Evaluation of Effect of Glucosamine-Chondroitin Sulfate, Tramadol, and Sodium Hyaluronic Acid on Expression of Cytokine Levels in Internal Derangement of Temporomandibular Joint

Abstract

Aim: Evaluation of the effect of glucosamine-chondroitin combination, tramadol, and sodium hyaluronic acid in temporomandibular joint (TMJ) disorders and its impact on the expression of various cytokines such as IL-6, IL-1ß, TNF-α, and PGE2. Materials and methods: The present study was conducted on 60 patients (males-30, females-30) suffering from internal derangement such as disc displacement with reduction of TMJ. The patients were divided into three groups of 20 each. Group I received a combination of 1.5g of glucosamine and 1.2 g of chondroitin sulfate per day and group II received 50 mg tramadol HCL peroral. Group III received sodium hyaluronate 10 mg/mL, 2 mL injection syringe on each joint. Pain (VAS) scale and maximum mouth opening (MMO) was measured. The level of IL-6, IL-1ß, TNF-α, and PGE2 levels were measured using Enzyme-linked immuno sorbent assay (ELISA). Results: There was an improvement in maximum mouth opening in all three groups (p < 0.05). There was a reduction in pain in all groups. IL-1 ß, TNF-α, and PGE2 leve ls showed reduction while IL-6 showed an increase in value in group II and III. Conclusion: The efficacy of glucosamine chondroitin sulfate , tramadol and hyaluronic acid in TMJ disorders has been found to be effective. Clinical significance: IL-6, IL-1ß, TNF-α, and PGE2 levels indicate the risk of TMJ disorders. Thus earlier assessment of their levels helps in diagnosis, and better management may be done.

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

“…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,…”