Jogigowda Sanjay Chikkarasinakere, Shastry Shilpa Padar, Christopher Varusha Sharon, Patil Karthikeya, Basavarajappa Ritu, Doddawad Vidya Gowdappa, B V Deepa
Department of Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research Mysuru, Karnataka, 570015, India.
Department of Oral Medicine and Radiology, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, 560066, India.
Oral Maxillofac Surg. 2025 Sep 18;29(1):155. doi: 10.1007/s10006-025-01448-x.
This systematic review evaluates the effectiveness and safety of intra-articular injections for temporomandibular joint (TMJ) arthralgia in adults, comparing various injection types against alternative treatments or placebo.
We conducted a comprehensive literature search across Scopus and Pubmed from January 2015 to December 2024, including randomized controlled trials, prospective comparative clinical trials, and observational studies with control groups. Eligibility criteria required adult patients with clinically diagnosed TMJ arthralgia, various intra-articular injections, and outcome measures including pain reduction and jaw function improvement. The Cochrane Risk of Bias Tool (RoB 2) assessed methodological quality across included studies.
The review included seven high-quality studies with sample sizes ranging from 20 to 114 participants across multiple countries. All injection types-corticosteroids, hyaluronic acid, and platelet-rich plasma-demonstrated significant pain reduction and functional improvement within treatment groups. Between-group differences were often not statistically significant in high-quality randomized controlled trials. Specific advantages were noted: sodium hyaluronate may be more effective for reducing joint noises, while corticosteroids showed better short-term pain relief.
The evidence supports intra-articular injections as effective treatment options for TMJ arthralgia, though no single intervention consistently outperformed others across all outcomes. Treatment selection should be individualized based on patient presentation and preferences.
This review was prospectively registered in PROSPERO (CRD42025632073) and received no external funding.
本系统评价评估关节内注射治疗成人颞下颌关节（TMJ）关节痛的有效性和安全性，比较不同注射类型与替代治疗或安慰剂的效果。
我们在2015年1月至2024年12月期间对Scopus和Pubmed进行了全面的文献检索，包括随机对照试验、前瞻性比较临床试验和有对照组的观察性研究。纳入标准要求临床诊断为TMJ关节痛的成年患者、接受各种关节内注射以及包括疼痛减轻和下颌功能改善的结局指标。采用Cochrane偏倚风险工具（RoB 2）评估纳入研究的方法学质量。
该评价纳入了7项高质量研究，样本量从20至114名参与者不等，涉及多个国家。所有注射类型——皮质类固醇、透明质酸和富血小板血浆——在治疗组内均显示出显著的疼痛减轻和功能改善。在高质量随机对照试验中，组间差异通常无统计学意义。注意到了特定优势：透明质酸钠在减少关节弹响方面可能更有效，而皮质类固醇在短期疼痛缓解方面表现更好。
有证据支持关节内注射作为TMJ关节痛的有效治疗选择，尽管在所有结局指标上没有一种干预措施始终优于其他措施。治疗选择应根据患者的表现和偏好进行个体化。
本评价已在PROSPERO（CRD42025632073）上进行前瞻性注册，且未接受外部资金。
