Is There a Difference in Intra-Articular Injections of Corticosteroids, Hyaluronate, or Placebo for Temporomandibular Osteoarthritis?

Liu, Yan; Wu, Jiashun; Wei, Fei; Cen, Xiao; Xiong, Yi; Wang, Shasha; Tang, Yaling; Liang, Xin‐hua

doi:10.1016/j.joms.2017.10.028

Cited by 29 publications

(34 citation statements)

References 32 publications

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“…In this context, arthrocentesis is thought to improve outcomes of TMDs by flushing out inflammatory mediators and reducing the joint vacuum thereby improving the lubrication of the joint 26 . To supplement the efficacy of the procedure, clinicians have also injected several drugs at the end of TMJ arthrocentesis like corticosteroids, sodium hyaluronate, platelet‐rich plasma, and analgesics 5‐7 . A meta‐analysis of RCTs by Liu et al 7 has demonstrated that intra‐articular corticosteroids injected post‐arthrocentesis has no effect on pain and MMO at short‐term follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…To supplement the efficacy of the procedure, clinicians have also injected several drugs at the end of TMJ arthrocentesis like corticosteroids, sodium hyaluronate, platelet‐rich plasma, and analgesics 5‐7 . A meta‐analysis of RCTs by Liu et al 7 has demonstrated that intra‐articular corticosteroids injected post‐arthrocentesis has no effect on pain and MMO at short‐term follow‐up. Similarly, Ferreira et al 27 in a systematic review of 21 studies have concluded that visco‐supplementation with sodium hyaluronate does not appear to improve outcomes as compared to arthrocentesis alone.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the use of intra‐articular drugs after arthrocentesis has gained popularity in the past decade. Several clinical trials have attempted to improve the efficacy of TMJ arthrocentesis by injecting corticosteroids, sodium hyaluronate, platelet‐rich plasma, etc into the joint space 5‐7 . Experience from arthroscopy procedures on knee joints has demonstrated that intra‐articular analgesics may be injected at the end of the procedure to provide early pain relief 8,9 .…”

Section: Introductionmentioning

confidence: 99%

“…Several clinical trials have attempted to improve the efficacy of TMJ arthrocentesis by injecting corticosteroids, sodium hyaluronate, platelet-rich plasma, etc into the joint space. [5][6][7] Experience from arthroscopy procedures on knee joints has demonstrated that intra-articular analgesics may be injected at the end of the procedure to provide early pain relief. 8,9 Inspired by these trials, several clinicians have also experimented with the use of intra-articular analgesics after TMJ arthrocentesis.…”

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confidence: 99%

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Do intra‐articular injections of analgesics improve outcomes after temporomandibular joint arthrocentesis?: A systematic review and meta‐analysis

Liu

Zhang

2020

J of Oral Rehabilitation

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Since its first description by Nitzan et al in 1991, 1 arthrocentesis of the temporomandibular joint (TMJ) has become a routine procedure for the management of temporomandibular joint disorders (TMDs). The procedure has been used for anchored disk phenomenon, closed lock, anterior disc displacement with/without reduction and osteoarthritis. 2 It has gained wide popularity worldwide owing to its simple, inexpensive and minimally invasive nature. 2 Clinicians usually employ arthrocentesis in patients not responding to conservative therapies like painkillers, occlusal splints and physical therapy. 3

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Do intra‐articular injections of analgesics improve outcomes after temporomandibular joint arthrocentesis?: A systematic review and meta‐analysis

Liu

Zhang

2020

J of Oral Rehabilitation

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“…Sustained synovitis, cartilage destruction, subchondral bone remodeling, and pain often occur together in patients with TMJ disorders (Stegenga 2001). The current clinical therapies for inflammatory TMJ diseases focus on oral or intra-articular injection drugs, such as nonsteroidal anti-inflammatory drugs, corticosteroid, glucosamine, and hyaluronate (Liu et al 2018). These drugs effectively alleviate pain but show minimal improvement in cartilage and bone loss (Sun et al 2018).…”

Section: Introductionmentioning

confidence: 99%

DPSCs Attenuate Experimental Progressive TMJ Arthritis by Inhibiting the STAT1 Pathway

Cui

Zhang

et al. 2020

J Dent Res

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Severe inflammation, progressive cartilage, and bone destruction are typical pathologic changes in temporomandibular joint (TMJ) arthritis and lead to great difficulty for treatment. However, current therapy is inefficient to improve degenerative changes in progressive TMJ arthritis. This study investigated the therapeutic effects of human dental pulp stem cells (DPSCs) on severe inflammatory TMJ diseases. Progressive TMJ arthritis in rats was induced by intra-articular injection of complete Freund’s adjuvant and monosodium iodoacetate. DPSCs were injected into the articular cavity to treat rat TMJ arthritis, with normal saline injection as control. Measurement of head withdrawal threshold, micro–computed tomography scanning, and histologic staining were applied to evaluate the severity of TMJ arthritis. Results showed that local injection of DPSCs in rats with TMJ arthritis relieved hyperalgesia and synovial inflammation, attenuated cartilage matrix degradation, and induced bone regeneration. Inflammatory factors TNF-α and IFN-γ were elevated in progressive TMJ arthritis and partially decreased by local injection of DPSCs. MMP3 and MMP13 were elevated in the arthritis + normal saline group and decreased in the arthritis + DPSCs group, which indicated amelioration of matrix degradation. The isolated primary synoviocytes were cocultured with DPSCs after inflammatory factors stimulated to explore the possible biological mechanisms. The expression of MMP3 and MMP13 in synoviocytes was elevated after TNF-α and IFN-γ stimulation and partially reversed by DPSC treatment in the in vitro study. The signal transducer and activator of transcription 1 (STAT1) was activated by inflammatory stimulation and suppressed by DPSC coculture. The upregulation of MMP3 and MMP13 triggered by inflammation was blocked by STAT1-specific inhibitor, suggesting that STAT1 regulated the expression of MMP3 and MMP13. In conclusion, this study demonstrated the possible therapeutic effects of local injection of DPSCs on progressive TMJ arthritis by inhibiting the expression of MMP3 and MMP13 through the STAT1 pathway.

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Ultrasound‐Guided Vs Non‐Guided Prolotherapy for Internal Derangement of Temporomandibular Joint. A Randomized Clinical Trial

Alhaj Kheder,

Kandil,

El‐Ghareeb

et al. 2024

J of Ultrasound Medicine

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ObjectivesThis randomized clinical trial study aims to compare ultrasound‐guided versus non‐guided Dextrose 10% injections in patients suffering from internal derangement in the temporomandibular joint (TMJ).Material and MethodsThe study population included 22 patients and 43 TMJs suffering from unilateral or bilateral TMJ painful clicking, magnetic resonance imaging (MRI) proved disc displacement with reduction (DDWR), refractory to or failed conservative treatment. The patients were divided randomly into two groups (non‐guided and ultrasound (US)‐guided groups). The procedure involved injection of 2 mL solution of a mixture of 0.75 mL 0.9% normal saline solution, 0.3 mL 2% lidocaine and 0.75 mL dextrose 10% using a 25G needle in the joint and 1 mL intramuscular injection to the masseter muscle at the most tender point. The Visual Analogue Score (VAS) was used to compare joint pain intensity over four different periods, beginning with pre‐injection, 1‐, 2‐, and 6‐months postinjection.ResultsTwenty‐two patients 5 males (n = 5/22, 22.7%) and 17 females (n = 17/22, 77.2%) were included in this study. The mean age was 27.3 ± 7.4 years (30.2 ± 7.0) for the non‐guided group and 24.3 ± 6.9 for the US‐guided group. The dextrose injection reduced intensity over time in both groups with statistically significant improvement (P value <.05) at 2 and 6 months in both groups. There was no statistically significant difference in VAS assessment between both groups.ConclusionIntra‐articular injection of dextrose 10% for patients with painful clicking and DDWR resulted in reduced pain intensity in both US‐guided and non‐guided groups with significant symptomatic improvement over time in both groups. US guidance allowed accurate anatomical localization and safe procedure with a single joint puncture.

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Is There a Difference in Intra-Articular Injections of Corticosteroids, Hyaluronate, or Placebo for Temporomandibular Osteoarthritis?

Cited by 29 publications

References 32 publications

Do intra‐articular injections of analgesics improve outcomes after temporomandibular joint arthrocentesis?: A systematic review and meta‐analysis

Do intra‐articular injections of analgesics improve outcomes after temporomandibular joint arthrocentesis?: A systematic review and meta‐analysis

DPSCs Attenuate Experimental Progressive TMJ Arthritis by Inhibiting the STAT1 Pathway

Ultrasound‐Guided Vs Non‐Guided Prolotherapy for Internal Derangement of Temporomandibular Joint. A Randomized Clinical Trial

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