Efficacy of different intraarticular injection materials in the arthrocentesis of arthrogenic temporomandibular disorders: A systematic review and network meta-analysis of randomized controlled trials.

IF 3.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of prosthodontic research Pub Date : 2025-01-06 DOI:10.2186/jpr.JPR_D_23_00272

Kata Kelemen, János König, Szilárd Váncsa, Bence Szabó, Péter Hegyi, Gábor Gerber, Péter Schmidt, Péter Hermann

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Abstract

Purpose: Arthrogenic temporomandibular disorders (TMDs) that do not respond to conservative treatment necessitate the use of semi-conservative methods, such as arthrocentesis. However, the ranking of intraarticular devices used in arthrocentesis remains controversial. Therefore, a network meta-analysis and systematic review were conducted to compare the different materials used for arthrocentesis.

Study selection: Databases of Cochrane Library, EMBASE, PubMed, and Web of Science were searched systematically to retrieve randomized controlled trials (RCTs) published in English comparing the efficacy of different intraarticular materials used for arthrocentesis. The mean differences (MD) and 95% confidence interval (CI) were calculated for maximum mouth opening (MMO) and pain perception using Bayesian network meta-analysis.

Results: Among the 7674 studies retrieved, 13 RCTs were included in the quantitative synthesis. Evaluation of the short-term follow-up (1-3 months) outcomes revealed that saline-platelet-rich plasma (saline-PRP) and saline-steroid yielded the greatest improvement in MMO, with MDs of 3.49 (CI: -4.23, 10.81) and 3.36 (CI: -4.70, 10.46), respectively. Saline-PRP exhibited improvement in terms of pain reduction (MD=-2.72 (CI: -5.80, 0.35). Evaluation of the long-term follow-up outcomes revealed that saline-PRP yielded promising results for both outcomes: MD of 1.58 (CI: -6.84, 9.92) and -2.79 (CI: -9.44, 3.60) for MMO and pain reduction, respectively.

Conclusion: Saline-PRP injection led to a clinically noticeable shift in MMO and pain perception in the short term; in contrast, the results of saline-PRP, saline-hyaluronic acid (HA), and saline steroids were statistically insignificant. Saline-HA and saline-steroid effectively increased MMO in the long term, whereas saline-PRP yielded the most distinct reduction in pain.

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不同关节内注射材料在关节源性颞下颌紊乱的关节置换术中的疗效：随机对照试验的系统回顾和网络荟萃分析。

目的：关节源性颞下颌疾病（TMDs）对保守治疗无效，需要使用半保守方法，如关节穿刺。然而，在关节置换术中使用的关节内装置的排名仍然存在争议。因此，我们进行了网络荟萃分析和系统评价来比较不同材料用于关节穿刺。研究选择：系统检索Cochrane Library、EMBASE、PubMed和Web of Science数据库，检索已发表的英文随机对照试验（RCTs），比较不同关节内材料用于关节置换术的疗效。使用贝叶斯网络meta分析计算最大开口（MMO）和疼痛感知的平均差异（MD）和95%置信区间（CI）。结果：在检索到的7674项研究中，13项rct被纳入定量综合。短期随访（1-3个月）结果的评估显示，富含血小板的血浆（盐- prp）和盐-类固醇对MMO的改善最大，MDs分别为3.49 （CI: -4.23, 10.81）和3.36 （CI: -4.70, 10.46）。盐- prp在疼痛减轻方面表现出改善(MD=-2.72 （CI: -5.80, 0.35）。对长期随访结果的评估显示，盐- prp对两种结果都产生了很好的结果：MMO和疼痛减轻的MD分别为1.58 （CI: -6.84, 9.92）和-2.79 （CI: -9.44, 3.60）。结论：盐- prp注射可在短期内引起临床明显的MMO和痛觉改变；相比之下，盐- prp、盐-透明质酸（HA）和盐类固醇的结果在统计学上不显著。从长期来看，ha -盐和类固醇-盐有效地增加了MMO，而prp -盐对疼痛的缓解效果最为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of prosthodontic research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

6.90

自引率

11.10%

发文量

161

期刊介绍： Journal of Prosthodontic Research is published 4 times annually, in January, April, July, and October, under supervision by the Editorial Board of Japan Prosthodontic Society, which selects all materials submitted for publication. Journal of Prosthodontic Research originated as an official journal of Japan Prosthodontic Society. It has recently developed a long-range plan to become the most prestigious Asian journal of dental research regarding all aspects of oral and occlusal rehabilitation, fixed/removable prosthodontics, oral implantology and applied oral biology and physiology. The Journal will cover all diagnostic and clinical management aspects necessary to reestablish subjective and objective harmonious oral aesthetics and function. The most-targeted topics: 1) Clinical Epidemiology and Prosthodontics 2) Fixed/Removable Prosthodontics 3) Oral Implantology 4) Prosthodontics-Related Biosciences (Regenerative Medicine, Bone Biology, Mechanobiology, Microbiology/Immunology) 5) Oral Physiology and Biomechanics (Masticating and Swallowing Function, Parafunction, e.g., bruxism) 6) Orofacial Pain and Temporomandibular Disorders (TMDs) 7) Adhesive Dentistry / Dental Materials / Aesthetic Dentistry 8) Maxillofacial Prosthodontics and Dysphagia Rehabilitation 9) Digital Dentistry Prosthodontic treatment may become necessary as a result of developmental or acquired disturbances in the orofacial region, of orofacial trauma, or of a variety of dental and oral diseases and orofacial pain conditions. Reviews, Original articles, technical procedure and case reports can be submitted. Letters to the Editor commenting on papers or any aspect of Journal of Prosthodontic Research are welcomed.