Does the Hyaluronic Acid Dosage During Arthrocentesis Influence Pain Reduction and Maximal Incisal Opening?

IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Onur Sahar, Olgun Topal
{"title":"Does the Hyaluronic Acid Dosage During Arthrocentesis Influence Pain Reduction and Maximal Incisal Opening?","authors":"Onur Sahar, Olgun Topal","doi":"10.1016/j.joms.2025.06.227","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The efficacy of hyaluronic acid (HA) after arthrocentesis in temporomandibular joint (TMJ) disorders is recognized, but the therapeutic effect of different HA doses remains unclear.</p><p><strong>Purpose: </strong>The study purpose was to measure and compare the therapeutic efficacy of different HA doses among patients with intra-articular pain and dysfunction undergoing arthrocentesis.</p><p><strong>Study design, setting, sample: </strong>Subjects with intra-articular pain and dysfunction presented to Afyonkarahisar University of Health Sciences between September 2022 and December 2023 were screened for study inclusion. The inclusion criteria were over 18 years of age, with magnetic resonance imaging-confirmed disc displacement without reduction, and classified as stage 3 to 4 according to Wilke's classification. The exclusion criteria were the presence of systemic disease, pregnancy, TMJ ankylosis, myofascial pain, hypersensitivity to local anesthetics, and a history of TMJ surgery.</p><p><strong>Predictor variable: </strong>The predictor variable was HA dose. Subjects were randomly assigned to receive 10 mg/ml (HA10) or 20 mg/ml (HA20).</p><p><strong>Outcome variable: </strong>The primary outcome variable was the therapeutic effect, which was assessed using visual analog scale (VAS) and maximum incisal opening (MIO). The secondary outcomes were lateral excursions, protrusion, and joint sounds. All measurements were recorded at baseline (T0), month 1 (T1), and month 3 (T2).</p><p><strong>Covariates: </strong>The covariates were demographics (age and sex), perioperative (Wilke's classification), and side of the arthrocentesis procedure (unilateral or bilateral).</p><p><strong>Analyses: </strong>Statistical analysis using IBM SPSS included Mann-Whitney U test, χ<sup>2</sup> test, and Fisher's exact test for group comparisons, with significance at P < .05.</p><p><strong>Results: </strong>The study sample was composed of 36 subjects with a mean age of 32.78 (SD = 9.53), and 29 (80.6%) were female. There were 18 subjects in each study group. For the TMJ, VAS scores decreased from 7.33 ± 2.06 to 0.97 ± 1.24 in HA10 and from 7.78 ± 3.26 to 1.82 ± 2.11 in HA20 (P = .3 at T0, P = .07 at T2). MIO increased from 37.44 ± 8.3 to 45.06 ± 6.8 in HA10 and from 37 ± 10.84 to 42.94 ± 10.54 in HA20 (P = .9 at T0, P = .5 at T2). No statistically significant differences were found between the groups in VAS and MIO at any time point.</p><p><strong>Conclusions and relevance: </strong>The results suggest that HA dose is not associated with therapeutic efficacy. As such, the lower price HA option is adequate.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oral and Maxillofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.joms.2025.06.227","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The efficacy of hyaluronic acid (HA) after arthrocentesis in temporomandibular joint (TMJ) disorders is recognized, but the therapeutic effect of different HA doses remains unclear.

Purpose: The study purpose was to measure and compare the therapeutic efficacy of different HA doses among patients with intra-articular pain and dysfunction undergoing arthrocentesis.

Study design, setting, sample: Subjects with intra-articular pain and dysfunction presented to Afyonkarahisar University of Health Sciences between September 2022 and December 2023 were screened for study inclusion. The inclusion criteria were over 18 years of age, with magnetic resonance imaging-confirmed disc displacement without reduction, and classified as stage 3 to 4 according to Wilke's classification. The exclusion criteria were the presence of systemic disease, pregnancy, TMJ ankylosis, myofascial pain, hypersensitivity to local anesthetics, and a history of TMJ surgery.

Predictor variable: The predictor variable was HA dose. Subjects were randomly assigned to receive 10 mg/ml (HA10) or 20 mg/ml (HA20).

Outcome variable: The primary outcome variable was the therapeutic effect, which was assessed using visual analog scale (VAS) and maximum incisal opening (MIO). The secondary outcomes were lateral excursions, protrusion, and joint sounds. All measurements were recorded at baseline (T0), month 1 (T1), and month 3 (T2).

Covariates: The covariates were demographics (age and sex), perioperative (Wilke's classification), and side of the arthrocentesis procedure (unilateral or bilateral).

Analyses: Statistical analysis using IBM SPSS included Mann-Whitney U test, χ2 test, and Fisher's exact test for group comparisons, with significance at P < .05.

Results: The study sample was composed of 36 subjects with a mean age of 32.78 (SD = 9.53), and 29 (80.6%) were female. There were 18 subjects in each study group. For the TMJ, VAS scores decreased from 7.33 ± 2.06 to 0.97 ± 1.24 in HA10 and from 7.78 ± 3.26 to 1.82 ± 2.11 in HA20 (P = .3 at T0, P = .07 at T2). MIO increased from 37.44 ± 8.3 to 45.06 ± 6.8 in HA10 and from 37 ± 10.84 to 42.94 ± 10.54 in HA20 (P = .9 at T0, P = .5 at T2). No statistically significant differences were found between the groups in VAS and MIO at any time point.

Conclusions and relevance: The results suggest that HA dose is not associated with therapeutic efficacy. As such, the lower price HA option is adequate.

关节穿刺时透明质酸的用量是否影响疼痛的减轻和最大的切口开口?
背景:关节置换术后透明质酸(HA)治疗颞下颌关节(TMJ)疾病的疗效已得到认可,但不同HA剂量的治疗效果尚不清楚。目的:研究目的是测量和比较不同剂量的透明质酸对关节内疼痛和功能障碍患者进行关节穿刺的治疗效果。研究设计、环境、样本:筛选2022年9月至2023年12月期间到Afyonkarahisar健康科学大学就诊的关节内疼痛和功能障碍患者纳入研究。纳入标准为年龄在18岁以上,磁共振成像证实椎间盘移位无复位,根据Wilke分级分为3 ~ 4期。排除标准为全身性疾病、妊娠、TMJ强直、肌筋膜疼痛、局部麻醉剂过敏和有TMJ手术史。预测变量:预测变量为血凝素剂量。受试者被随机分配接受10 mg/ml (HA10)或20 mg/ml (HA20)。结果变量:主要结果变量为治疗效果,采用视觉模拟量表(VAS)和最大切牙开度(MIO)进行评估。次要结果为外侧偏移、突出和关节音。在基线(T0)、第1个月(T1)和第3个月(T2)记录所有测量结果。协变量:协变量为人口统计学(年龄和性别)、围手术期(Wilke分类)和关节穿刺一侧(单侧或双侧)。分析:采用IBM SPSS进行统计学分析,组间比较采用Mann-Whitney U检验、χ2检验和Fisher确切检验,P < 0.05为显著性。结果:研究样本共36例,平均年龄32.78岁(SD = 9.53),其中女性29例(80.6%)。每个研究组有18名受试者。对于TMJ, HA10的VAS评分从7.33±2.06降至0.97±1.24,HA20的评分从7.78±3.26降至1.82±2.11 (P = 0.3, P = 0.07)。HA10组MIO由37.44±8.3上升至45.06±6.8,HA20组由37±10.84上升至42.94±10.54 (P = 0.9, P = 0.5)。各组VAS和MIO评分各时间点差异均无统计学意义。结论及相关性:结果提示HA剂量与治疗效果无关。因此,价格较低的HA选项就足够了。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Oral and Maxillofacial Surgery
Journal of Oral and Maxillofacial Surgery 医学-牙科与口腔外科
CiteScore
4.00
自引率
5.30%
发文量
0
审稿时长
41 days
期刊介绍: This monthly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信