Comparison of Different Intraarticular Injection Substances Followed by Temporomandibular Joint Arthroscopy

Nowadays, temporomandibular joint (TMJ) arthroscopies are often finished with intraarticular injections. There are a couple of different substances that can be injected into the articular cavity following arthroscopy; however, it is still unclear which one can help to reach the best clinical results.The aim of this systematic review was to compare different substances that can be injected intraarticularly following TMJ arthroscopy to enhance clinical success.A review protocol was registered in PROSPERO (Registration number: CRD42018114833). An electronic search was performed using PubMed, Cochrane Library, PlosOne, and Science Direct databases using a combination of the terms "temporomandibular" and "arthroscopy" to identify clinical trials published from 2009 until 2019. Mean differences of pain levels were evaluated in random-effect meta-analysis.In total, 951 records were screened, of which only 3 fulfilled the inclusion criteria and were included into qualitative data synthesis, and only 2 articles were included into quantitative data analysis.The results showed that subjects who received plasma rich in growth factors intraarticular injections had statistically significantly lower pain levels 18 months postoperatively than patients who received hyaluronic acid injections.The results of the meta-analysis revealed that intraarticular injections followed by TMJ arthroscopy were more effective than arthroscopy alone in pain management (mean difference = -1.00, 95% confidence interval: -4.76 to 2.77, I = 97% with significant heterogeneity).The authors conclude that, although the sample is not extensive (only 3 studies), a tendency towards the superiority of plasma rich in growth factors over other treatments is seen in pain management of TMD.