Abstract
Viscosupplementation is a minimally invasive technique that replaces synovial fluid by intra-articular injection of hyaluronic acid (HA). Although effective in some joints, there is not conclusive evidence regarding temporomandibular disorders. This case series described the efficacy of a viscosupplementation protocol in intra-articular temporomandibular disorders. Ten patients with a diagnosis of disc displacement and/or osteoarthritis by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to four monthly injections of low or medium molecular weight HA. Pain, mandibular function, image analysis by tomography and magnetic resonance, and quality of life were assessed at baseline and follow-ups (1 and 6 months). Pain, jaw range-of-motion, mandibular function, and quality of life improved at follow-up evaluations. Osteoarthritis changes decreased, and 20% of patients improved mandibular head excursion after treatment. Resolution of effusion and improvement in disc morphology were observed for most patients. This viscosupplementation protocol reduced pain and symptoms associated with internal derangement of temporomandibular joint, improved quality of life, and showed benefits from both low and medium molecular weight HA in alternate cycles.
Highlights
Temporomandibular disorders (TMDs) are a heterogeneous group of disorders involving the temporomandibular joint (TMJ), the masticatory muscles, and associated structures [1,2,3]
One and 6 months after treatment, there was a significant change in patient diagnosis according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I Group I, that is, no patient was diagnosed with myofascial pain
We evaluated the effectiveness of a protocol of four injections of low and medium MW hyaluronic acid (HA) on pain, mandibular function, signs of intra-articular disease by image analysis, and quality of life in ten patients with TMD
Summary
Temporomandibular disorders (TMDs) are a heterogeneous group of disorders involving the temporomandibular joint (TMJ), the masticatory muscles, and associated structures [1,2,3]. Viscosupplementation (VS) is a minimally invasive technique that involves replacement of synovial fluid by intra-articular injection of hyaluronic acid (HA) which restores its concentration and molecular weight in joint cavity [8]. It has been suggested that high molecular weight HA is important in lubrication and protection of joint structures due to its improvement of highly hydrated and rheological environment [10, 11]. Low molecular weight HA induces its endogen production by type B synoviocytes restoring natural properties of synovial fluid [12, 13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
