Current temporomandibular joint viscosupplementation protocols for the treatment of temporomandibular disorders: integrative review

Abstract

Osteoarthritis is the most common joint disease. Injection of hyaluronic acid into the TMJ is a treatment option that aims to provide analgesia, improve joint function and delay the progression of the disease. Different formulations of hyaluronic acid are available in the management of osteoarthritis. The objective was to present current TMJ viscosupplementation protocols and try to define what delivers the best results in terms of joint signs and symptoms in TMD. Clinical trials, cohorts, reports and case series were included. Studies involving animal studies, reviews and other articulations were excluded. The studies involved patients diagnosed with TMJ osteoarthritis, osteoarthritis associated with disc displacement with or without reduction, and osteoarthritis concomitant with neck pain. Functional limitation, pain intensity, openness and function were assessed from the immediate post-treatment period to 6 months. Regarding the improvement of signs and symptoms, it was not possible to establish a superior protocol. To this day, there is no consensus on whether the best results are obtained with fewer or more hyaluronic acid injections. The most used protocols are those with one and three injections. They all showed good results. It is not yet possible to define a protocol that is superior to others.