Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and maxillofacial surgeryShort-term therapeutic outcome of intra-articular high molecular weight hyaluronic acid injection for nonreducing disc displacement of the temporomandibular joint
Section snippets
Materials and methods
From a large pool of patients attending the outpatient clinic at the department of Oral and Maxillofacial Surgery, University of Hong Kong, those clinically diagnosed with TMD and who were unsuccessfully treated by conservative therapy (soft diet, jaw exercises, splint therapy) were considered for recruitment into this study.
From the above large group, patients who still complained of any one of the following: pain on mastication, joint clicking, joint noise, or limited MMO, were approached to
Preinjection findings
A total of 27 patients, 7 males and 20 females, male-to-female ratio 1:2.9, received intra-articular injection in 34 temporomandibular joints. The age range was 21 to 63 years (mean age 39.3 years) and the majority (mean 48.1%) of patients were from the age group of 40 to 49 years (Fig. 3). All patients did not have diabetes and none of them was on steroid therapy. Five patients were smokers.
The diagnoses of the joint condition based on the MRI in these 27 patients are shown in Table I.
Discussion
The use of sodium hyaluronate was first described in the 1970s by Rydell and Balazs40 and by Helfet41 in the treatment of osteoarthrosis of the knee. Many studies conducted since then on osteoarthrosis of the knee demonstrated that sodium hyaluronate helps to alleviate pain, improve knee function, and reduce knee joint crepitus.42, 43 In the treatment of TMJ disorders, this substance presents a therapeutic opportunity either as an adjunct medication after arthrocentesis or as a therapeutic
Conclusion
Based on this observational study, intra-articular TMJ injection of high molecular weight hyaluronic acid appears to be a safe and effective therapeutic method with a long-lasting effect (6 months to 1 year) in patients with nonreducing disc displacement.
The authors recommend the use of 2 injections of high molecular weight hyaluronic acid given at 2-week intervals. This therapeutic option is in our opinion preferable to the use of nonsteroidal anti-inflammatory drugs and corticosteroids, which
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Comprehensive review on biosynthesis of hyaluronic acid with different molecular weights and its biomedical applications
2023, International Journal of Biological MacromoleculesIntra-articular injection of a mixture of hyaluronic acid and corticosteroid versus arthrocentesis in TMJ internal derangement
2020, Journal of Stomatology, Oral and Maxillofacial SurgeryCitation Excerpt :While Hepguler [24] used double intra articular injection with one week interval and showed the same results. This study showed significant difference in the lateral movement in HA group but this was controversial with the result obtained by Yeung et al. [25] who used two intra-articular injections of 2 ml hyaluronic acid and recorded that there was no statistically significant difference in the mean lateral excursion even after one-year follow-up. In a study conducted by Giraddi et al. [22] an improvement in the TMJ clicking was recorded.
Comparison of treatment efficacy between hyaluronic acid and arthrocentesis plus hyaluronic acid in internal derangements of temporomandibular joint
2019, Journal of Cranio-Maxillofacial SurgeryCitation Excerpt :Arthrocentesis increases disc mobilization and removes adhesions, thus making joint movements easier (Guarda-Nardini et al., 2010; Tozoglu et al., 2011). HA injection provides lubrication that reduces friction of the joint surfaces, thus increasing movement capacity of the joint (Yeung et al., 2006). Relief of pain and a decrease in the negative pressure also improve mouth opening (Korkmaz et al., 2016).
Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review
2016, International Journal of Oral and Maxillofacial SurgeryIs Hyaluronic Acid Injection Effective for the Treatment of Temporomandibular Joint Disc Displacement With Reduction?
2016, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :These outcomes are compatible with data in the literature and support the efficacy of HA injection for DDR of the TMJ. The intra-articular application of HA yields permanent useful effects, although the half-life of hyaluronate is approximately 13 hours.24 In the present study, the effect of HA injection is believed to have lasted until the sixth month.