Short-Term Effects of Intra-Articular Hyaluronic Acid Administration in Patients with Temporomandibular Joint Disorders.

Maciej Sikora,Marcin Sielski,Maciej Adam Chęciński,Dariusz Chlubek,Barbara Czerwińska-Niezabitowska

doi:10.3390/jcm9061749

Abstract

The study described in this paper was conducted to assess the short-term outcomes of intra-articular administration of hyaluronic acid in patients with symptoms of temporomandibular joint disorders. A group of 40 patients suffering from temporomandibular joint disorders underwent a series of hyaluronic acid intra-articular injections. Questionnaires and clinical examinations were conducted to assess stress exposure of the subjects and to evaluate short-term treatment outcomes, i.e., reducing joint and muscle pain and increasing the mobility of the mandible. A weak positive correlation between stress exposure and pain was observed. As a result of treatment, 61% of subjects revealed a total reduction of muscle pain, while joint pain completely resolved in 88% of patients. Mandibular mobility increased by 11%, 31%, 9%, and 11% regarding opening, protrusive, and lateral right and left movements, respectively. The study confirms the short-term effectiveness of intra-articular administration of hyaluronic acid on reducing joint and muscle pain in patients with articular disc displacement. The treatment positively affected the mobility of the mandible in all directions. The verification of late treatment effects of hyaluronic acid viscosupplementation requires the continuation of the research.

Highlights

Temporomandibular joints (TMJs) belong to the category of synovial joints in the human body, where joint surfaces are lubricated by the synovial fluid produced by the synovial membrane lining the joint capsule
The study included 40 adult patients with symptoms of masticatory system disorders, who qualified for intra-articular hyaluronic acid (HA) injections in accordance with the guidelines published by Escoda-Francoli et al [3] and developed on the basis of a meta-analysis of research on viscosupplementation of the temporomandibular joint published between 1966 and 2008
A person in whom both muscular and joint pain were present after the end of HA therapy was a 34-year-old woman who had reported the presence of pain in the right temporomandibular joint for about a month before the start of HA injections

Summary

Introduction

Temporomandibular joints (TMJs) belong to the category of synovial joints in the human body, where joint surfaces are lubricated by the synovial fluid produced by the synovial membrane lining the joint capsule. An appropriate concentration of HA in the synovial fluid is crucial for proper tissue elasticity and for reducing friction between the joint surfaces of the bone and the synovial disc. In this way, the viscoelastic properties of the synovial fluid protect the chondrocytes against mechanical damage caused by excessive pressure. HA has antioxidant properties, reducing the amount of free radicals present in the joint cavity. By interacting with collagen, HA forms a barrier against microorganisms and toxins

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Discussion

Conclusion