Bliźniak Filip, Chęciński Maciej, Chęcińska Kamila, Lubecka Karolina, Kamińska Monika, Szuta Mariusz, Chlubek Dariusz, Sikora Maciej
Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland.
Department of Glass Technology and Amorphous Coatings, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Mickiewicza 30, 30-059 Kraków, Poland.
J Clin Med. 2024 Jul 11;13(14):4056. doi: 10.3390/jcm13144056.
: This systematic review was designed to summarize randomized controlled trials of intra-articular administration of non-steroidal anti-inflammatory drugs (NSAIDs) for temporomandibular disorders. : Randomized controlled trials regarding intra-articular injections of non-steroidal anti-inflammatory drugs for temporomandibular disorders were included in the review. The final search was conducted on 16 June 2024 in the Bielefeld Academic Search Engine, PubMed, and Scopus databases. : Of the 173 identified studies, 6 were eligible for review. In trials comparing arthrocentesis alone to arthrocentesis with NSAIDs, slight differences in joint pain were noted. For tenoxicam, differences were under 1 point on a 0-10 scale after 4 weeks, with inconsistent results. Piroxicam showed no significant difference, and pain levels were minimal in both groups. For maximum mouth opening (MMO), tenoxicam showed no significant difference. Piroxicam increased MMO by nearly 5 mm, based on one small trial with bias concerns. : Currently, there is no strong scientific evidence supporting the injection of NSAIDs into the temporomandibular joint to relieve pain or increase jaw movement. Preliminary reports on piroxicam with arthrocentesis and tenoxicam or diclofenac without rinsing justify further research.
本系统评价旨在总结关节腔内注射非甾体抗炎药（NSAIDs）治疗颞下颌关节紊乱病的随机对照试验。纳入了关于关节腔内注射非甾体抗炎药治疗颞下颌关节紊乱病的随机对照试验。最终检索于2024年6月16日在比勒费尔德学术搜索引擎、PubMed和Scopus数据库中进行。在173项已识别的研究中，有6项符合纳入评价的标准。在比较单纯关节穿刺与关节穿刺联合NSAIDs的试验中，发现关节疼痛存在轻微差异。对于替诺昔康，4周后在0至10分的量表上差异小于1分，结果不一致。吡罗昔康未显示出显著差异，两组的疼痛水平均最低。对于最大开口度（MMO），替诺昔康未显示出显著差异。基于一项存在偏倚问题的小型试验，吡罗昔康使MMO增加了近5毫米。目前，没有强有力的科学证据支持将NSAIDs注射到颞下颌关节以缓解疼痛或增加下颌运动。关于吡罗昔康联合关节穿刺以及替诺昔康或双氯芬酸不冲洗的初步报告为进一步研究提供了依据。
