title: Comparison of 2 hyaluronic acid drugs for the treatment of temporomandibular joint osteoarthritis.
abstract: OBJECTIVE
  To compare the effectiveness of 2 treatment protocols providing 5 weekly temporomandibular joint (TMJ) arthrocenteses immediately followed by injections of 2 different molecular weight hyaluronic acid (HA) drugs to manage symptoms in patients with inflammatory-degenerative TMJ disease.
  
  
  METHODS
  Patients with a Research Diagnostic Criteria for Temporomandibular Disorders diagnosis of osteoarthritis were randomly assigned to 1 of 2 study groups receiving either low- or medium-molecular weight HA after arthrocentesis. The level of maximum pain at chewing was the primary outcome variable, and maximum pain at rest, subjective chewing efficiency, functional limitation, treatment tolerability, perceived treatment effectiveness, and jaw range-of-motion function in millimeters were the secondary outcomes. All variables were assessed and compared between groups at baseline, at the end of treatment, and 3 months later.
  
  
  RESULTS
  Forty subjects entered the study. At the end of the follow-up period, all the outcome variables improved in both groups of patients. A between-group comparison of changes over time showed that differences were not significant for any of the outcome variables, that is, pain at chewing (F = 0.056, P = .815), pain at rest (F = 0.383, P = .541), chewing efficiency (F = 0.050, P = .825), functional limitation (F = 0.268, P = .609), and mouth opening (F = 0.003, P = .954). In addition, no between-group differences were shown for perceived treatment effectiveness and treatment tolerability.
  
  
  CONCLUSIONS
  Similar positive effectiveness was shown for 2 treatment protocols for TMJ osteoarthritis (ie, 5-session single-needle arthrocentesis plus low- or medium-molecular weight HA).
authors.affiliation: TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Padua, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guarda-Nardini
authors.forename: Cristina
authors.initials: C
authors.lastname: Cadorin
authors.forename: Antonio
authors.initials: A
authors.lastname: Frizziero
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferronato
authors.forename: Daniele
authors.initials: D
authors.lastname: Manfredini
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000188:drug therapy; D016009:Chi-Square Distribution; D004305:Dose-Response Relationship, Drug; D005157:Facial Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D008409:Mastication; D008875:Middle Aged; D008970:Molecular Weight; D010003:Osteoarthritis / Q000188:drug therapy*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy*; D007507:Therapeutic Irrigation; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid