Is Hyaluronic Acid or Corticosteroid Superior to Lactated Ringer Solution in the Short-Term Reduction of Temporomandibular Joint Pain After Arthrocentesis? Part 1

Bouloux, Gary F.; Chou, Joli C.; Krishnan, Deepak G.; Aghaloo, Tara; Kahenasa, Nora; Smith, Julie Ann; Giannakopoulos, Helen

doi:10.1016/j.joms.2016.08.006

Cited by 45 publications

(42 citation statements)

References 65 publications

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“…The use of HA (as reported in 3 trials of this review) after arthrocentesis is controversial at best, with low quality of literature . Some support the use of HA claiming its lubricating effect provides faster and longer relief from pain, while another study reports no significant difference in outcome while using arthrocentesis alone . Similarly, the role of splint after arthrocentesis is questionable.…”

Section: Discussionmentioning

confidence: 93%

Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

Nagori¹,

Chowdhury

Thukral³

et al. 2018

J of Oral Rehabilitation

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The aim of this systematic review was to investigate the current evidence in order to assess the efficacy of single puncture arthrocentesis vs standard double needle arthrocentesis in the management of temporomandibular joint(TMJ) disorders. An electronic search of the PubMed, Scopus, Cochrane CENTRAL and Google Scholar databases was performed to identify English studies published up until October 2017. Eligible studies were selected based on inclusion criteria and included randomised controlled trials(RCTs) comparing single puncture arthrocentesis and standard double needle arthrocentesis for the management TMJ disorders. The initial screening identified 984 records, of which only 5 fulfilled the inclusion criteria. A high degree of heterogeneity was found in the 5 studies with each reporting different sample selection and arthrocentesis protocol. All 5 studies reported no difference in reduction in pain intensity and improvement in maximal mouth opening between the single puncture technique and standard double needle technique. This review provides some evidence that single puncture arthrocentesis is clinically as efficacious as standard double needle arthrocentesis. There is a need of well-designed RCT with standard protocol of arthrocentesis comparing different single puncture techniques and standard double needle technique for the management of TMJ disorders.

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Section: Discussionmentioning

confidence: 93%

Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

Nagori¹,

Chowdhury

Thukral³

et al. 2018

J of Oral Rehabilitation

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“…The question becomes whether TMJ arthralgia is caused by an inflammation triggered by IA agents, which is diluted at the IA intervention, or whether the nerve block anaesthetic stops a windup phenomenon. In addition, in arthrocentesis studies in which the intervention procedure was completed with or without deposition of corticosteroids for treatment of TMJ arthralgia, arthrosis and internal derangement have no significant effects on pain intensity . Thus, it seems obvious that the combination of procedures, local anaesthetic and injected fluid reduce TMJ pain.…”

Section: Discussionmentioning

confidence: 99%

Pain relief following a single‐dose intra‐articular injection of methylprednisolone in the temporomandibular joint arthralgia—A multicentre randomised controlled trial

Isacsson¹,

Schumann²,

Nohlert³

et al. 2018

J of Oral Rehabilitation

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. SummaryBackground: Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation. Objective:The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain.Methods: This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population. Results:In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812).Treatment-related adverse events were doubled in the methylprednisolone group. Conclusion:Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia. K E Y W O R D Sarthralgia, corticosteroids, injection, intra-articular, pain management, temporomandibular joint

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“…The initial literature search yielded on 2067 articles (Cochrane Library=45/ Web of Science=5/ Google Scholar=1390/ PubMed=47/ ProQuest=107/ Scopus=473), in which 1402 articles remained after removing duplicates. After the first screening based on the title and abstract, 11 studies ( 13 , 16 , 17 , 20 - 27 ) were found eligible which reached to 7 studies ( 13 , 17 , 20 - 24 ) after excluding high risk articles (Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review

Davoudi

Khaki²,

Mohammadi³

et al. 2018

Med Oral

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BackgroundTemporomandibular disorders (TMDs) are musculoskeletal conditions that can inhibit the normal function of temporomandibular joints (TMJs) and affect the patient’s quality of life, negatively. Arthrocentesis (AC) is a minimally invasive surgical procedure used for treating TMDs. The aim of present paper is to evaluate the advantages of administrating corticosteroid (CS) during AC by reviewing high quality released articles.Material and MethodsSearching on Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, and Scopus databases were performed with focusing on proper key words. Related titles and abstracts, up to December 2017, were screened and selected based on inclusion criteria. The full text of all randomized controlled trials (RCTs) was extensively read and subjected to quality assessments.ResultsAfter initial search, a total of 2067 articles were included into the study. Finally, 7 studies were reliable enough in methodology and randomization to be included into the study. All of the observed studies showed improvements in jaw functions and pain relief with no statistical differences in both AC and control groups. One study reported painless maximum incisal opening in CS group than the control group.ConclusionsBased on available RCTs, the AC of TMJ with CS seems to result in similar findings to other therapeutic drugs, with no significant differences. Key words:Arthrocentesis, corticosteroid, temporomandibular joints, temporomandibular joint disorders.

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Is Hyaluronic Acid or Corticosteroid Superior to Lactated Ringer Solution in the Short-Term Reduction of Temporomandibular Joint Pain After Arthrocentesis? Part 1

Abstract: Arthrocentesis alone is as efficacious as arthrocentesis with HA or CS in decreasing TMJ pain.

Cited by 45 publications

References 65 publications

Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

Pain relief following a single‐dose intra‐articular injection of methylprednisolone in the temporomandibular joint arthralgia—A multicentre randomised controlled trial

Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review

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