The efficacy of intra‐articular sodium hyaluronate in patients with reducing displaced disc of the temporomandibular joint

Abstract

In this clinical trial, we examined the efficacy of intra-articular hyaluronic acid (HA) treatment in 38 patients with reducing displaced disc of the temporomandibular joint (TMJ). Subjects received two unilateral upper space injections of HA or physiological saline solution with 1 week apart. Efficacy was based on the following measurements: pain and sound intensity of the joint measured by visual analogue scale (VAS), modified Helkimo's clinical dysfunction index and the intensity of joint vibration during opening and closing the mouth measured by accelerometers. These measurements were performed before the first injection and 1 and 6 months after the last injection. In the treatment group (n=19), all measurements improved significantly at month 1 and at month 6 compared with the baseline (P < 0.01). The same measurements, in the placebo group (n=19), did not show any change, except for the pain intensity which improved at month 1 and month 6 (P < 0.05). The change in baseline measurements of all of the efficacy criteria at month 1 and at month 6 in the treatment group was significantly better compared with the change obtained with placebo at the same time intervals. This study demonstrates that intra-articular sodium hyaluronate (Orthovisc) injection into the TMJ is an effective treatment for a reducing displaced disc.

Viscossuplementação como tratamento das alterações internas da articulação temporomandibular: relato de casos

“…Comparando-se a viscossuplementação por HS com placebo, não se percebe diferenças estatísticas significativas em curto prazo na melhora de sinais clínicos das DTM. No entanto, há evidências de que o HS tenha efeito em longo prazo na melhora de sinais e sintomas em relação ao placebo 11 . O HS apresenta os mesmos efeitos benéficos que a infiltração com corticosteroide a curto e longo prazo na melhora dos sintomas e sinais clínicos das DTM 12,13 .…”

O uso do hialuronato de sódio no tratamento das disfunções temporomandibulares articulares

“…Considering HA properties, viscosuplementation with HA has been used in different joint TMDs, such as reducing and nonreducing disc displacement, osteoarthritis and degenerative joint disease 16,17,20,21,23,[34][35][36][37][38] . A multicenter study 16 involved a sample of 121 participants divided in two parallel groups, who were followed up for six months.…”

“…NRDD results have shown improvement in at least one class of dysfunction in all HA group patients with significant difference between groups (level of evidence 2). In a different study 17 , RDD patients aged above 21 years who have not responded to conservative therapy for more than two months were divided in two parallel groups and followed up for six months. Each group was composed of 19 patients with mean age of 31.9 years for HA group and 31.1 years for SS group.…”

“…MPs act on collagen and proteoglycans, weakening joint cartilage matrix. Thus, there are collagen and proteoglycan fragments, in addition to leukotriens and cytokines in the capsular ligament, leading to joint movement limitation and followed or not by pain [16][17][18][19] . TMJ viscosuplementation is a minimally invasive technique consisting in intra-articular injection of HA (sodium hyalorunate) aiming at eliminating or decreasing pain and providing joint functional gain, promoting qualitative and quantitative improvement of the synovial fluid [20][21][22] .…”

Scientific evidence on the usefulness of intraarticular hyaluronic acid injection in the management of temporomandibular dysfunction

“…HA is a natural component of joint synovial fluid, and is also found in the extracellular matrix of connective tissue (1,2). The authors that make use of HA consider that the intraarticular injection of HA in patients with temporomandibular joint dysfunction (TMJD) improves function and lessens pain.…”