Oliveras-Moreno Jose-Maria, Hernandez-Pacheco Esther, Oliveras-Quintana Teresa, Infante-Cossio Pedro, Gutierrez-Perez Jose-Luis
Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Faculty of Dentistry, University of Seville, Seville, Spain.
J Oral Maxillofac Surg. 2008 Nov;66(11):2243-6. doi: 10.1016/j.joms.2008.01.067.
To show whether an intra-articular (IA) infiltration of 1 mL sodium hyaluronate (SH) into the temporomandibular joint (TMJ) would significantly reduce pain and improve joint function in Wilkes stage II disease, compared with the oral administration of a combination of methocarbamol and paracetamol.
Forty-one patients with Wilkes stage II disease were selected and randomly assigned to 2 groups. The experimental group received 1 IA infiltration of SH with assessments at days 14, 28, 56, and 84. The control group was given 2 tablets of a combination of methocarbamol 380 mg and paracetamol 300 mg every 6 hours for 4 weeks, with assessments at days 14 and 28.
Forty-one patients were randomized into the study (SH: 20 patients, control drug: 21 patients). A statistically significant difference (P < . 05) was detected in favor of the SH group from day 56 onward for TMJ pain at rest, from day 14 onward for pain on jaw opening, and at days 28 and 56 for pain on mastication. The TMJ function was statistically significantly (P < .05) better in the test group at all follow-up visits. The global evaluation of efficacy by both, the patients and investigators, was better for the test group. No adverse reactions were detected with SH.
An IA infiltration of SH showed better efficacy in reducing pain and improving joint function in Wilkes stage II disease, compared with the oral administration of methocarbamol-paracetamol tablets.
比较向颞下颌关节（TMJ）关节腔内（IA）注射1毫升透明质酸钠（SH）与口服美索巴莫和对乙酰氨基酚联合用药，对威尔克斯II期疾病患者疼痛的显著减轻及关节功能改善情况。
选取41例威尔克斯II期疾病患者，随机分为2组。试验组接受1次关节腔内SH注射，并在第14、28、56和84天进行评估。对照组每6小时服用2片含380毫克美索巴莫和300毫克对乙酰氨基酚的复方制剂，持续4周，并在第14和28天进行评估。
41例患者被随机纳入研究（SH组：20例患者，对照药物组：21例患者）。从第56天起，试验组静息时TMJ疼痛情况显著优于对照组（P <.05）；从第14天起，开口时疼痛情况显著优于对照组；在第28和56天，咀嚼时疼痛情况显著优于对照组。在所有随访中，试验组TMJ功能均显著优于对照组（P <.05）。患者和研究者对试验组疗效的总体评价更好。未发现SH有不良反应。
与口服美索巴莫 - 对乙酰氨基酚片相比，关节腔内注射SH对威尔克斯II期疾病患者在减轻疼痛和改善关节功能方面疗效更佳。
