Osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate
Osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate
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DOI：
10.1111/j.1365-2842.2007.01759.x
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发表时间：
2007-08-01
影响因子：
2.9
通讯作者：
Moystad, A.
中科院分区：
文献类型：
--
作者：
Bjornland, T.;Gjaerum, A. A.;Moystad, A.
本研究的目的是比较关节内颞下颌关节（TMJ）注射治疗40例TMJ骨性关节炎的疗效和并发症。受试者被随机分为两组，患者接受两次关节内注射透明质酸钠或两次关节内注射皮质类固醇，间隔14天。在首次注射后14天、1天和6个月，根据以下指标评估治疗效果：疼痛强度、疼痛定位、关节声音、下颌功能和并发症。在6个月的随访中，两组患者的疼痛强度均有所减轻，与皮质类固醇相比，接受透明质酸钠治疗的患者疼痛强度明显减轻（P = 0.001）。在两组患者中都可以观察到心肺功能的下降。20例接受透明质酸钠治疗的患者，下颌骨垂直开口和突出度均显著增加（P < 0.000）。注射透明质酸钠（P = 0.024）和皮质类固醇（P = 0.042）的受试者患侧侧身活动增加。总之，本研究证实，在TMJ注射透明质酸钠或皮质类固醇可以减轻骨关节炎患者的疼痛并改善功能。与同时患有TMJ和肌筋膜疼痛的患者相比，这种注射对只有TMJ疼痛的患者更有效。注射透明质酸钠明显比皮质类固醇更有效地减轻疼痛强度。注射后可观察到暂时的疼痛。
The purpose of this study was to compare the efficacy and the complications of intra-articular temporomandibular joint (TMJ) injections in 40 patients with osteoarthritis of the TMJ. The subjects were randomly divided into two groups, and the patients received either two intra-articular injections with sodium hyaluronate or two intra-articular injections with corticosteroids, 14 days apart. The effect of the treatment was evaluated 14 days, I and 6 months after the initial injection and was based on the following measurements: pain intensity, pain localization, joint sounds, mandibular function and complications. Both groups of patients had less pain intensity at the 6-month follow-up, and there was significantly less pain intensity in the group of patients receiving sodium hyaluronate compared with corticosteroids (P = 0.001). A decrease in crepitation was seen in both groups. In the 20 subjects receiving sodium hyaluronate both the mandibular vertical opening and protrusion increased significantly (P < 0.000). Lateral movement from the affected side increased both in subjects injected with sodium hyaluronate (P = 0.024), and those injected with corticosteroids (P = 0.042). in conclusion, this study confirms that injections in the TMJ with sodium hyaluronate or corticosteroids may reduce pain and improve function in patients with osteoarthritis. The injections were more effective in patients with only TMJ pain compared with patients suffering from both TMJ and myofascial pain. injection with sodium hyaluronate was significantly more effective in decreasing pain intensity than corticosteroids. Temporary pain after injections may be observed.