Association of interocclusion device and viscosupplementation with hyaluronic acid for the treatment of osteoarthritis in the temporomandibular joint: Case report
DOI:
https://doi.org/10.33448/rsd-v15i5.50958Keywords:
Osteoarthritis, Temporomandibular Dysfunction Syndrome, Viscosupplementation.Abstract
Objective: To report a case on the association of an interocclusal device and viscosupplementation with hyaluronic acid in the treatment of osteoarthritis of the temporomandibular joint. Materials and Methods: Descriptive, retrospective, qualitative study, using direct observation technique (Pereira et al. 2018), in Portuguese and English, using textbooks in the area of TMD and Orofacial Pain and the Pubmed, Google Scholar, LILACS, MEDLINE, and SCIELO databases. Case report: A 23-year-old female patient, with leucoderma, presented with the chief complaint of "a crepitus sound when I open my mouth," bilaterally, but without pain. Based on clinical findings and cone-beam computed tomography, the diagnosis was osteoarthritis. The recommended treatment was viscosupplementation with Ostenil hyaluronic acid (1.0% sodium hyaluronate) combined with the use of an interocclusal device. Results: The combination reduced the degenerative impacts of osteoarthritis and provided sustainable symptomatic relief for the patient, with no crepitus sound observed in the right temporomandibular joint (TMJ) after viscosupplementation. On the left side, the crepitus sound changed to a clicking sound, shifting from osteoarthritis to disc displacement with reduction (DDCR). Conclusion: Hyaluronic acid (HA) is effective in regulating intra-articular inflammatory biochemistry and improving lubrication of articular structures. Interocclusal devices help reduce the impact of overload on articular structures, promoting the repair of articular tissues. Finally, in this case report, there was a significant improvement in clinically observed signs and symptoms after the concomitant use of the detailed therapeutic techniques.
References
Altaweel, A. A.; Ismail, H. A. & Fayad, M. I. (2021). Effect of simultaneous application of arthrocentesis and occlusal splint versus splint in management of non-reducing TMJ disc displacement. Journal of Dental Sciences, v. 16, p. 732-737, 2021. DOI: https://doi.org/10.1016/j.jds.2020.08.008.
Baron, D. et al. (2022). Predictors for patient satisfaction of a single intra-articular injection of crosslinked hyaluronic acid combined with mannitol (HANOX-M-XL) in patients with temporomandibular joint osteoarthritis: Results of a prospective open-label pilot study (HAPPYMINI-ARTEMIS trial). BMC Musculoskeletal Disorders, 2022. DOI: https://doi.org/10.1186/s12891-022-05352-3.
Batista, J. F. L. et al. (2024). Therapies used for the management of myofascial temporomandibular disorders: bibliometric analysis. Brazilian Journal of Pain, 2024. DOI: https://doi.org/10.5935/2595-0118.20240024-en.
Chunjie, L. et al. (2011). Glucosamine hydrochloride combined with hyaluronate for temporomandibular joint osteoarthritis: A primary report of randomized controlled trial. West China Journal of Stomatology, 29(6), 2011.
Cipriano, M. S. et al. (2021). Viscosuplementação de ATM nos tratamentos de DTM: Uma revisão de literatura. Brazilian Journal of Surgery and Clinical Research, 36(3), 44-48, 2021.
Conti, P. C. R. (2022). DTM disfunções temporomandibulares e dores orofaciais: aplicação clínica das evidências científicas. Maringá: Dental Press, 2022.
Cruz, J. H. de A. et al. (2020). Disfunção temporomandibular: revisão sistematizada. Archives of Health Investigation, 9(6), 570–575, 2020. DOI: https://doi.org/10.21270/archi.v9i6.3011.
Cunha, C. O.; Poluha, R. L.; & Conti, P. C. (2022). Distúrbios da articulação temporomandibular: diagnóstico e controle. In: CONTI, P. C. R. DTM disfunções temporomandibulares e dores orofaciais: aplicação clínica das evidências científicas. Maringá: Dental Press, 2022.
Dutra, L. C. et al. (2016). Métodos de tratamento da disfunção temporomandibular: revisão sistemática. Revista Atenção à Saúde, São Caetano do Sul, 14(50), 85-95, 2016. DOI: https://doi.org/10.13037/rbcs.vol14n50.3784.
Ferreira, N. R. et al. (2022). Comparison between two viscosupplementation protocols for temporomandibular joint osteoarthritis. The Journal of Craniomandibular & Sleep Practice, 2022. DOI: https://doi.org/10.1080/08869634.2022.2141784.
Flores, P. (2021). ATM – Diagnóstico por imagem. Nova Odessa: Napoleão, 2021.
Fonseca, R. M. D. F. B. et al. (2018). Effectiveness of sequential viscosupplementation in temporomandibular joint internal derangements and symptomatology: a case series. Pain Research and Management, v. 2018, 2018.
Grossmann, E.; Valle, R. T.; Januzzi, E. (2019). Viscossuplementação da ATM. In: Valle, R. T. & Grossmann, E. Disfunções temporomandibulares: Novas perspectivas. Ribeirão Preto: Livraria e Editora Tota, 2019.
Grossman, E; Poluha, R. L.; Leite, J. P. B. (2019). Viscossuplementação da articulação temporomandibular. In: Grossman, E. Algias craniofaciais diagnóstico e tratamento. São Paulo: Editora dos Editores, 2019.
Januzzi, E. et al. (2022). Viscosupplementation in the upper and lower compartments of the temporomandibular joint checked by ultrasonography in an ex vivo and in vivo study. Scientific Reports, 12(1), 17976, 2022. DOI: https://doi.org/10.1038/s41598-022-21781-5.
Melo, A. D. et al. (2020). Disfunção Temporomandibular e Dor Orofacial: classificação, epidemiologia, importância do diagnóstico e implicações para o Sistema Único de Saúde (SUS). In: DE Castro, R. D.; Batista, A. U. D. Evidências científicas e práticas clínicas odontológicas no âmbito do Sistema Único de Saúde. 1. ed. João Pessoa: Editora UFPB, p. 323–346, 2020.
Millon-Cruz, A. et al. (2015). Relationship between intra-articular adhesions and disc position in temporomandibular joints: magnetic resonance and arthroscopic findings and clinical results. Journal of Cranio-Maxillofacial Surgery, 43(4), 497–502, 2015.
Okeson, J. P. (2020). Tratamento das desordens temporomandibulares e oclusão. (8. ed.). Rio de Janeiro: Elsevier, 2020.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria: Ed. UAB/NTE/UFSM, 2018.
Poluha, R. L. et al. (2019). Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation. Journal of Applied Oral Science, v. 27, 2019.
Wang, X. D. et al. (2012). Sustained inflammation induces degeneration of the temporomandibular joint. Journal of Dental Research, 91(5), 499–505, 2012.
Weymar, L. B. (2021). Placa oclusal versus toxina botulínica para controle da dor na disfunção temporomandibular: uma revisão sistemática. 2021. Dissertação (Mestrado) — Universidade Federal de Pelotas, Pelotas. https://repositorio.ufpel.edu.br/handle/prefix/85
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