Objectives: Although, arthrocentesis is an accepted safe treatment modality used for the management of TMD patients with pain, the benefit of hyaluronic acid (HA) injections remains uncertain. The aim of this study was to investigate whether intra-articular injections of hyaluronic acid as an adjunct therapy with arthrocentesis can be more effective than other medications for the improvement of symptoms associated with temporomandibular disorders. Materials and methods: For this purpose, an electronic search of Medline, Scopus and Cochrane databases was performed up to September 2020. No language, and publication date limitation was set. The following search terms were used: “arthrocentesis”, “hyaluronic acid”, “intra-articular injections”, “viscosupplementation”, with “temporomandibular disorders”. Inclusion criteria was prospective or retrospective studies, case reports, and randomized clinical trials that reported the application of HA injections compared to other intra-articular drugs for the treatment of temporomandibular disorders. Exclusion criteria included systemic reviews, animal studies. Additionally, a retrospective clinical study was performed on 12 TMD cases for evaluation of changes before and after arthrocentesis with hyaluronic acid (HA) injections in quality of life (QoL) of these patients. Results: In the systemic review, the initial screening included 1327 articles. After a more detailed evaluation of the titles, abstracts, and full texts; a total of 29 studies were selected (26 randomized studies, 2 controlled clinical trials, 1 retrospective report). In the clinical study 12 patients were included. According to the results, intra-articular injections of HA and other medications together with arthrocentesis seemed to be beneficial for improvement of functional symptoms of TMD and pain. The case series also supported support the efficacy of HA injections with a significant improvement of QoL of these patients. However, after the evaluation of the reports in literature, it was impossible to identify an optimum drug or a protocol in improving the pain and/or functional symptoms of temporomandibular problems due to diversity of treatment modalities and conflicting results. Conclusion: As a conclusion, there was no consensus in the studies that HA injections showed better results in comparison with other treatment modalities. According to the results of this systematic review and clinical study HA injections with/without arthrocentesis seems to be beneficial in terms of clinical symptoms and QoL of the patients.

EVALUATION OF ARTHROCENTESIS WITH HYALURONIC ACID INJECTIONS FOR MANAGEMENT OF TEMPOROMANDIBULAR DISORDERS / F. Goker ; tutor: M. Del Fabbro ; coordinator: M. Del Fabbro. Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, 2021 Mar 01. 33. ciclo, Anno Accademico 2020. [10.13130/goker-funda_phd2021-03-01].

EVALUATION OF ARTHROCENTESIS WITH HYALURONIC ACID INJECTIONS FOR MANAGEMENT OF TEMPOROMANDIBULAR DISORDERS

F. Goker
2021

Abstract

Objectives: Although, arthrocentesis is an accepted safe treatment modality used for the management of TMD patients with pain, the benefit of hyaluronic acid (HA) injections remains uncertain. The aim of this study was to investigate whether intra-articular injections of hyaluronic acid as an adjunct therapy with arthrocentesis can be more effective than other medications for the improvement of symptoms associated with temporomandibular disorders. Materials and methods: For this purpose, an electronic search of Medline, Scopus and Cochrane databases was performed up to September 2020. No language, and publication date limitation was set. The following search terms were used: “arthrocentesis”, “hyaluronic acid”, “intra-articular injections”, “viscosupplementation”, with “temporomandibular disorders”. Inclusion criteria was prospective or retrospective studies, case reports, and randomized clinical trials that reported the application of HA injections compared to other intra-articular drugs for the treatment of temporomandibular disorders. Exclusion criteria included systemic reviews, animal studies. Additionally, a retrospective clinical study was performed on 12 TMD cases for evaluation of changes before and after arthrocentesis with hyaluronic acid (HA) injections in quality of life (QoL) of these patients. Results: In the systemic review, the initial screening included 1327 articles. After a more detailed evaluation of the titles, abstracts, and full texts; a total of 29 studies were selected (26 randomized studies, 2 controlled clinical trials, 1 retrospective report). In the clinical study 12 patients were included. According to the results, intra-articular injections of HA and other medications together with arthrocentesis seemed to be beneficial for improvement of functional symptoms of TMD and pain. The case series also supported support the efficacy of HA injections with a significant improvement of QoL of these patients. However, after the evaluation of the reports in literature, it was impossible to identify an optimum drug or a protocol in improving the pain and/or functional symptoms of temporomandibular problems due to diversity of treatment modalities and conflicting results. Conclusion: As a conclusion, there was no consensus in the studies that HA injections showed better results in comparison with other treatment modalities. According to the results of this systematic review and clinical study HA injections with/without arthrocentesis seems to be beneficial in terms of clinical symptoms and QoL of the patients.
1-mar-2021
Settore MED/28 - Malattie Odontostomatologiche
arthrocentesis; hyaluronic acid; intra-articular injections; temporomandibular disorders; quality of life
DEL FABBRO, MASSIMO
DEL FABBRO, MASSIMO
Doctoral Thesis
EVALUATION OF ARTHROCENTESIS WITH HYALURONIC ACID INJECTIONS FOR MANAGEMENT OF TEMPOROMANDIBULAR DISORDERS / F. Goker ; tutor: M. Del Fabbro ; coordinator: M. Del Fabbro. Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, 2021 Mar 01. 33. ciclo, Anno Accademico 2020. [10.13130/goker-funda_phd2021-03-01].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/820923
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