Benefit of Temporomandibular Joint Lavage With Intra-Articular Steroids Versus Lavage Alone in the Management of Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis

Antonarakis, Gregory S.; Courvoisier, Delphine S.; Hanquinet, Sylviane; Dhouib, Amira; Carlomagno, Raffaella; Hofer, Michaël; Scolozzi, Paolo

doi:10.1016/j.joms.2017.12.030

Cited by 20 publications

(16 citation statements)

References 20 publications

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“…Tras la lectura de títulos y/o abstracts fueron eliminados 140 por no ajustarse al objetivo de la revisión y otros 18 se excluyeron por no cumplir con los criterios de inclusión y exclusión acordados. Tras el análisis de otras revisiones previas existentes en la literatura se añadió un estudio que cumplía con dichos criterios, con lo que al final se incluyeron un total de 10 artículos [19][20][21][22][23][24][25][26][27][28] en el presente estudio (Figura 1). Todos los artículos incluidos, salvo dos estudios de cohortes prospectivos realizados en población infantil con artritis idiopática juvenil (AIJ) 23,28 , fueron ensayos clínicos aleatorizados (5 con doble ciego 19,21,22,24,25 y 3 con ciego simple 20,26,27 ).…”

Section: Resultsunclassified

Artrocentesis de la articulación temporomandibular y corticoides. Revisión de la literatura

Bou¹,

Sarrión²

2022

j.maxilo

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El tratamiento de los trastornos de la articulación temporomandibular (ATM) es todavía un tema controvertido. La artrocentesis (AC) de la ATM es un procedimiento mínimamente invasivo al que puede asociarse la inyección intrarticular de diversas sustancias terapéuticas, entre ellas los corticoides (CS), sin que exista en la actualidad consenso sobre cuál ofrece los mejores resultados. Con esta revisión se quiere evaluar si el uso de la AC asociada a la inyección intrarticular de CS proporciona mejores resultados en cuanto a reducció n del dolor y mejoría de la función mandibular en pacientes con trastornos de la ATM en comparación con otros tratamientos.Material y métodos: Siguiendo el protocolo de las guías PRISMA, y tras aplicar unos criterios de inclusión y exclusión establecidos previamente, se ha realizado una revisión sistemática de los artículos existentes en PubMed enfocados en el uso de CS asociado a la AC de la ATM publicados en los últimos 10 años.Resultados: Un total de 167 artículos fueron obtenidos tras la búsqueda inicial, de los cuales finalmente 10 se incluyeron en la revisión, comprendiendo 366 pacientes (424 articulaciones). Entre los estudios revisados existe una gran heterogeneidad tanto en los diagnósticos como en los protocolos de tratamiento, lo que hace difícil la comparación de los resultados.Conclusiones: Según los estudios analizados, la AC por sí misma es suficiente para obtener buenos resultados en el tratamiento de los trastornos de la ATM. El uso de CS intrarticulares asociado a la AC no aporta beneficios respecto a realizar la AC sola ni ofrece mejores resultados que otras sustancias utilizadas.

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Section: Resultsunclassified

Artrocentesis de la articulación temporomandibular y corticoides. Revisión de la literatura

Bou¹,

Sarrión²

2022

j.maxilo

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“…The most common medications used after arthrocentesis are corticosteroids, sodium hyaluronate and non-steroidal anti-inflammatory drugs (NSAID's). Some studies have proved an added benefit of pain management when intra-articular injections are performed in adjunct to arthrocentesis while other studies have shown that no significant benefit has been drawn from those additional injections in comparison to arthrocentesis alone [10, [48][49][50][51][52].…”

Section: Intra-articular Injectionsmentioning

confidence: 99%

Pain Management in Temporomandibular Disorders: A Review of the Literature

Melek¹,

Renton²

2020

SJODR

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“…Both systemic and local treatments have been used in patients with TMJ arthritis [13][14][15]. Several observational studies report short-term effect of intraarticular corticosteroid injections (IACs) to the TMJ on pain and maximal incisal opening (MIO) [16][17][18][19][20][21]. It has also been shown that the IACs can be safely performed by trained specialists both with the "landmark guiding technique" guided by anatomical landmarks, and with MRI, ultrasound or computed tomography (CT) guidance [17,19,22,23].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of intraarticular corticosteroid injections in adolescents with juvenile idiopathic arthritis in the temporomandibular joint: a Norwegian 2-year prospective multicenter pilot study

et al. 2020

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Background Intraarticular corticosteroids (IACs) have been used to treat temporomandibular joint (TMJ) arthritis. However, prospective clinical studies with magnetic resonance imaging (MRI) scoring are lacking. The aim of this study was to examine efficacy and safety of a single IAC in the TMJ in adolescents with juvenile idiopathic arthritis (JIA) in a clinical setting. Methods In this Norwegian prospective multicenter pilot study 15 patients with JIA (mostly persistent oligoarthritis or RF negative polyarthritis categories) and a clinically and MRI-verified diagnosis of TMJ arthritis were treated with IACs and followed for 2 years. Demographics, systemic medication, general disease activity and outcome measures were recorded including a pain-index score and maximal incisal opening (MIO). Inflammation and bone damage scores were assessed, using two recently published MRI scoring systems with masked radiological evaluation. Results Among the 15 patients, 13 received a single IAC (5 bilateral), and 2 repeated IACs once unilaterally. Thus, the total number of IACs was 22. Median age was 15 years and the majority had an age not thought of as critical regarding mandibular growth retardation due to steroid injection. During the 2-year observation period systemic medication with disease modifying antirheumatic drugs (DMARDs) including biologics was initiated or adjusted in 10/15 (67%) patients. At the 2-months study visit after injection we observed a minimal improvement in MIO from median 44 (1st, 3rd quartiles; 36, 48) mm to 45 (43, 47) mm, p = 0.045 and decreased MRI mean additive inflammatory score from 4.4 ± 1.8 standard deviations (SD) to 3.4 ± 2.0, p = 0.040. From baseline to the 2-months follow-up pain improved in 6/11 patients but pain scores were not significantly improved. MRI-assessed damage increased in two patients with repeated IACs, and decreased in 3 patients but most of the patients were stable over the 2-year follow-up. Intra-rater repeatability of the MRI scoring system domains varied from poor to excellent. Conclusions In this pilot study of predominately single IACs to the TMJ in combination with systemic treatment we observed improvement in MRI-assessed inflammation, mostly stable condylar bone conditions and minimal clinical improvement in adolescents with JIA and TMJ arthritis. No severe side effects were seen.

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Benefit of Temporomandibular Joint Lavage With Intra-Articular Steroids Versus Lavage Alone in the Management of Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis

Cited by 20 publications

References 20 publications

Artrocentesis de la articulación temporomandibular y corticoides. Revisión de la literatura

Artrocentesis de la articulación temporomandibular y corticoides. Revisión de la literatura

Pain Management in Temporomandibular Disorders: A Review of the Literature

Efficacy and safety of intraarticular corticosteroid injections in adolescents with juvenile idiopathic arthritis in the temporomandibular joint: a Norwegian 2-year prospective multicenter pilot study

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