Scholarlink

Objectives <p>To evaluate the effectiveness of minimally invasive interventions (arthrocentesis and intra-articular injections) versus conservative therapies for temporomandibular joint osteoarthritis (TMJ OA).</p> Methods <p>This systematic review included randomized controlled and prospective or observational studies involving patients with TMJ OA. A comprehensive search of five databases was conducted up to November 2024. Pain intensity (VAS) and maximum mouth opening (MMO) were analyzed via meta-analysis, with risk of bias assessed using ROB 2 and ROBINS-I tools, and certainty of evidence using GRADE. The significance level adopted for the analysis was set at α = 0.05.</p> Results <p>Sixteen studies (901 patients) were included. Arthrocentesis, alone or with adjuvants such as PRP, i-PRF, corticosteroids, or NSAIDs, significantly improved pain (MD − 5.50; 95%CI: − 6.61 to − 4.39) and MMO (MD 6.97&#xa0;mm; 95%CI: 1.96 to 11.98) versus baseline and between groups. Intra-articular hyaluronic acid, with or without glucosamine, showed clinical benefit over time, but its superiority over conservative care was inconsistent. Substantial heterogeneity was observed, mainly in injection-based protocols. GRADE indicated high certainty of evidence for most comparisons, except one (MMO, moderate certainty).</p> Conclusions <p>Minimally invasive therapies, especially arthrocentesis with biological adjuvants, seems to be effective for TMJ OA management. However, due to heterogeneity and methodological limitations, their superiority over conservative strategies remains uncertain.</p> Statement Clinical Relevance <p>Minimally invasive therapies, particularly arthrocentesis with or without&#xa0;biological agents, may reduce pain and improve jaw function in TMJ OA,&#xa0;offering a potential alternative to conservative treatments over a 3- to 12-month period.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effectiveness of treatments for temporomandibular joint osteoarthritis: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月15日

查看全文
  • Luiz Guilherme Spadon-Brito,
  • Caio Sberni Pinheiro Souza,
  • Alex Moreira Mélo,
  • Maria Amália Dias Pereira Calças,
  • Melissa Oliveira Melchior,
  • Fernanda Leal Vieira,
  • Fabiane Carneiro Lopes-Olhê,
  • Joel Ferreira Santiago-Junior,
  • Lais Valencise Magri,
  • Jardel Francisco Mazzi-Chaves

摘要

Objectives

To evaluate the effectiveness of minimally invasive interventions (arthrocentesis and intra-articular injections) versus conservative therapies for temporomandibular joint osteoarthritis (TMJ OA).

Methods

This systematic review included randomized controlled and prospective or observational studies involving patients with TMJ OA. A comprehensive search of five databases was conducted up to November 2024. Pain intensity (VAS) and maximum mouth opening (MMO) were analyzed via meta-analysis, with risk of bias assessed using ROB 2 and ROBINS-I tools, and certainty of evidence using GRADE. The significance level adopted for the analysis was set at α = 0.05.

Results

Sixteen studies (901 patients) were included. Arthrocentesis, alone or with adjuvants such as PRP, i-PRF, corticosteroids, or NSAIDs, significantly improved pain (MD − 5.50; 95%CI: − 6.61 to − 4.39) and MMO (MD 6.97 mm; 95%CI: 1.96 to 11.98) versus baseline and between groups. Intra-articular hyaluronic acid, with or without glucosamine, showed clinical benefit over time, but its superiority over conservative care was inconsistent. Substantial heterogeneity was observed, mainly in injection-based protocols. GRADE indicated high certainty of evidence for most comparisons, except one (MMO, moderate certainty).

Conclusions

Minimally invasive therapies, especially arthrocentesis with biological adjuvants, seems to be effective for TMJ OA management. However, due to heterogeneity and methodological limitations, their superiority over conservative strategies remains uncertain.

Statement Clinical Relevance

Minimally invasive therapies, particularly arthrocentesis with or without biological agents, may reduce pain and improve jaw function in TMJ OA, offering a potential alternative to conservative treatments over a 3- to 12-month period.