title: Single-needle temporomandibular joint arthrocentesis with hyaluronic acid injections. Preliminary data after a five-injection protocol.
abstract: OBJECTIVE
  The classical technique for temporomandibular joint (TMJ) arthrocentesis provides a double access to the joint space, which may lead to patient's postoperatory discomfort. For this reason, a less invasive, single-needle approach has been recently described, and the present investigation reports findings on a case series of patients with TMJ osteoarthritis treated with hyaluronic acid injections following a single needle arthrocentesis. METHODS. Fourteen consecutive patients with a diagnosis of TMJ osteoarthritis according to the Research Diagnostic Criteria for Temporo-mandibular Disorders were treated with a cycle of five weekly injections of hyaluronic acid after arthrocentesis. A number of subjective (pain at rest and mastication, masticatory efficiency, functional limitation, subjective efficacy of treatment, tolerability of treatment) and objective (maximum assisted and unassited mouth opening, protrusive and laterotrusive movements) outcome variables were assessed before and after the treatment period.
  
  
  RESULTS
  At the end of the five-injection protocol, significant improvements were showed in almost all the subjective outcome variables. Tolerability of the treatment was good on a four-point ordinal scale since the time of the first injection.
  
  
  CONCLUSIONS
  The present investigation suggested that the single needle technique for TMJ hyaluronic injection following arthrocentesis in osteoarthritic joints may have promising applications in the clinical setting, which have to be confirmed with future studies.
authors.affiliation: TMD Clinic, Department of Maxillofacial Surgery, University of Padua, Padua, Italy. daniele.manfredini@tin.it
authors.forename: D
authors.initials: D
authors.lastname: Manfredini
authors.forename: L
authors.initials: L
authors.lastname: Guarda-Nardini
authors.forename: G
authors.initials: G
authors.lastname: Ferronato
mesh_terms: D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009339:Needles; D010003:Osteoarthritis / Q000628:therapy*; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D007507:Therapeutic Irrigation
chemical_list: D006820:Hyaluronic Acid