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Published in: Oral and Maxillofacial Surgery 4/2018

01-12-2018 | Review Article

The use of intra-articular analgesics to improve outcomes after temporomandibular joint arthrocentesis: a review

Authors: Venkatesan Gopalakrishnan, Shakil Ahmed Nagori, Sanjay Kumar Roy Chowdhury, Vivek Saxena

Published in: Oral and Maxillofacial Surgery | Issue 4/2018

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Abstract

Purpose

The aim of this review was to assess the efficacy of intra-articular analgesics in improving outcomes after temporomandibular joint (TMJ) arthrocentesis.

Material and methods

An electronic search of PubMed, Scopus, and Google scholar databases was performed for papers in English published up to December 2017 reporting the use of intra-articular analgesics after TMJ arthrocentesis. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), comparative studies, retrospective studies, and case series were included while case reports, technical reports, animal studies, cadaveric studies, and review papers were excluded.

Results

Of the six studies included in the review, three were RCTs, two were randomized comparative studies, and one was a retrospective study. Both opioids and non-steroidal anti-inflammatory drugs have been used after TMJ arthrocentesis. Morphine, tramadol, fentanyl, buprenorphine, tenoxicam, and COX-2 inhibitors are the drugs used till date. Placebo-controlled studies reported improved outcomes after TMJ arthrocentesis with morphine and fentanyl but no such results with buprenorphine and tenoxicam. Tramadol was found to be better than COX-2 inhibitor. The quality of literature was not high.

Conclusions

There is inconclusive evidence in literature on the benefits of using intra-articular analgesics after TMJ arthrocentesis. Well-designed high-quality RCTs with standard protocol studying the effects of intra-articular opioids and NSAIDS after TMJ arthrocentesis would provide stronger evidence on its use.
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Metadata
Title
The use of intra-articular analgesics to improve outcomes after temporomandibular joint arthrocentesis: a review
Authors
Venkatesan Gopalakrishnan
Shakil Ahmed Nagori
Sanjay Kumar Roy Chowdhury
Vivek Saxena
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 4/2018
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-018-0720-z

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