The Hierarchy of Different Treatments for Arthrogenous Temporomandibular Disorders: A Network Meta-Analysis of Randomized Clinical Trials

ConclusionThe results of the present metanalysis support a paradigm shift in arthrogenous TMJ disorder treatment. There is a new evidence (though on a very low to moderate quality level) that minimally invasive procedures, particularly in combination with IAI of adjuvant pharmacological agents (PRP, HA or CS), are significantly more effective than conservative treatments for both pain reduction and improvement of MMO in both short (≤5 months) and intermediate term (6 months to 4 years) periods. In contrast to traditional concepts mandating exhaustion of conservative treatment options, minimally invasive procedures, therefore, deserve to be implemented as efficient first-line treatments (e.g. IAIs and/or Arthrocentesis) or should be considered rather early, i.e. as soon as patients do not show a clear benefit from an initial conservative treatment.
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research

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Our purpose was to measure the temporomandibular joint (TMJ) synovial fluid (SF) levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) before and after intra-articular injection of hyaluronic acid (HA) and to investigate the possible mechanism involved in the therapeutic value of HA. We analysed the synovial fluid of 30 patients with unilateral internal derangement (ID) or osteoarthritis (OA) of the TMJ (confirmed by magnetic resonance imaging and cone-beam computed tomography) and recorded clinical signs and symptoms including maximal mouth opening, subjective joint pain, and joint noi...
Source: The British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Source Type: research
Human amniotic membrane (HAM) has recently been used as an interpositional material to prevent ankylosis or primary re-ankylosis after temporomandibular joint (TMJ) arthroplasty. Here, the authors describe an unusual case of a 32-year-old woman who presented with a noninflammatory degenerative osteoarthritis of the TMJ in which a HAM was placed following a high condylar arthroplasty and discectomy and show the clinicoradiological results. The procedure resulted in total pain relief and significant improvement in jaw movements. On the long-term follow-up computed tomography, complete remodeling of the glenoid fossa with for...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
In this study, we assessed the expression of DKK1 in the synovial fluid of TMD-OA patients before and after treatment with HA via enzyme-linked immunosorbent assay. We also investigated the role of DKK1 in TMD-OA via immunohistochemical staining. The relationship between the expression of DKK1 and the clinicopathological characteristics was determined by Pearson analysis. The results showed that the expression of DKK1 was significantly decreased after treatment with HA. Correlation analyses indicated that the expression of DKK1 in the TMD-OA samples was closely correlated with mouth opening and pain. These findings suggest...
Source: Journal of Huazhong University of Science and Technology -- Medical Sciences -- - Category: Research Source Type: research
PRGF® endoret injections for temporomandibular joint osteoarthritis treatment: a one-year follow-up. J Biol Regul Homeost Agents. 2019 Nov-Dec;33(6 Suppl. 2):215-222 Authors: DENTAL SUPPLEMENT, Giacomello M, Mortellaro C, Viganoni C, Crimella A, Fossati J, Lauritano D Abstract This clinical trial investigates the efficacy of PRGF-Endoret® injections for the treatment of temporomandibular joint osteoarthritis by providing patient evaluations at a one-year follow-up. Fifty-two patients with a diagnosis of osteoarthritis according to the American Society of Temporomandibular Joint Surgeons' guidel...
Source: Journal of Biological Regulators and Homeostatic Agents - Category: Biomedical Science Tags: J Biol Regul Homeost Agents Source Type: research
Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists....
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Authors: Li F, Wu C, Sun H, Zhou Q Abstract AIMS: To study the effect of platelet-rich plasma (PRP) injections on pain reduction in patients with temporomandibular joint osteoarthritis (TMJ OA). METHODS: The authors performed a comprehensive search of the MEDLINE, PubMed, and Web of Science databases to retrieve RCTs published up to July 2018. Pain outcomes (visual analog scale scores) were extracted to assess the effect of PRP injections on TMJ OA. All data analyses were conducted using RevMan 5.3. RESULTS: Six studies were included. According to the results of these trials, intra-articular injections of P...
Source: Journal of Orofacial Pain - Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research
In this study, we aimed to investigate effective therapies to reverse or suppress TMJOA progression.
Source: Osteoarthritis and Cartilage - Category: Rheumatology Authors: Source Type: research
NIDCR Grand Rounds The temporomandibular joint (TMJ) is a complex joint and the only bilateral joints that must function together as one unit to support mastication and speech. TMJ trauma and diseases, such as osteoarthritis, can be debilitating and severely reduce quality of life. Current TMJ treatments generally involve either pain management or invasive surgeries, such as total joint replacement surgery. There are no minimally invasive, regenerative TMJ therapies. Dr. Embree and her lab have identified TMJ-specific fibrocartilage stem cells that self-organize and regenerate cartilage, fat, and vascularized bone. She has...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
Abstract Mechanical overloading of the temporomandibular joint (TMJ) promotes both the initiation and progression of TMJ osteoarthritis (OA). New preclinical animal models are needed for the evaluation of the molecular basis of cellular load transmission. This would allow a better understanding of the underlying mechanisms of TMJ-OA pain and disability, and help identify new therapeutics for its early diagnosis and management. The purpose of this study was to evaluate the role of mechanical loading in the progression of TMJ-OA in surgical instability arising from unilateral partial discectomy (UPD) in a murine mod...
Source: The Bulletin of Tokyo Dental College - Category: Dentistry Authors: Tags: Bull Tokyo Dent Coll Source Type: research
CONCLUSIONS AND CLINICAL RELEVANCE: The assessed lesions were associated with osteoarthritis, and they accumulated in the TMJs as horses aged. In the absence of signs of pain manifested as changes in mastication, behavior, or performance, it would be difficult to determine the point at which accrued pathological changes represented the onset of clinically important osteoarthritis of the TMJs. PMID: 31763947 [PubMed - in process]
Source: American Journal of Veterinary Research - Category: Veterinary Research Authors: Tags: Am J Vet Res Source Type: research
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