Eficácia da artrocentese associada a viscossuplementação de ácido hialurônico em comparação com a artrocentese isolada

Abstract

Temporomandibular dysfunction (TMD) is a condition that affects the temporomandibular joint (TMJ) and can cause pain, limited mouth opening, and impaired masticatory function. Treatment for TMD is typically varied, complex, and multidisciplinary. Treatment options include conservative, minimally invasive, and invasive approaches. This study aimed to evaluate two minimally invasive approaches and compare their effectiveness in the treatment of articular TMD. The formulated PICOS question was: Is arthrocentesis combined with hyaluronic acid viscosupplementation more effective in reducing pain and improving maximum mouth opening than arthrocentesis alone in patients with articular TMD? An electronic search was conducted without limitations on year or language until November 2023, using the following databases: PubMed, Web of Science, Embase, and Scopus. The outcomes analyzed were pain relief and maximum mouth opening improvement. An integrative literature review was performed, analyzing 12 randomized clinical trials that compared the results of these two approaches. In 66.6% of the articles reviewed, hyaluronic acid viscosupplementation was more effective in both pain relief and the increase of maximum mouth opening. No study found that arthrocentesis alone was superior to its combination with hyaluronic acid. According to the analysis of the articles, it was concluded that isolated arthrocentesis and arthrocentesis combined with hyaluronic acid are effective for the treatment of articular TMD, with better results in terms of pain improvement and increased mouth width when using the association of arthrocentesis with hyaluronic acid.