Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report

Detalhes bibliográficos
Autor(a) principal: Grossmann,Eduardo
Data de Publicação: 2015
Outros Autores: Fonseca,Roberta, Almeida-Leite,Camila, Gonçalves,Rafael Tardin, Oliveira,Pedro Gonçalves de, Januzzi,Eduardo
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Revista Dor
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-00132015000400306
Resumo: ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders are diseases causing pain and dysfunction in joints and muscles controlling mandibular movements. Their etiology is multifactorial and multidisciplinary approaches are needed to reach a differential diagnosis and an adequate management plan. This case report proposes a management protocol, with monthly sodium hyaluronate infiltrations, with different molecular weights, to control such changes and promote improvement of temporomandibular joint biomechanics and pain. CASE REPORT: This study describes a case of a 48-year old patient with a 10-year history of temporomandibular pain with function loss since 2001. Patient has classified her pain as 9 according to analog visual scale. In addition, history and detailed physical evaluation have shown different signs and symptoms, such as localized pain (right side), and right temporomandibular joint arthralgia with noise. Diagnosis was disc displacement with reduction and possible synovitis/ capsulitis to the right. Right temporomandibular joint osteoarthritis was also diagnosed by cone beam CT-scan. Initially, a flat upper splint with total coverage and contact with all antagonist teeth was used. In the attempt to decrease temporomandibular arthralgia, non-steroid anti-inflammatory drugs and muscle relaxants were used. Since right temporomandibular joint pain was not effectively managed, we decided to use intra-joint sodium hyaluronate injections with different molecular weights, per month, in a total of four applications. At treatment completion, clinical evaluation has shown normal function, no pain with visual analog scale = zero, in addition to adequate interincisal distance. CONCLUSION: This report has suggested that viscosupplementation cycles with sodium hyaluronate of different molecular weights may provide excellent results in the long run, to control joint temporomandibular disorder symptoms. Therapeutic benefits were maintained for four years with no need for annual maintenance cycles.
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spelling Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case reportDisk displacement with reductionSodium hyaluronateTemporomandibular jointViscosupplementationABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders are diseases causing pain and dysfunction in joints and muscles controlling mandibular movements. Their etiology is multifactorial and multidisciplinary approaches are needed to reach a differential diagnosis and an adequate management plan. This case report proposes a management protocol, with monthly sodium hyaluronate infiltrations, with different molecular weights, to control such changes and promote improvement of temporomandibular joint biomechanics and pain. CASE REPORT: This study describes a case of a 48-year old patient with a 10-year history of temporomandibular pain with function loss since 2001. Patient has classified her pain as 9 according to analog visual scale. In addition, history and detailed physical evaluation have shown different signs and symptoms, such as localized pain (right side), and right temporomandibular joint arthralgia with noise. Diagnosis was disc displacement with reduction and possible synovitis/ capsulitis to the right. Right temporomandibular joint osteoarthritis was also diagnosed by cone beam CT-scan. Initially, a flat upper splint with total coverage and contact with all antagonist teeth was used. In the attempt to decrease temporomandibular arthralgia, non-steroid anti-inflammatory drugs and muscle relaxants were used. Since right temporomandibular joint pain was not effectively managed, we decided to use intra-joint sodium hyaluronate injections with different molecular weights, per month, in a total of four applications. At treatment completion, clinical evaluation has shown normal function, no pain with visual analog scale = zero, in addition to adequate interincisal distance. CONCLUSION: This report has suggested that viscosupplementation cycles with sodium hyaluronate of different molecular weights may provide excellent results in the long run, to control joint temporomandibular disorder symptoms. Therapeutic benefits were maintained for four years with no need for annual maintenance cycles.Sociedade Brasileira para o Estudo da Dor2015-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-00132015000400306Revista Dor v.16 n.4 2015reponame:Revista Dorinstname:Sociedade Brasileira para o Estudo da Dor (SBED)instacron:SBED10.5935/1806-0013.20150063info:eu-repo/semantics/openAccessGrossmann,EduardoFonseca,RobertaAlmeida-Leite,CamilaGonçalves,Rafael TardinOliveira,Pedro Gonçalves deJanuzzi,Eduardoeng2015-12-07T00:00:00Zoai:scielo:S1806-00132015000400306Revistahttps://www.scielo.br/j/rdor/ONGhttps://old.scielo.br/oai/scielo-oai.phpdor@dor.org.br||dor@dor.org.br2317-63931806-0013opendoar:2015-12-07T00:00Revista Dor - Sociedade Brasileira para o Estudo da Dor (SBED)false
dc.title.none.fl_str_mv Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
title Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
spellingShingle Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
Grossmann,Eduardo
Disk displacement with reduction
Sodium hyaluronate
Temporomandibular joint
Viscosupplementation
title_short Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
title_full Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
title_fullStr Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
title_full_unstemmed Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
title_sort Sequential infiltration of sodium hyaluronate in the temporomandibular joint with different molecular weights. Case report
author Grossmann,Eduardo
author_facet Grossmann,Eduardo
Fonseca,Roberta
Almeida-Leite,Camila
Gonçalves,Rafael Tardin
Oliveira,Pedro Gonçalves de
Januzzi,Eduardo
author_role author
author2 Fonseca,Roberta
Almeida-Leite,Camila
Gonçalves,Rafael Tardin
Oliveira,Pedro Gonçalves de
Januzzi,Eduardo
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Grossmann,Eduardo
Fonseca,Roberta
Almeida-Leite,Camila
Gonçalves,Rafael Tardin
Oliveira,Pedro Gonçalves de
Januzzi,Eduardo
dc.subject.por.fl_str_mv Disk displacement with reduction
Sodium hyaluronate
Temporomandibular joint
Viscosupplementation
topic Disk displacement with reduction
Sodium hyaluronate
Temporomandibular joint
Viscosupplementation
description ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders are diseases causing pain and dysfunction in joints and muscles controlling mandibular movements. Their etiology is multifactorial and multidisciplinary approaches are needed to reach a differential diagnosis and an adequate management plan. This case report proposes a management protocol, with monthly sodium hyaluronate infiltrations, with different molecular weights, to control such changes and promote improvement of temporomandibular joint biomechanics and pain. CASE REPORT: This study describes a case of a 48-year old patient with a 10-year history of temporomandibular pain with function loss since 2001. Patient has classified her pain as 9 according to analog visual scale. In addition, history and detailed physical evaluation have shown different signs and symptoms, such as localized pain (right side), and right temporomandibular joint arthralgia with noise. Diagnosis was disc displacement with reduction and possible synovitis/ capsulitis to the right. Right temporomandibular joint osteoarthritis was also diagnosed by cone beam CT-scan. Initially, a flat upper splint with total coverage and contact with all antagonist teeth was used. In the attempt to decrease temporomandibular arthralgia, non-steroid anti-inflammatory drugs and muscle relaxants were used. Since right temporomandibular joint pain was not effectively managed, we decided to use intra-joint sodium hyaluronate injections with different molecular weights, per month, in a total of four applications. At treatment completion, clinical evaluation has shown normal function, no pain with visual analog scale = zero, in addition to adequate interincisal distance. CONCLUSION: This report has suggested that viscosupplementation cycles with sodium hyaluronate of different molecular weights may provide excellent results in the long run, to control joint temporomandibular disorder symptoms. Therapeutic benefits were maintained for four years with no need for annual maintenance cycles.
publishDate 2015
dc.date.none.fl_str_mv 2015-12-01
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dc.publisher.none.fl_str_mv Sociedade Brasileira para o Estudo da Dor
publisher.none.fl_str_mv Sociedade Brasileira para o Estudo da Dor
dc.source.none.fl_str_mv Revista Dor v.16 n.4 2015
reponame:Revista Dor
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reponame_str Revista Dor
collection Revista Dor
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