Is Hyaluronic Acid Injection Effective for the Treatment of Temporomandibular Joint Disc Displacement With Reduction?

Purpose: Hyaluronic acid (HA) injections and occlusal splints have been suggested in the treatment of temporomandibular joint (TMJ) derangements, but no sufficient data are available from controlled clinical trials comparing HA injection with another treatment modality. This study compared the effectiveness of a single HA injection, a double HA injection, and splint therapy for the treatment of TMJ disc displacement with reduction (DDR). Materials and Methods: A prospective clinical trial was designed. The study sample included patients with TMJ DDR. The primary predictor variable was treatment method. Patients were divided into 4 groups: control, single HA injection, double HA injection, and stabilization splint therapy. Patients were randomly assigned to 1 of 3 treatment groups. The control group was self-selected. The primary outcome variable was pain at rest and during mastication. The secondary outcome variables were TMJ noise, quality of life, and level of jaw movements. Clinical symptoms and jaw movements were evaluated at baseline and at 6-month follow-up. Descriptive, comparative, correlation, and multivariate analyses were conducted. Results: The sample included 51 patients (66 TMJs) 18 to 48 years old. All treatment groups showed significant improvement compared with baseline values for pain, TMJ noise, quality of life, and maximum mouth opening (MMO) at 6-month follow-up (P < .05). However, the 2 HA injection groups indicated superior improvement for pain, MMO, and quality of life compared with the stabilization splint group (P < .05). Conclusions: The results of this study showed that HA injection and stabilization splinting are acceptably successful treatment modalities to alleviate the clinical signs and symptoms of TMJ DDR. (C) 2016 American Association of Oral and Maxillofacial Surgeons