Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

Derwich, Marcin; Mituś-Kenig, Maria; Pawłowska, Elżbieta

doi:10.3390/ijms22147405

Cited by 64 publications

(55 citation statements)

References 82 publications

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“…where e is the effectiveness resulting from the calculations for this study, f (7 or 9) is the final value given by the authors of the given report and i (6 or 8) is the initial value extracted from the same report. These calculations provided further data: (10) improvement in mandibular abduction; (11) reducing the value of joint pain [29][30][31][32]. In the case of mandibular mobility, values greater than 100% indicated good results of the therapy, and in the domain of pain, values less than 100% indicated a decrease in symptoms.…”

Section: Methodsmentioning

confidence: 99%

“…Among the minimally invasive puncture techniques within TMJ, lavage of the joint cavity, supplementation of hyaluronic acid (HA) and administration of corticosteroids (CS) are commonly known and used [5][6][7]. TMJ arthrocentesis is effective in the domains of pain relief and increases the extent of mandibular abduction [8][9][10][11]. The administration of HA complements the main component of the synovial fluid and is also referred to as viscosupplementation [6].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Chęciński¹,

Chęcińska

Nowak

et al. 2022

JCM

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Introduction: Hyaluronic acid, steroids and blood products are popularly injected into the temporomandibular joint (TMJs) to relieve pain and increase the extent of mandibular abduction. The purpose of this review is to identify other injectable substances and to evaluate them in the above-mentioned domains. Material and methods: The review included articles describing clinical trials of patients treated with intra-articular injections with or without arthrocentesis. Results: The following emerging substances were initially evaluated to be effective in treating TMJ pain and increasing the amplitude of mandibular abduction: analgesics, dextrose with lidocaine, adipose tissue, nucleated bone marrow cells and ozone gas. Discussion: Better effects of intra-articular administration are achieved by preceding the injection with arthrocentesis. Conclusions: The most promising substances appear to be bone marrow and adipose tissue.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Chęciński¹,

Chęcińska

Nowak

et al. 2022

JCM

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“…Lavage of the articular cavity also reduces pain and improves mandibular mobility, possibly by reducing inflammatory mediators [ 4 , 12 ]. A single-visit rinsing of the joint cavity followed by injection of HA does not seem to improve the therapeutic effect compared to sole arthrocentesis [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…The studies conducted so far suggest the safety and efficacy of administering PRP to the temporomandibular joint cavity [ 15 ]. Nevertheless, the summary of the studies on intra-articular PRP administration does not provide clear evidence of the effectiveness of such a procedure, which implies the need for further studies [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

Sikora

Sielski²,

Chęciński³

et al. 2022

JCM

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Background: Temporomandibular joint disorders (TMDs) are manifested, inter alia, by pain and limited scope of the mandibular abduction. Among the treatment strategies for these ailments, intra-articular injections of autologous blood preparations, including platelet-rich plasma (PRP), are administered. This prospective case series was aimed at assessing the effectiveness of repeated platelet-rich plasma (PRP) administration to the TMJ cavities in terms of reducing articular pain and increasing the mobility of the mandible. Material and methods: 40 consecutive patients diagnosed with TMJ pain qualified for the case series. The entire treatment program consisted of five PRP administrations and a summary appointment. Regression was analyzed for (1) intensity of spontaneous pain; (2) effectiveness of spontaneous pain relief; (3) mastication efficiency values; (4) painless mandibular abduction; (5) maximum mouth opening. The correlations between the abovementioned variable series were analyzed. Results: The mean spontaneous pain decreased consistently with successive PRP administrations in line with the regression model: −0.4x + 4.2 (R2 = 0.98). Articular pain improvement was reported in 71% of joints treated. Improvement in chewing quality at the end of the entire injection cycle was found in 63% of patients. The equations for the linear regression models for painless mandibular abduction (five applications of PRP) and maximum mouth opening (the first four applications of PRP) were x + 34 (R2 = 0.89) and 0.6x + 43.6 (R2 = 0.96), respectively. Improvement in these domains was found in 78% and 53% of patients, respectively. The strongest correlations were found between pain and chewing efficiency (−0.95), pain and painless mandible abduction (−0.96), and painless mandibular abduction and mastication efficiency (0.94). Conclusion: PRP injections into TMJ cavities should be considered as a low invasive, highly accessible form of treatment for various TMDs causing pain and mandible movement limitation.

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“…However, this treatment modality carries a risk of articular cartilage damage. It is generally believed that corticosteroids should not be injected more than four times per year [23,24]. HA injection for DJD involves injecting HA directly into the articular cavity so as to maintain an appropriate concentration of low molecular weight solution in the articular cavity, improve rheological properties, and reduce the friction force in the articular cavity (with the goal of improving symptomology) [25,26].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Injection and Home Physical Exercise with Physical Therapy in Elderly Patients with Temporomandibular Joint Degenerative Disease: A Prospective Cohort Study

Liu,

Fan,

et al. 2022

Preprint

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Background There are few reports on the treatment of elderly patients with temporomandibular joint degenerative disease (DJD) and on the effects of physical exercise in DJD. Herein, we aimed to study and compare the efficacy of injection and home physical exercise with physical therapy alone and to explore an optimal treatment strategy for elderly patients with DJD. Methods We included 213 elderly patients with DJD treated at our medical center from June 2020 to June 2021, 64 of whom were selected for analysis. Of these 64 patients, 32 received injection combined with home physical exercise, and the other 32 received physical therapy alone. Propensity score matching was used to ensure that there were no statistically significant differences between the two groups with regard to both categorical and continuous variables. Measurements included pain intensity, maximum mouth opening, joint crepitus, jaw functional limitation scale (JFLS) scores, treatment times, and treatment durations. Improvement in each measurement was compared between the two groups at 2, 4, and 12 weeks after the start of treatment, as were the final treatment times and treatment durations. Results Pain intensity, maximum mouth opening, and JFLS scores in the two groups were improved at 2, 4, and 12 weeks after treatment (all p < 0.05). The crepitus ratio was significantly improved only in the combined treatment group at 12 weeks. Compared with the physical therapy group, improvement in mouth opening pain was improved at 2, 4, and 12 weeks in the combined treatment group; the improvement in maximal mouth opening in the physical therapy group was better than that in the injection group at 2 weeks after treatment. There were no statistically significant differences between the two groups in terms of improvement in joint crepitus and JFLS scores at each observation point. The number of visits in the combined therapy group was statistically significantly lower than that in the physical therapy group, but the treatment duration was longer. Conclusion The combined therapy showed a stronger effect on elderly patients with DJD than physical therapy alone, specifically with regard to mouth opening pain control and the number of visits.

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Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

Cited by 64 publications

References 82 publications

Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

Comparison of Injection and Home Physical Exercise with Physical Therapy in Elderly Patients with Temporomandibular Joint Degenerative Disease: A Prospective Cohort Study

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