Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis-A Systematic Review

Int J Mol Sci. 2021 Jul 9;22(14):7405. doi: 10.3390/ijms22147405.

Abstract

Temporomandibular joint osteoarthritis (TMJ OA) is a low-inflammatory disorder with multifactorial etiology. The aim of this review was to present the current state of knowledge regarding the mechanisms of action and the efficacy of hyaluronic acid (HA), corticosteroids (CS) and platelet-rich plasma (PRP) in the treatment of TMJ OA.: The PubMed database was analyzed with the keywords: "(temporomandibular joint) AND ((osteoarthritis) OR (dysfunction) OR (disorders) OR (pain)) AND ((treatment) OR (arthrocentesis) OR (arthroscopy) OR (injection)) AND ((hyaluronic acid) OR (corticosteroid) OR (platelet rich plasma))". After screening of 363 results, 16 studies were included in this review. Arthrocentesis alone effectively reduces pain and improves jaw function in patients diagnosed with TMJ OA. Additional injections of HA, either low-molecular-weight (LMW) HA or high-molecular-weight (HMW) HA, or CS at the end of the arthrocentesis do not improve the final clinical outcomes. CS present several negative effects on the articular cartilage. Results related to additional PRP injections are not consistent and are rather questionable. Further studies should be multicenter, based on a larger group of patients and should answer the question of whether other methods of TMJ OA treatment are more beneficial for the patients than simple arthrocentesis.

Keywords: arthrocentesis; corticosteroids; hyaluronic acid; intraarticular injections; platelet-rich plasma; temporomandibular joint disorders; temporomandibular joint osteoarthritis.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Humans
  • Hyaluronic Acid / pharmacology
  • Hyaluronic Acid / therapeutic use*
  • Injections, Intra-Articular
  • Osteoarthritis / drug therapy*
  • Osteoarthritis / physiopathology
  • Platelet-Rich Plasma / metabolism*
  • Signal Transduction / drug effects
  • Signal Transduction / genetics
  • Temporomandibular Joint Disorders / drug therapy*
  • Temporomandibular Joint Disorders / metabolism
  • Temporomandibular Joint Disorders / physiopathology

Substances

  • Adrenal Cortex Hormones
  • Hyaluronic Acid