Long et al.55 Long X, Chen G, Cheng AH, Cheng Y, Deng M, Cai H, et al. A randomized controlled trial of superior and inferior temporomandibular joint space injection with hyaluronic acid in treatment of anterior disc displacement without reduction. J Oral Maxillofac Surg. 2009;67(2):357-61.
|
Randomized clinical trial |
To compare HA infiltration in the lower and upper joint space |
120 |
DDSR |
Pain improvement in both groups |
The intra-articular infiltration of HA in the upper and lower joint space was effective |
Korkmaz et al.99 Korkmaz YT, Altintas NY, Korkmaz FM, Candirli C, Coskun U, et al. Is hyaluronic acid injection effective for the treatment of temporomandibular joint disc displacement with reduction? J Oral Maxillofac Surg. 2016;74(9):1728-40.
|
Prospective clinical study |
Compare the HA therapy and the treatment with the occlusal splint |
- |
DDCR |
Better results with the HA therapy |
The injection of HA and the occlusal splint therapy were effective in relieving the signs and symptoms of DDCR |
Guarda-Nardini et al.1010 Guarda-Nardini L, Cadorin C, Frizziero A, Ferronato G, Manfredini D. Comparison of 2 hyaluronic acid drugs for the treatment of temporomandibular joint osteoarthritis. J Oral Maxillofac Surg. 2012;70(11):2522-30.
|
Retrospective clinical trial |
To compare the efficacy of the HA infiltration therapy in different age groups |
76 |
Osteoarthritis of the TMJ |
The HA was effective in most of the evaluated symptoms |
The treatment protocol was more effective in people over 45 years of age |
Li et al.1111 Li C, Long X, Deng M, Li J, Cai H, Meng Q. Osteoarthritic changes after superior and inferior joint space injection of hyaluronic acid for the treatment of temporomandibular joint osteoarthritis with anterior disc displacement without reduction: a cone-beam computed tomographic evaluation. J Oral Maxillofac Surg. 2015;73(2):232-44.
|
Randomized clinical trial |
To compare the effects of HA infiltration in the lower and upper joint space |
141 |
Osteoarthritis of the TMJ and DDSR |
Improvement of TMJ function in both groups |
The HA infiltration is an effective method for the treatment of DDSR associated with osteoarthritis |
Bonotto et al.1212 Bonotto D, Machado E, Cunali RS, Cunali PA. Viscosupplementation as a treatment of internal derangements of the temporomandibular joint: retrospective study. Rev Dor. 2014;15(1):2-5.
|
Retrospective clinical study |
Discuss the viscosupplementation in the treatment of internal alterations of the TMJ |
55 |
DDSR and osteoarthritis of the TMJ |
There was an increase in mouth opening in patients with DDSR and osteoarthritis |
The viscosupplementation with HA is considered a good alternative to improve the function of the TMJ in the short term |
Goiato et al.1313 Goiato MC, da Silva EV, de Medeiros RA, Túrcio KH, Dos Santos DM. Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review. Int J Oral Maxillofac. Surg. 2016;45(12):1531-7.
|
Systematic review |
Compare the HA injections and other drugs used in the arthrocentesis of the TMJ |
- |
Internal TMJ disorders |
Intra-articular injections of HA are beneficial to improve the functional symptoms of TMD |
Positive results were observed with the HA therapy, but other therapies may be used |
Iturriaga et al.1414 Iturriaga V, Bornhardt T, Manterola P, Brebi P. Effect of hyaluronic acid on the regulation of inflammatory mediators in osteoarthritis of the temporomandibular joint: a systematic review. Int J Oral Maxillofac Surg. 2017;46(5):590-5.
|
Systematic review |
Analyze the evidence of the efficacy of the HA |
- |
Osteoarthritis of the TMJ |
The application of HA had positive results |
Further research is needed. |
Guarda-Nardini, Manfredini and Ferronato1515 Guarda-Nardini L, Manfredini D, Ferronato G. Short-term effects of arthrocentesis plus viscosupplementation in the management of signs and symptoms of painful TMJ disc displacement with reduction. A pilot study. Oral Maxillofac Surg. 2010;14(1):29-34.
|
Pilot study |
Provide data about the effect of a cycle of five arthrocentesis plus HA infiltration |
31 |
DDCR and arthralgia |
Improvement regarding all variables of the study |
Five infiltrations of HA after arthrocentesis was effective to ameliorate the DDR symptoms |
Aktas, Yalcin and Sencer1616 Aktas S, Yalcin SS, Sencer S. Prognostic indicators of the outcome of arthrocentesis with and without sodium hyaluronate injection for the treatment of disc displacement without reduction: a magnetic resonance imaging study. Int J Oral Maxillofac Surg. 2010;39(11):1080-5.
|
Retrospective clinical study |
Analyze the prognosis of arthrocentesis with and without HA |
25 |
DDSR |
It is sufficient to use only arthrocentesis in patients without degenerative alterations |
Having a standardized study group for future studies is necessary |
Guarda-Nardini et al.1717 Guarda-Nardini L, Rossi A, Ramonda R, Punzi L, Ferronato G, Manfredini D. Effectiveness of treatment with viscosupplementation in temporomandibular joints with or without effusion. Int J Oral Maxillofac Surg. 2014;43(10):1218-23.
|
Case-control study |
Determine the effectiveness of viscosupplementation with the HA |
25 |
Osteoarthritis of the TMJ |
Improvement in all outcome parameters |
Effective therapy for pain improvement and the TMJ function |
Guarda-Nardini et al.1818 Guarda-Nardini L, Cadorin C, Frizziero A, Masiero S, Manfredini D. Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: effects of intra-articular injection with hyaluronic acid. Cranio, 2017;35(5):276-82.
|
Retrospective clinical study |
Evaluate the effect of viscosupplementation with HA |
49 |
Osteoarthritis |
Significant reduction of pain over time |
Further studies are required |
Guarda-Nardini et al.1919 Guarda-Nardini L, Manfredini D, Stifano M, Staffieri A. Marioni G. Intra-articular injection of hyaluronic acid for temporomandibular joint osteoarthritis in elderly patients. Stomatologija. 2009;11(2):60-5.
|
Retrospective clinical study |
Evaluate the efficacy of the HA in elderly patients |
50 |
Osteoarthritis of the TMJ |
Significant improvement of signs and symptoms |
There was no significant difference between the groups |
Guarda-Nardini et al.2020 Guarda-Nardini L, Rossi A, Arboretti R, Bonnini S, Stellini E, Manfredini D. Single- or multiple-session viscosupplementation protocols for temporomandibular joint degenerative disorders: a randomized clinical trial. J Oral Rehabil. 2015;42(7):521-8.
|
Randomized clinical trial |
Compare the efficacy of a single session protocol with a five-session protocol of HA infiltration in the TMJ |
30 |
Osteoarthritis of the TMJ |
There was greater reduction of pain in the group treated with the 5-session protocol of HA infiltration |
The five-session protocol showed better results in 6 months |
Manfredini, Piccotti and Guarda-Nardini2121 Manfredini D, Piccotti F, Guarda-Nardini L. Hyaluronic acid in the treatment of TMJ disorders: a systematic review of the literature. Cranio. 2010;28(3):166-76.
|
Systematic review |
Evaluate the clinical studies on HA infiltration in the TMJ |
- |
TMJ disorders |
All studies reported a decrease in pain levels |
The results are similar to those obtained with corticosteroid injection and the use of occlusal splints |
Manfredini et al.2222 Manfredini D, Favero L, Gregorini G, Cocilovo F, Guarda-Nardini L. Natural course of temporomandibular disorders with low pain-related impairment: a 2-to-3-year follow up study. J Oral Rehabil. 2013;40(6):436-42.
|
Prospective randomized clinical trial |
Evaluate the efficacy of platelet-rich plasma with growth factors injection versus HA |
100 |
Internal TMJ disorder and osteoarthritis |
The group treated with platelet-rich plasma with growth factors injection had better results |
The injection of platelet-rich plasma with growth factors after arthroscopy has shown to be more effective than the HA injection in patients with internal TMJ disorders |