title: Effectiveness of treatment with viscosupplementation in temporomandibular joints with or without effusion.
abstract: The objective of this study was to determine whether the effectiveness of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) degenerative disorders depends on the presence of intra-articular effusion. In this study of case-control design, two groups of 25 patients were recruited: patients with a clinical diagnosis of painful chronic TMJ osteoarthritis and magnetic resonance imaging (MRI) signs of TMJ degeneration, with (effusion group) or without (no effusion group) MRI evidence of TMJ effusion. All patients underwent five weekly single-needle arthrocenteses plus medium molecular weight HA and 6 months of follow-up. Several clinical outcome parameters were assessed. For all variables, analysis of variance (ANOVA) for repeated measures was performed to assess the existence of significant within-group and between-group treatment effects. Over time, both groups showed significant improvements in all outcome parameters, which were maintained at the 6-month follow-up (P<0.05). Between-group comparisons showed that the treatment effects did not differ significantly for either the primary outcome variable (pain levels: F=0.849, P=0.548) or secondary outcome variables (chewing efficiency: F=0.854, P=0.544; functional limitation: F=1.35, P=0.226; mouth opening: F=0.658, P=0.707). The null hypothesis that there are no differences in treatment effectiveness between patients with and without effusion could not be rejected.
authors.affiliation: Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Guarda-Nardini
authors.affiliation: Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Ramonda
authors.affiliation: Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Punzi
authors.affiliation: Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferronato
authors.affiliation: Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy. Electronic address: daniele.manfredini@tin.it.
authors.forename: D
authors.initials: D
authors.lastname: Manfredini
mesh_terms: D016022:Case-Control Studies; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019152:Paracentesis / Q000379:methods; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy*; D016896:Treatment Outcome; D055675:Viscosupplements / Q000627:therapeutic use*
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: arthrocentesis; effusion; hyaluronic acid; osteoarthritis; temporomandibular joint; viscosupplementation