Efficiency of intra-articular injections with hyaluronic acid in patients with temporomandibular joint osteoarthritis – a retrospective study

Background & Objective: According to the RDC/TMD classification of temporomandibular disorders (TMDs), one very often diagnosis is osteoarthritis of temporomandibular joint (TMJOA). TMJOA is a slowly progressive and degenerative disease affecting all TMJ structures, mainly the articular cartilage. Its etiology is trauma and joint overloading. TMJOA’s management has been attempted with several treatments, but the most usual choice is intra-articular injections with hyaluronic acid. The aim of this study is to evaluate the efficiency of such injections at patients with TMJOA. Methods: Thirty five (35) patients, 9 men and 26 women, have been included in the study. They are divided into two age groups: seventeen (17) of age 40 – 59 years old and eighteen (18) of age over 60 years old. Their medical records have been gathered and examined, and a follow-up visit was scheduled for each of them for clinical examination and discussion over a structured questionnaire. Results: Regarding the pain, the average value of painful symptoms is 3,780 out of 5 before treatment, whereas after treatment the same average value is equal to 0,457. It seems that the number of patients that stopped complaining about TMJ sounds is higher after their treatment by 16 patients (10 out of 35 before treatment, 26 out of 35 after treatment). Finally, a reduction of mouth opening was pointed out in only 3 patients at the follow-up visit, much less that the initial number of 33 patients with reduced mouth opening before treatment. Conclusion: Intra-articular injections with hyaluronic acid appear to be of great value for patients with TMJOA. TMJOA is usually expressed with painful symptomatology, but the prevalence of asymptomatic patients is not very low. So, it is important to suspect TMJOA clinically and refer patients for radiological assessment.