Temporomandibular joint disorder and the impact of intra-articular injections of hyaluronic acid, tenoxicam and betametazon

A comparative study on the impact of intra-articular injections of hyaluronic acid, tenoxicam and betametazon on the relief of temporomandibular joint disorder complaints.

Article specifications

This clinical Trial was published in 2014 in Journal of J Craniomaxillofac Surg. (IF 2015:1.48) by Turkish specialists. The aim of this study was to compare the efficacy of intra-articular injections of three different agents with well-known anti-inflammatory properties. In the study group there were 55 female and 45 male patients who were non-responders to conventional anti-inflammatory treatment for TMJ complaints. The patients were randomly divided into four groups consisting of a control group and three different groups who underwent intra-articular injection of one given anti-inflammatory agent for each group. We injected saline solution to intra-articular space in the control group. Of three anti-inflammatory agents including hyaluronic acid (HA, Hyalgan intra-articular injection, Sodium hyaluronate 10 mg/ml, 2 ml injection syringe); betamethasone (CS, Diprospan flacon, 7.0 mg betamethasone/1 ml) and; tenoxicam (TX, Tilcotil flacon, 20 mg tenoxicam/ml) were administered intra-articularly under, ultrasonographic guidance. Changes in subjective symptoms were compared with visual analogue scales, (VAS) scores at 1st and 6th weeks' follow-up visits between four groups.

 

Results

We found that HA produced better pain relief scores when compared to the other anti-inflammatory agents studied. The main disadvantage of HA is its relatively higher cost. Additionally, it does not have a reimbursement status by state or private health insurance systems in Turkey. Despite the lower VAS scores, intra-articular TX and CS may be assessed as more economic alternatives to intra-articular HA injections.