Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland.
Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
Biomolecules. 2024 Sep 26;14(10):1216. doi: 10.3390/biom14101216.
Hyaluronic acid (HA) is a glycosaminoglycan composed of D-glucuronic acid and N-acetylglucosamine with an up-to-several-million-Daltons chain-length responsible for the lubricating properties of the temporomandibular joint (TMJ) synovial fluid. Arthritis results in the predominance of HA degradation over synthesis leading to temporomandibular disorders (TMDs). TMD injection treatments are divided into HA supplementation and platelet-rich plasma (PRP) inflammation suppression. We questioned whether either approach lubricated the TMJ better and answered it in a two-arm equal-allocation trial with a non-concurrent active treatment control (two groups of 39 patients each). HA statistically significantly improved ( < 0.01) and PRP did not statistically significantly change (0.06 ≤ ≤ 0.53) articular mobility compared to baselines in 128 TMJs. Statistically significant inter-group discrepancies were observed for abduction (MD = -4.05 mm; SE = 1.08; = 0.00; = -0.85) and protrusion (MD = -0.97 mm; SE = 0.43; = 0.03; = -0.51) but not for rightward (MD = -0.21; SE = 0.43; = 0.63; = -0.11) and leftward (MD = -0.30; SE = 0.42; = 0.47; = -0.16) movements. HA supplementation proved superior to PRP autografting in ad hoc TMJ lubrication and hence is more appropriate in hypomobile TMD cases of symptomatic treatment.
透明质酸（HA）是一种糖胺聚糖，由 D-葡萄糖醛酸和 N-乙酰葡萄糖胺组成，其链长可达数百万道尔顿，负责颞下颌关节（TMJ）滑液的润滑特性。关节炎导致 HA 的降解超过合成，导致颞下颌紊乱（TMD）。TMD 注射治疗分为 HA 补充和富含血小板的血浆（PRP）炎症抑制。我们质疑这两种方法是否都能更好地润滑 TMJ，并在一项具有非同期主动治疗对照的双臂均等分配试验中回答了这个问题（每组 39 例患者）。与基线相比，128 个 TMJ 中 HA 统计学上显著改善（<0.01），而 PRP 统计学上没有显著变化（0.06≤≤0.53）。在外展（MD=-4.05mm；SE=1.08；=0.00；= -0.85）和突出（MD=-0.97mm；SE=0.43；=0.03；= -0.51）方面观察到统计学上显著的组间差异，但在右侧（MD=-0.21mm；SE=0.43；=0.63；= -0.11）和左侧（MD=-0.30mm；SE=0.42；=0.47；= -0.16）运动方面没有差异。HA 补充在 TMJ 临时润滑方面优于 PRP 自体移植，因此在症状性治疗的低活动性 TMD 病例中更合适。
