Guarda-Nardini Luca, Manfredini Daniele, Stifano Marco, Staffieri Alberto, Marioni Gino
Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
Stomatologija. 2009;11(2):60-5.
Preliminary findings gave encouraging results for the use of hyaluronic acid in temporomandibular joints with inflammatory/degenerative processes. This investigation aimed at evaluating retrospectively the efficacy of intra-articular injections of hyaluronic acid in elderly patients (aged >65 years) with osteoarthritis of the temporomandibular joint as compared with those of a group of adult non-elderly patients.
Two groups of patients with Research Diagnostic Criteria for Temporomandibular Disorders axis I group IIIb diagnosis of osteoarthritis, aged over (N=17)/under (N=33) 65 years respectively (elderly/non-elderly groups), underwent a cycle of five injections (one per week) of 1 ml low molecular weight hyaluronic acid and four follow-up assessments after the end of the treatment (at one week, at one month, at three months, at six months).
At the end of the treatment period, improvements in the elderly group were significant with respect to baseline values in the minimum and maximum masticatory pain, maximum pain at rest values, and functional limitation scores. In the non-elderly group, significant improvements at the end of treatment were showed in all treatment outcome variables, except than minimum pain at rest values. All improvements were maintained over the six-month span of the follow-up period, and no significant differences were showed between groups for any of the outcome variables, except than functional limitation scores, which improved more in the elderly group.
These findings are not supportive for a difference in efficacy between the elderly patients and the other subjects, even though further works on different age groups are needed before generalization of results.
初步研究结果表明,透明质酸用于患有炎症/退行性病变的颞下颌关节取得了令人鼓舞的效果。本研究旨在回顾性评估关节内注射透明质酸对老年(年龄>65岁)颞下颌关节骨关节炎患者的疗效,并与一组成年非老年患者进行比较。
两组符合颞下颌关节紊乱研究诊断标准轴I组IIIb诊断为骨关节炎的患者,分别为年龄超过(N=17)/低于(N=33)65岁(老年/非老年组),接受一个周期的五次注射(每周一次)1毫升低分子量透明质酸,并在治疗结束后进行四次随访评估(在一周、一个月、三个月、六个月)。
在治疗期结束时,老年组在最小和最大咀嚼痛、静息时最大疼痛值以及功能受限评分方面相对于基线值有显著改善。在非老年组中,除静息时最小疼痛值外,所有治疗结果变量在治疗结束时均有显著改善。所有改善在随访期的六个月内均得以维持,除功能受限评分在老年组改善更多外,两组在任何结果变量上均未显示出显著差异。
这些发现并不支持老年患者与其他受试者在疗效上存在差异,尽管在结果普遍化之前还需要对不同年龄组进行进一步研究。