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A one-year case series of arthrocentesis with hyaluronic acid injections for temporomandibular joint osteoarthritis.

Guarda-Nardini L, Stifano M, Brombin C, Salmaso L, Manfredini D

Department of Maxillofacial Surgery, University of Padova, Padova, Italy.

OBJECTIVE: The present study presents a case series on the efficacy of arthrocentesis with hyaluronic acid injections for the treatment of temporomandibular joint osteoarthritis by providing patient evaluations at a one-year follow-up. STUDY DESIGN: Twenty-five patients with a diagnosis of osteoarthritis according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD axis I group IIIb) underwent a cycle of 5 arthrocenteses with injections (1 per week) of 1 mL hyaluronic acid. A number of clinical parameters (pain at rest and mastication, masticatory efficiency, maximum nonassisted and assisted mouth openings, functional limitation, subjective efficacy, and tolerability of the treatment) were assessed by the same blinded operator at the time of the diagnosis (baseline), at each appointment during the treatment, and at 1-week, 1-month, 3-month, 6-month, and 1-year follow-up appointments. RESULTS: Descriptive analysis showed improvements which were maintained over time for all the study parameters. Permutation tests evidenced the significance of changes which occurred in many clinical parameters within the first 2 injections. Differences with baseline levels remained significant at the end of the follow-up period, particularly for the masticatory efficiency and pain at mastication (minimum and maximum) parameters. CONCLUSIONS: Data from the present investigation support findings from studies on other joints, which show the efficacy of serial injections of hyaluronic acid after arthrocentesis to reduce symptoms of osteoarthritis and to maintain improvements over time.

Published 28 May 2007 in Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 103(6): e14-22.
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