Comparison of outcomes with intra-articular hyaluronic acid vs corticosteroids after TMJ arthrocentesis: a systematic review and meta-analysis

Objective: This review aimed to examine differences in outcomes with the use of intraarticular hyaluronic acid vs corticosteroids after temporomandibular joint arthrocentesis. Method and materials: Studies were searched on PubMed, Embase, Web of Science, and Google Scholar up to 15th January 2024. Randomized controlled trials comparing hyaluronic acid with corticosteroids after TMJ arthrocentesis were included. The outcomes were pain and maximal mouth opening. Results: Te n articles corresponding to nine randomized clinical trials were included. There was no statistically significant difference in pain scores at 1 week (mean difference [MD] -0.30, 95% CI -1.25 to 0.65, I2 = 0%), 1 month (MD -0.55, 95% CI -1.23 to 0.13, I2 = 0%), and 6 months (MD -0.57, 95% CI -2.10 to 0.96, I2 = 58%) between the two groups. However, pain scores were found to be significantly lower in the hyaluronic acid group at 3 months (MD -1.07, 95% CI -1.84 to -0.31, I2 = 0%). No statistically significant difference was noted in maximal mouth opening at 1 week (MD 0.78, 95% CI -1.79 to 3.35, I2 = 0%), 1 month (MD 0.32, 95% CI -1.83 to 2.46, I2 = 0%), and 3 months (MD -0.41, 95% CI -3.90 to 3.07, I2 = 0%) between the two groups. Descriptive analysis for studies not included in the metaanalysis also presented similar results. Conclusions: Lowquality evidence suggests that both intraarticular hyaluronic acid and corticosteroids have similar efficacy in improving pain scores and maximal mouth opening after temporomandibular joint arthrocentesis.(Quintessence Int 2024;55:660-668; doi:10.3290/j.qi.b5586037)