Effect of sodium hyaluronate in treating temporomandibular joint disorders

ABSTRACT

temporomandibular disorders is used to describe a group of conditions that involve the temporomandibular joint, masticatory muscles, and associated structures. Many modalities have been proposed for treating temporomandibular disorders, including medication, physical therapy, occlusal stabilization splints with or without manual repositioning, surgery, and arthrocentesis. Temporomandibular disorders are treated in a step-wise manner. Initially, conservative treatment is used. Depending on the response, more aggressive interventions may be necessary. This usually takes the form of arthrocentesis. Arthrocentesis is used in the treatment of not only acute, closed, and locked TMJs but also various other temporomandibular disorders. Recently, the intra-articular injection of sodium hyaluronate after arthrocentesis was shown to have long-term palliative effects on TMJ symptoms. Synovial fluid consists of plasma and glycosaminoglycan, including hyaluronic acid derived from synovial cells. Sodium hyaluronate, the sodium salt of hyaluronic acid, is a high-molecular-weight polysaccharide and a major component of synovial fluid. This highly viscous substance has analgesic properties, lubricant effects, and anti-inflammatory actions; it causes cartilage formation and plays a role in the nutrition of avascular parts of the disc and condylar cartilage. We conclude that the intra-articular injection of sodium hyaluronate is effective for treating temporomandibular disorders.