Department of Head and Neck Oncology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China (mainland).
Department of Oral and Maxillofacial Surgery, Zigong Fourth People's Hospital, Zigong, Sichuan, China (mainland).
Med Sci Monit. 2018 Aug 20;24:5793-5801. doi: 10.12659/MSM.908821.
BACKGROUND The aim of this study was to determine the clinical effects of sodium hyaluronate injection into the superior and inferior joint space for osteoarthritis of the temporomandibular joint (TMJ) and to evaluate the joint changes using cone-beam computed tomography (CBCT). MATERIAL AND METHODS A retrospective observational clinical study included 51 patients and 56 TMJs, with a diagnosis of osteoarthritis. All patients received sodium hyaluronate injections into the superior and inferior TMJ joint spaces (articular cavities). At baseline and post-treatment the condylar bony changes were evaluated by CBCT. To evaluate TMJ function, maximum mouth opening (MMO), and Helkimo's index was used, which included an anamnestic index (Ai) and a clinical dysfunction index (Di). Patients were divided into short-term (one year) follow-up groups. RESULTS In both patient follow-up groups, sodium hyaluronate injection of the superior and inferior TMJ space significantly improved MMO, the Ai, and the Di (P<0.05). There were no significant differences between the two groups in condylar bony changes of the TMJ seen by CBCT (sclerosis, erosion, hyperplasia, and flattening) (P>0.05). CBCT showed a good predictive ability on post-treatment symptom relief following sodium hyaluronate injection into the superior and inferior TMJ space in patients with osteoarthritis of the TMJ (P=0.024). CONCLUSIONS The findings of this clinical and CBCT imaging study showed that sodium hyaluronate injection into the superior and inferior TMJ space in patients with osteoarthritis improved clinical symptoms, but did not control the progression of osteoarthritic joint destruction.
本研究旨在确定向颞下颌关节（TMJ）骨关节炎的上下关节间隙注射透明质酸钠的临床效果，并使用锥形束 CT（CBCT）评估关节变化。
本回顾性观察性临床研究纳入了 51 名患者和 56 个 TMJ，诊断为骨关节炎。所有患者均接受透明质酸钠注射至上、下 TMJ 关节间隙（关节腔）。在基线和治疗后，使用 CBCT 评估髁突骨变化。为评估 TMJ 功能，采用最大张口度（MMO）和 Helkimo 指数，包括病史指数（Ai）和临床功能障碍指数（Di）。患者分为短期（1 年）随访组。
在两组患者随访中，向 TMJ 上、下关节间隙注射透明质酸钠均可显著改善 MMO、Ai 和 Di（P<0.05）。CBCT 观察到的 TMJ 髁突骨变化（硬化、侵蚀、增生和变平）在两组之间无统计学差异（P>0.05）。CBCT 显示，在 TMJ 骨关节炎患者中，向 TMJ 上、下关节间隙注射透明质酸钠后，对治疗后症状缓解具有良好的预测能力（P=0.024）。
本临床和 CBCT 影像学研究结果表明，向 TMJ 骨关节炎患者的上、下关节间隙注射透明质酸钠可改善临床症状，但不能控制骨关节炎性关节破坏的进展。
