modifying agents, like as chondroitin and glucosamine sulphates, showed promising results, and especially safety. Thus, through a systematic literature review, this study aimed to analyze and discuss effectiveness and safety of chondroitin and glucosamine in degenerative changes of the TMJ.Methods: Survey in research bases MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and January 2009, with focus in randomized clinical trial (RCTs) and quasi-randomized clinical trials, systematic reviews and meta-analysis. Results:After application of the inclusion criteria 2 articles were selected, both randomized controlled double-blind clinical trials, which evaluated the effectiveness of chondroitin and glucosamine in degenerative changes of the TMJ. Conclusions:There is the necessity of further RCT, with representative samples and long follow-up time, to obtainment more precise cause-effect relationships and to achieve an effective and objective protocol involving chondroitin and glucosamine in cases of degenerative changes of the TMJ. Introdução: as alterações degenerativas da Articulação Temporomandibular (ATM) têm aumentado em prevalência e em severidade ao longo dos anos. Dentro desse contexto, surge a necessidade de se obter terapêuticas efetivas e seguras para o controle e o manejo do paciente em situações de osteoartrite e osteoartrose da ATM. As opções terapêuticas variam desde protocolos de infiltrações articulares, dispositivos interoclusais, terapias farmacológicas e medidas fisioterápicas e educacionais. A alternativa de tratamento com agentes modificadores de estrutura -tais como o sulfato de condroitina e o sulfato de glicosamina -apresenta resultados promissores e, principalmente, seguros. KeywordsObjetivo: através de uma revisão sistemática da literatura, este trabalho teve como objetivo analisar e discutir a efetividade e a segurança da condroitina e da glicosamina nas alterações degenerativas da ATM.Métodos: levantamento nas bases de dados MEDLINE, Cochrane, Embase, PubMed, LILACS e BBO, no período compreendido entre 1966 e 2009, com enfoque em estudos clínicos randomizados (RCTs) e quase-randomizados, revisões sistemáticas e meta-análises.Resultados: após a aplicação dos critérios de inclusão, chegou-se a dois artigos (estudos clínicos randomizados controlados e duplo-cegos), que avaliaram a efetividade da condroitina e da glicosamina nas alterações degenerativas da ATM.Conclusão: existe a necessidade da realização de novos RCTs -com amostras representativas e tempo de acompanhament...

Evaluation of stabilizing plate therapeutic effects of different types of temporomandibular disorders - painful evolution of patients treated in a reference center

“…The presence of crackles (accompanied or not by pain) suggests the presence of degenerative processes [33]. Many therapeutic approaches are indicated in this group in addition to the use of occlusal splints, such as: joint injections [40], physiotherapeutic and educational measures [41], pharmacologic therapies [20], and more recently the use of chondroprotective agents [42]. However, in most part of the cases, these therapeutic approaches only act by stabilizing the disorder, through the reduction of the articular inflammatory and pain process [41].…”

Evaluating the Effect of the Injectable PRF in comparison with the hyaluronic acid as an Intra-articular Medication Following Arthrocentesis in the Treatment of Internal Derangement

“…are examples of the invasive modalities. Arthrocentesis and arthroscopy are the examples of the third in-between group which is the minimally invasive modality [1,[3][4][5][6][7][8][9][10][11][12][13] . Arthrocentesis either followed with intra-articular injections, or not has gained a large deal of interest [7,10,[14][15][16] .…”

Effects of glucosamine supplements on painful temporomandibular joint osteoarthritis: A systematic review

“…GS are considered safer than anti‐inflammatory drugs; however, their effectiveness for the management of painful TMJ OA is yet a topic for discussion . Despite the fact that previous systematic reviews have investigated several interventions for the management of painful TMJ disorders, GS were not explored in‐depth, and there were not enough data to support its therapeutic effects regarding TMJ pain management.…”