Arthrocentesis and Sodium Hyaluronate Infiltration in Temporomandibular Disorders Treatment. Clinical and MRI Evaluation

Abstract

Arthrocentesis in temporomandibular joint disorders can be associated with the intra-articular infiltration of various drugs with the objective of increase treatment efficacy. The aim of this study was to evaluate the clinical indexes variation in patients affected by temporomandibular joint disorders treated with arthrocentesis and sodium hyaluronate (SH) injections. A total of 28 patients suffering from temporomandibular joint disorders underwent one cycle of five arthrocentesis and infiltrations of sodium hyaluronate. Spontaneous mouth opening improved from 36.3 ± 7.5 mm to 45.1 ± 1.9 mm at six months follow-up. A significant reduction in the pain at rest and during mastication mean values emerged at follow-up (p < 0.0001). The mean masticatory efficiency, evaluated through a visual analogic scale, showed improvement at the follow-up period, highlighted by the increase of mean value from a baseline of 3.1 ± 1.2 to a mean value of 8.5 ± 1.2 (p < 0.0001). The mean severity of the joint damage at baseline time was 2.4 ± 0.9 and decreased to 0.4 ± 0.3 at the end of the follow-up period. The decrease in values is confirmed by statistical test (p < 0.05). Our data show how arthrocentesis integrated with sodium hyaluronate infiltrations performed under local anesthesia is a valid method of treating temporomandibular joint disorders.

Orthodontics First in Hemimandibular Hyperplasia. “Mind the Gap”

“…As soon as the patient refrained from the protocol proposed, the authors had to offer an alternative treatment that aimed to restore facial aesthetic and correct dental occlusion, respecting the patient’s will not to perform bimaxillary orthognatic surgery as recommended by standard treatment guidelines. This setback is usually linked due to side effects risks perception by the patient and lack of severity of functional chewing problem that could be managed with conservative treatments [ 19 , 20 ]. Hence, the surgical approach was limited to a right condylectomy and orthodontic treatment protocol had to be adjusted accordingly.…”

Current Clinical Research Directions on Temporomandibular Joint Intra-Articular Injections: A Mapping Review

“…There is a steady upward trend in the number of primary ies on HA published in subsequent years. The primacy of HA from 2021 seems threatened by centrifuged blood products, but this group of substances is heterogen and cannot be compared to HA in terms of effectiveness as a w [18,19,22,25,38,43…”

“…There is a steady upward trend in the number of primary studies on HA published in subsequent years. The primacy of HA from 2021 seems to be threatened by centrifuged blood products, but this group of substances is heterogeneous and cannot be compared to HA in terms of effectiveness as a whole [18,19,22,25,38,43,49,51,54,[58][59][60]63,68,70,71,74,75,78,80,80,82,86,88,89,[91][92][93]95,[98][99][100][101][102]105,106,110,[113][114][115][116][117]120,121,124,126,127,129,130,…”