Comparison of treatment efficacy between hyaluronic acid and arthrocentesis plus hyaluronic acid in internal derangements of temporomandibular joint

Yilmaz, Onur; Korkmaz, Yavuz Tolga; Tüzüner, Tamer

doi:10.1016/j.jcms.2019.07.030

Cited by 28 publications

(14 citation statements)

References 35 publications

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“…We used the WMD and SD of the continuous variables for meta-analyses. In one of the studies where the range and median were given 20 , the mean and standard deviation were estimated with statistical formulas 18 . In another study, the standard deviation for the preoperative and post-operative pain measurements (VAS) were not available 27 , therefore, pain measurements from that study were excluded from the meta-analysis.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…The standard deviation of the post-operative MMO and VAS were assumed to be the same as the pre-operative values. In 3 of the studies, arthrocentesis was performed as the initial treatment for TMDs [20][21][22][23] , in 2 of the studies, arthrocentesis was done within 3 months of failing conservative treatment 24,25 , and in 5 of the studies, arthrocentesis was performed after at least 3 months of conservative treatment [26][27][28][29][30] . Both random effects model and fixed effects models were used for construction of forest plots, due to the intention of generalization inference and the high heterogeneity found in the included studies, but also because of the small number of studies included in the meta-analysis.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…The characteristics of the 11 included studies are shown in Table 1 In 4 of the included studies [20][21][22][23] , arthrocentesis was used as the initial treatment for TMDs.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Assessment of the quality of the studies was done. Two studies 22,24 showed a low risk of bias, 5 studies 20,21,26,27,29 showed a moderate risk of bias, and 4 studies 23,25,28,30 showed a high risk of bias. (Table 2)…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Timing of Arthrocentesis in the Management of Temporomandibular Disorders:A Systematic Review and Meta-analysis

Li¹,

Wong²,

Li³

et al. 2020

Preprint

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The aim of this study was to assess the best timing to perform arthrocentesis in the management of temporomandibular disorders with regards to conservative treatment. A systematic search based on PRISMA guidelines, including a computer search with specific keywords, reference list search, and manual search was done. Relevant articles were selected after 3 search rounds for final review based on 6 predefined inclusion criteria, followed by a round of critical appraisal. Eleven publications, including 5 randomized controlled trials and 6 prospective clinical studies informed this review. The studies were divided into 3 groups based on the timing of arthrocentesis: 1). Arthrocentesis as the initial treatment, 2). Early arthrocentesis, and 3). Late arthrocentesis. Meta-analyses compared the efficacy of improvement in mouth opening and pain reduction in the 3 groups. The results were statistically significant and favoured early arthrocentesis, followed by late arthrocentesis in terms of both improvements in mouth opening and pain reduction. All 3 groups showed improvement in mouth opening and pain reduction. We conclude that early arthrocentesis may be able to produce the best clinical results, while arthrocentesis before attempting conservative treatment may produce less favourable outcomes.

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Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…The characteristics of the 11 included studies are shown in Table 1 In 4 of the included studies [20][21][22][23] , arthrocentesis was used as the initial treatment for TMDs.…”

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Timing of Arthrocentesis in the Management of Temporomandibular Disorders:A Systematic Review and Meta-analysis

Li¹,

Wong²,

Li³

et al. 2020

Preprint

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show abstract

“…It was also important that well-defined physical examination techniques such as the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (36) or other validated techniques were used to identify the presence or absence of signs and symptoms that defined the patient sample. In our review of 31 published RCTs, some studies had no inclusion or exclusion criteria (2,14,33) or used a diagnosis of disk displacement with or without reduction as the inclusion criteria without reporting the exclusion of other pain sources such as masticatory muscle myalgia (3)(4)(5)(7)(8)(9)(10)(11)15,17,18,(20)(21)(22)24,(26)(27)(28)(29)(30)(31)(32). Only a few RCTs confirmed the source of pain was from TMJ innervated structures by either the use of a local anesthetic to anesthetize the auriculotemporal nerve and eliminating the TMJ pain (6) or by selectively loading the TMJ by contralateral biting and duplicating the intracapsular source of pain within the joint (19).…”

Section: Identifying the Appropriate Patient To Test Tmj Arthrocentesis Efficacymentioning

confidence: 99%

Temporomandibular joint arthrocentesis: an evidence-based review

Dolwick¹,

Widmer²

2020

Front Oral Maxillofac Med

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Temporomandibular joint (TMJ) intracapsular pain can sometimes persist after pursuing reversible techniques. TMJ pain reduction may require a more focused treatment approach such as arthrocentesis to remove intracapsular inflammatory mediators. Evidence of efficacy for treating TMJ pain and mandibular mobility using TMJ arthrocentesis is available from a small number of high-quality evidence randomized controlled trials (RCTs). However, there still remains a lack of high-quality evidence to test the efficacy of various supplements that have been proposed to further enhance the outcomes after arthrocentesis. The purpose of this review was to examine published RCTs to determine the efficacy of TMJ arthrocentesis alone and with supplementation by steroids, hyaluronic acid and platelet-rich plasma growth factors. Thirty-one RCTs were identified from the literature with most of the studies having low to medium quality evidence. Most of the RCTs suffered from a lack of controlling experimental bias, lack of inclusion and exclusion criteria, lack of pain source validation, lack of stratification by sex and inclusion of bilateral TMJ arthrocentesis procedures that can confound the interpretation of the results of the procedure. Some RCTs were single or double blind studies, but the majority did not use a blinded experimental design.Low to medium quality evidence RCTs that focused on a comparison of TMJ arthrocentesis alone to postarthrocentesis supplementation found no differences in resting pain intensity or mandibular mobility.However, one high-quality evidence RCT that evaluated steroid supplementation (triamcinolone acetonide) found a significant improvement and normalization of chewing pain and the normalization of mandibular mobility at 12 weeks post-arthrocentesis compared to the control group. Hyaluronic acid has been evaluated by medium quality evidence RCTs and these studies did not find differences between supplementation and control groups for pain or mandibular mobility. Finally, platelet-rich plasma has been used as a supplement and one study with medium quality evidence found significant differences between groups for pain, mandibular mobility and chewing efficiency. The paucity of high-quality evidence RCTs has not allowed a consensus for the efficacy of TMJ post-arthrocentesis supplements and further studies are required to guide the practicing clinician on their use.

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Timing of arthrocentesis in the management of temporomandibular disorders: an integrative review and meta-analysis

Wong

et al. 2021

International Journal of Oral and Maxillofacial Surgery

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Comparison of treatment efficacy between hyaluronic acid and arthrocentesis plus hyaluronic acid in internal derangements of temporomandibular joint

Cited by 28 publications

References 35 publications

Timing of Arthrocentesis in the Management of Temporomandibular Disorders:A Systematic Review and Meta-analysis

Timing of Arthrocentesis in the Management of Temporomandibular Disorders:A Systematic Review and Meta-analysis

Temporomandibular joint arthrocentesis: an evidence-based review

Timing of arthrocentesis in the management of temporomandibular disorders: an integrative review and meta-analysis

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