Abstract
The Effect of Intra-Articular Injection of Hyaluronic Acid on the Degenerative Pathology of the Temporo-Mandibular Joint
Highlights
Manducator dysfunction is common in the field of maxillo-facial surgery
Magnetic resonance imaging (MRI) scans were conducted on all patients before the first injection and 2 months post‐treatment to analyse the integrity of the disc and bone
Two hundred ten patients received an intra‐muscular injection of botulinum toxin type-A (BoNTA) 15 days prior to the intra-joint injection of Hyaluronic acid (HA) due to muscular hypertension, but this was considered unnecessary in 100 patients who presented with weak to normal musculature
Summary
Manducator dysfunction is common in the field of maxillo-facial surgery. Intra-articular injection of hyaluronic acid is beneficial in certain degenerative arthritic conditions leading to improved pain and function. This study investigated 310 patients treated with intra-joint hyaluronic acid for treatment-resistant, degenerative manducator apparatus dysfunction during 2 years from January 2015 to December 2016. Chronic dysfunction causes degeneration of the temporo-mandibular joints (TMJ), due to a disturbance in the equilibrium of the degenerative and repair processes of fibrous connective tissue, cartilage, bone and the synovial liquid [1]. Hyaluronic acid (HA) is a polysaccharide of the glycosaminoglycan family It can be found in a number of extra‐cellular tissues, including synovial liquid and cartilage. It is produced by chondrocytes in the articular discs and the synovialocytes [2]. HA is depolymerised resulting in a reduction of molecular weight and, viscoelasticity These changes increase the sensitivity of the cartilage to damage. Treatment using exogenic HA causes stimulation of the synthesis of its endogenous counterpart [2]
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