title: [Application of dental chairside evidence-based medicine for the treatment temporomandibular osteoarthritis].
abstract: OBJECTIVE
  To obtain an evidence-based treatment for an adolescent patient with temporomandibular osteoarthritis.
  
  
  METHODS
  The detailed history of an adolescent patient with temporomandibular osteoarthritis was analysed. Clinical Evidence (to Dec 2010), National Guideline Clearinghouse (2000-Dec 2010), Cochrane Library (Issue 4, 2010), MEDLINE(OVID, 1950-Dec 2010) and China Biology Medicine Database (1978-Dec 2010) were searched to obtain evidence such as clinical guidelines, systematic reviews and randomized controlled trials related to surgery or conservative treatment to temporomandibular osteoarthritis to find a personal treatment strategy for the patient.
  
  
  RESULTS
  Five articles were finally included, i.e. 1 clinical guideline, 3 systematic reviews and 1 randomized controlled trials. These evidence showed that: Conservative treatment like intra-articular injection instead of surgery should be adopted for adolescent patient; hyaluronate is the drug with sufficient evidence in supporting its use in treating temporomandibular disorders; inferior temporomandibular joint cavity injection or both upper and lower cavity injection has better effect than that of superior cavity injection only; and there was some evidence to support the use of glucosamine to treat temporomandibular disorders. Considering the situation of the case and the clinical evidence, an individual treatment plan of hyaluronate injection into the upper and lower cavity and glucosamine take orally was established. A long-term follow-up of 6 months showed a good treatment outcome.
  
  
  CONCLUSIONS
  Through the evidence-based methods and the use of clinical evidence, an individual treatment plan could be established for each patient with temporomandibular disorders, and this will provide strong supporting to the treatment of temporomandibular disorders. Up to now, it is clear that hyaluronate injection into the upper and lower cavity with glucosamine administration is effective in treating temporomandibular osteoarthritis.
authors: Dept. of Oral and Maxillofacial Surgery, People's Hospital of Anshun, Anshun 561000, China.
authors: Guanghua
authors: G
authors: Pan
authors: Chunjie
authors: C
authors: Li
authors: Shuangjun
authors: S
authors: Li
authors: Hongwei
authors: H
authors: Zhao
authors: Haiyan
authors: H
authors: Chen
mesh_terms: D002681:China; D019317:Evidence-Based Medicine; D006801:Humans; D006820:Hyaluronic Acid; D007270:Injections, Intra-Articular; D010003:Osteoarthritis; D013704:Temporomandibular Joint; D013705:Temporomandibular Joint Disorders; D016896:Treatment Outcome
chemical_list: D006820:Hyaluronic Acid