- 1. West China Stomatological Hospital; Sichuan University; Chengdu 610041; China2. Dept. of Dentistry; Peiking Union Medical College Hospital; Beijing 100730;
Objective To assess the effectiveness of intraarticular injection of hyaluronate (HA) on temporomandibular disorders (TMD).
Methods Searching various databases available, handsearching 15 Chinese dental journals to find articles, abstracts and unpublished literature with randomized or quasi-randomized design on the effects of intraarticular injection of HA on TMD.Data extraction, appraisal, and the methods for Meta-analysis were conducted based on the Cochrane guidelines.
Results 12 RCTs and 2 CCT on TMD and 1 RCT on rheumatoid arthritis involving temporomandibular joints (TMJ) were located, 10 of them fulfilled inclusion criteria in which 561 patients were reported.Except 71 cases with only qualitative data, 490 cases could be calculated in Meta-analysis: 277 on HA, 113 on placebo or non-treatment (PL) and 100 on corticosteroids (CO). In comparison with PL, HA injection showed no statistically significant effect on short and long term improvement of symptoms, and short term improvement of VAS as well. But it presented significant better effects than PL in short and long term improvement of clinical signs, especially mouth opening. When sensitivity analysis was conducted for improvement of short term signs, the conclusion was not stable. Comparison of the effect between HA and CO showed the same efficacy levels. Adverse reactions of HA were mild and transient.
Conclusions HA may improve short and long term clinical signs of TMD and have only mild and transient adverse reactions. However, more RCTs are needed to confirm its therapeutic effect.
Citation: SHI Zongdao,GUO Chunlan,Chen E. A Systematic Review on Intraarticular Injection of Hyaluronate for Treatment of Temporomandibular Disorders. Chinese Journal of Evidence-Based Medicine, 2004, 04(6): 368-376. doi: Copy
Copyright ? the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
| 1. | [1]Rugh JD, Solberg WK. Oral health status in the United States: temporomandibular disorders[J]. J Dent Edu., 1985;49(6) :398-405. |
| 2. | [2]Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults[J]. JADA,1979; 98(1): 25-34. |
| 3. | [3]Wanman A, Agerberg G. Mandibular dysfunction in adolescent[J]. Acta Odont Scand, 1986; 44(1): 45-73. |
| 4. | [4]Xu YH, Yi XZ, Luo ZH. An epidemiologic study of temporomandibular joint dysfunction in young people [J ]. Chin J Stomatol, 1989 (3) ;24,249-252. |
| 5. | 徐櫻華,易新竹,羅宗賚,任平惠.顳下頜關節紊亂綜合征在青年學生中的流行病學調查[J].中華口腔醫學雜志1989;24(3):249-52. |
| 6. | [5]Stegenga B, de Bont LGM, Boering G. Osteoarthrosis as the cause of craniomandibular pain and dysfuction, A unifying concept[J]. J Oral Maxillofac Surg, 1989;47(3) :249-256. |
| 7. | [6]Stegenga B, de Bont LGM, van der Kuijl B, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. Part I: Diagnostic significance of clinical and radiographic symptoms and signs[J]. J Cranio-mandibul Pract, 1992;10(2) :96-106. |
| 8. | [7]Toller PA. Use and misuse of intra-articular corticosteroids in treatment of temporomandibular joint pain. Proceedings of the Royal Society of Medicine[J], 1977; 70(7) :461-463. |
| 9. | [8]Kopp S, Wenneberg B. Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction. Acta Odontolog Scandinavica, 1981 ;39(2) :87-96. |
| 10. | [9]Zhang XN, Zhang ZK. Effect of intra-articular injection of prednisolone in treating organic destrucion of the TMJ disturbance syndrome[J]. Chin J Stomatol,1985 ;20(2) :93-95. |
| 11. | 張熙恩,張震康.關節下腔注射醋酸強的松龍治療顳下頜關節紊亂綜合征器質性破壞期的近期療效觀察[J].中華口腔醫學雜志,1985;20(2):93-95. |
| 12. | [10]Wenneberg B, Kopp S, Grondahl HG. Long-term effect of intra-articular injections of a glucocorticosteroid into the TMJ:a clinical and radiographic 8-year follow-up[J]. J Craniomandibul Disord: Facial & Oral Pain,1991; 5(1) :11-18. |
| 13. | [11]Kikiewicz D. Effect of hydrocortisone on experimental necrosis of cartilage of the temporomandibular joint in guinea pigs [ J ]. Annales Academiae Medicae Stetinensis in Polish,1985; 31:185-196. |
| 14. | [12]Gu ZY, Cai ZQ, Wu QL. The effects ofprednisolone on rabbit temporomandibular joints[J]. J Oral Maxillofac Surg,1993:3(4) :218-220. |
| 15. | 谷志遠,曹志強,吳求亮,.醋酸強的松龍對兔顳下頜關節的影響[J].口腔頜面外科雜志,1993;3(4):218-220. |
| 16. | [13]Hu B, Wang DH, Preliminary study on effects ofintraarticular injection of prednisolone on temporomandibular joint [ J ]. J Comprehensive Stomatol, 1995; 11 ( 2 ): 86-88. |
| 17. | 胡波,王大章.醋酸強的松龍關節內注射對顳下頜關節影響的初步研究[J]口腔醫學縱橫雜志,1995;11(2):86-88. |
| 18. | [14]Shi ZD, Yang F, He ZX, Shi B, Yang MZ. Comparative study on effects of sodium hyaluronate and prednisolone injecions on experimental temporomandibular joint osteoarthritis of rabbits[J]. Chin J Reparat and Reconstruct Surg, 2002; 16(1) :5-10. |
| 19. | 史宗道,楊峰,何志秀,史冰,楊名仲透明質酸鈉與強的松龍治療兔實驗性顳頜關節骨關節炎的對照研究[J].中國修復重建外科雜志,2002;16(1):5-10. |
| 20. | [15]Chandler GN,Wright V.Deleterious effect ofintra-articular hydrocorrisone[J]Lancet,1958;2(7048):661-663. |
| 21. | [16]Fu K,Ma X,Zheng Z.Pathologic study on synovialfluid after intra-articular corticosteroid therapy in temporomandibular jomt disorders[J].Chin J Stomatol 1999;34(1):55-57. |
| 22. | 傅開元,馬緒臣,張震康,孫開華,魏明潔.顳下頜關節紊亂病關節腔注射糖皮質激素后關節液病理分析[J]中華口腔醫學雜志,1999;34(1):55-57. |
| 23. | [17]Abatangelo G, Botri P, Bue D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs [ J ]. Clin Orthop Relat Res, 1989;241:286-99. |
| 24. | [18]Galateo D, Schiavinato A, Lini E, Guidolin D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs[J]. Clin J Orthop, 1989 ;241:286-299. |
| 25. | [19]Kitoh Y, Katsuramaki T, Tanaka H. Effect ofSL-1010 (sodium hyaluronate with high molecular weight) on experimental osteoarthritis induced by intra-articularly applied papain in rabbits[J]. Nippon Yakurigaku Zasshi,1992 ;100( 1 ) :67-76. |
| 26. | [20]Neo H, IsmimaruJI, Kurita K, Goss AN. The effect ofhyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep[J]. J Oral Maxillofac Surg, 1997; 55(10):1 114-1 119. |
| 27. | [21]Zhang SZ; Wu YH. The effect of sodium hyaluronate on the rabbit osteoarthrosis[J]. Shanghai J Stomatol, 2003; 12 (3):187-190. |
| 28. | 張世周,吳益華.透明質酸鈉對兔顳下頜關節骨病的作用[J].上海口腔醫學,2003;12(3):187-190. |
| 29. | [22]Rydel NW, Butler J, Balazs EA. Hyaluronic acid in synovial fluid VI. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of arthritis in track horses[J]. Acta Veterinaria Scandinavica, 1970(2) ;11:139-155. |
| 30. | [23]Peyron JG, Balazs EA. Preliminary clinical assessment of Nahyaluronate injection into human arthritic joints [ J ]. Pathologieet Biologie, 1974 ;22 (8) :731. |
| 31. | [24]Kopp S, Wenneberg B. Injektion av healonid i kakled-En prelininar rapport [ M ]. Report Series, Department of Stomatognathic Physiology, Goteborg University, 1979. |
| 32. | [25]Kopp S, Wenneberg B, Haraldson T, Carlsson GE. The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction [ J ]. J Oral Maxillofac Surg, 1985;43(6) :429-35. |
| 33. | [26]Kopp S, Carlsson GE, Haraldson T, Wenneberg B. Longterm effect of intra-articular injecttion of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis[J]. J Oral Maxillofa Surg,1987 ;45(11 ) :929-935. |
| 34. | [27]McCanin JP, Balazs EA, de la Rua H. Preliminary studies on the use of a viscoelastic solution in arthroscopic surgery of the terporomandibular joint[J ]. J Oral Maxillofac Surg, 1989;47:1 161-1 168. |
| 35. | [28]Kopp S, Akerman S, Nilner M. Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injectious on rheumatoid arthritis [ J ]. J Craniomandibul Disord :Facial & Oral Pain,1991 ;5:231-8. |
| 36. | [29]Bertolari CN, Gay T, Clark GT, Rendell J, Shetty V, Liu C, Swann DA. Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind,placebo controlled clinical trial [ J ]. J Oral and Maxillofac Surg, 1993 ;51 (3) ;232-242. |
| 37. | [30]Gu ZY, GuoQ, Wu QL, Xie ZJ. The effect of sodiur hyaluronate in treating temporomandibuiar joint disturbance syndrome[J]. Chin J Dental Material and Devices,1997; 6(2):58-9. |
| 38. | 谷志遠,郭琦,吳求亮,謝志堅.透明質酸鈉在治療顥下頜關節紊亂綜合征中的作用[J].口腔材料器械雜志1997;6(2):58-59. |
| 39. | [31]Gu Z, Wu Q, Zhang Y, Zhang Z, Sun K. Visco-supplementation therapy in internal derangement of temporomandibular joint[J]. Chin Med J (Eng),1998; 111(7) :656-9. |
| 40. | [32]Qian DY. Hyaluronase in treating temporomandibular joint disorders [ J ]. JHengyang Medical College, 1999; 27(2) :139-140. |
| 41. | 蹇敦羽.透明質酸治療顳下頜關節紊亂綜合征[J]衡陽醫學院學報1999;27(2):139-140. |
| 42. | [33]Chu JQ, Hu QG. Using arthrocentesis and hyaluronate to treat non-reducing disc displacement of the temporomandibular joint [ M ] . in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Preceedings of the Third National Symposium on Advancement of Basic R. esearch and Clinical Studies on Temporomandibular Diseases, Xiamen,China, 2001:73. |
| 43. | 儲嘉琪,胡勤鋼.顳頜關節灌洗加透明質酸治療不可復性盤前移[M].見:中華口腔醫學顳下頜關節病學組.全國第三屆顳下頜關節紊亂病專題研討會顳下頜關節病基礎與臨床進展論文匯編.廈門,2001:73. |
| 44. | [34]Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders [ M ]. in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Proceedings of the Third National Symposium on Advancement of Basic Research and Clinical Studies on Temporomandibular Diseases, Xiamen, China, 2001:73. |
| 45. | 齊東元,潘巨利,劉成海.透明質酸鈉關節腔注射治療關節盤不可復性前移位[M].見:中華口腔醫學顳下頜關節病學組.全國第三屆顳下頜關節紊亂病專題研討會顳下頜關節病基礎與臨床進展論文匯編.廈門,2001:73. |
| 46. | [35]Alpaslan GH, Alpaslan C. Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements[J]. J Oral and Maxillofac Surg, 2001 ;59(6) :613-618. |
| 47. | [36]Hepguler S, Akkoc YS, Pehlivan M, Ozturk C, Celebi G,Saracoglu A, Ozpinar B. The efficacy of intra-articular sodium hyaluronate in patients with recucing displaced disc [J ]. J Oral Rehabil, 2002 ;29 ( 1 ) :80-86. |
| 48. | [37]Shi ZD, Yang F, Zhang JY, Shi B. Randomized controlled trial of sodium hyaluronate for degenerative disorders of the temporomandibular joint. Chinese Journal of Reparative and Reconstructive Surgery. 2002; 16 ( 1 ): 11-15. |
| 49. | 史宗道,楊峰,張靜儀,史冰透明質酸鈉治療顳頜關節退行性關節病臨床隨機對照研究[J].中國修復重建外科雜志,2002;16(1):11-15. |
| 50. | [38]Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders[ J ] . J Modern Stomatol, 2003;17(1) :91. |
| 51. | 齊東元,潘巨利,劉成海.透明質酸鈉關節腔注射治療顙下頜關節盤不可復性前移位.現代口腔醫學雜志2003;17(1):91. |
| 52. | [39]Peng GG, LiJP, WuJW, Lin M, ChenJF, Li J,Xian D, He GY, Fu Z, Wang WH. The short-term effect of intra-articular injections of sodium hyaluronate on temporomandibular joint interal derangement [ J ]. J Clin Stomatol, 2002 ;18 (5) :372-373. |
| 53. | 彭國光,李嘉朋,吳俊偉,林銘,陳巨峰,李捷,冼淡,何國燕,傅忠,王維煥.關節上腔留注透明質酸鈉治療TMJID的療效觀察[J].臨床口腔醫學雜志2002;18(5):372-373. |
| 54. | [40]Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique [ J ]. J Craniomandibul Disorders:Facial & Oral Pain, 1992;6(4) :301-355. |
| 55. | [41]Stegenga B, de Bont LG, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. 2 Specific diagnostic criteria[J]. Cranio,1992;10(2):107-116. |
| 56. | [42]List T, Dworkin SF. Research diagnostic criteria for TMJ guidelines[J]. J Orofac Pain, 1996; 10 ( 3 ) :240-253. |
| 57. | [43]Clarke M, Oxman AD, editors. Assessment of study quality.Cochrane Reviewers’ Handbook 4.0 [ updated July 1999 ]Review Manager ( RevMan) [ Computer Program]. Version 4.0. Oxford, England: The Cochrane Collaboration, 1999. |
| 58. | [44]Balazs EA. Analgesic effect of elastoviscous hyaluronan solutions and the treatment of arthritic pain [ J ]. Cells Tissues Organs, 2003;174(1-2) :49-62. |
- 1. [1]Rugh JD, Solberg WK. Oral health status in the United States: temporomandibular disorders[J]. J Dent Edu., 1985;49(6) :398-405.
- 2. [2]Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults[J]. JADA,1979; 98(1): 25-34.
- 3. [3]Wanman A, Agerberg G. Mandibular dysfunction in adolescent[J]. Acta Odont Scand, 1986; 44(1): 45-73.
- 4. [4]Xu YH, Yi XZ, Luo ZH. An epidemiologic study of temporomandibular joint dysfunction in young people [J ]. Chin J Stomatol, 1989 (3) ;24,249-252.
- 5. 徐櫻華,易新竹,羅宗賚,任平惠.顳下頜關節紊亂綜合征在青年學生中的流行病學調查[J].中華口腔醫學雜志1989;24(3):249-52.
- 6. [5]Stegenga B, de Bont LGM, Boering G. Osteoarthrosis as the cause of craniomandibular pain and dysfuction, A unifying concept[J]. J Oral Maxillofac Surg, 1989;47(3) :249-256.
- 7. [6]Stegenga B, de Bont LGM, van der Kuijl B, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. Part I: Diagnostic significance of clinical and radiographic symptoms and signs[J]. J Cranio-mandibul Pract, 1992;10(2) :96-106.
- 8. [7]Toller PA. Use and misuse of intra-articular corticosteroids in treatment of temporomandibular joint pain. Proceedings of the Royal Society of Medicine[J], 1977; 70(7) :461-463.
- 9. [8]Kopp S, Wenneberg B. Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction. Acta Odontolog Scandinavica, 1981 ;39(2) :87-96.
- 10. [9]Zhang XN, Zhang ZK. Effect of intra-articular injection of prednisolone in treating organic destrucion of the TMJ disturbance syndrome[J]. Chin J Stomatol,1985 ;20(2) :93-95.
- 11. 張熙恩,張震康.關節下腔注射醋酸強的松龍治療顳下頜關節紊亂綜合征器質性破壞期的近期療效觀察[J].中華口腔醫學雜志,1985;20(2):93-95.
- 12. [10]Wenneberg B, Kopp S, Grondahl HG. Long-term effect of intra-articular injections of a glucocorticosteroid into the TMJ:a clinical and radiographic 8-year follow-up[J]. J Craniomandibul Disord: Facial & Oral Pain,1991; 5(1) :11-18.
- 13. [11]Kikiewicz D. Effect of hydrocortisone on experimental necrosis of cartilage of the temporomandibular joint in guinea pigs [ J ]. Annales Academiae Medicae Stetinensis in Polish,1985; 31:185-196.
- 14. [12]Gu ZY, Cai ZQ, Wu QL. The effects ofprednisolone on rabbit temporomandibular joints[J]. J Oral Maxillofac Surg,1993:3(4) :218-220.
- 15. 谷志遠,曹志強,吳求亮,.醋酸強的松龍對兔顳下頜關節的影響[J].口腔頜面外科雜志,1993;3(4):218-220.
- 16. [13]Hu B, Wang DH, Preliminary study on effects ofintraarticular injection of prednisolone on temporomandibular joint [ J ]. J Comprehensive Stomatol, 1995; 11 ( 2 ): 86-88.
- 17. 胡波,王大章.醋酸強的松龍關節內注射對顳下頜關節影響的初步研究[J]口腔醫學縱橫雜志,1995;11(2):86-88.
- 18. [14]Shi ZD, Yang F, He ZX, Shi B, Yang MZ. Comparative study on effects of sodium hyaluronate and prednisolone injecions on experimental temporomandibular joint osteoarthritis of rabbits[J]. Chin J Reparat and Reconstruct Surg, 2002; 16(1) :5-10.
- 19. 史宗道,楊峰,何志秀,史冰,楊名仲透明質酸鈉與強的松龍治療兔實驗性顳頜關節骨關節炎的對照研究[J].中國修復重建外科雜志,2002;16(1):5-10.
- 20. [15]Chandler GN,Wright V.Deleterious effect ofintra-articular hydrocorrisone[J]Lancet,1958;2(7048):661-663.
- 21. [16]Fu K,Ma X,Zheng Z.Pathologic study on synovialfluid after intra-articular corticosteroid therapy in temporomandibular jomt disorders[J].Chin J Stomatol 1999;34(1):55-57.
- 22. 傅開元,馬緒臣,張震康,孫開華,魏明潔.顳下頜關節紊亂病關節腔注射糖皮質激素后關節液病理分析[J]中華口腔醫學雜志,1999;34(1):55-57.
- 23. [17]Abatangelo G, Botri P, Bue D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs [ J ]. Clin Orthop Relat Res, 1989;241:286-99.
- 24. [18]Galateo D, Schiavinato A, Lini E, Guidolin D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs[J]. Clin J Orthop, 1989 ;241:286-299.
- 25. [19]Kitoh Y, Katsuramaki T, Tanaka H. Effect ofSL-1010 (sodium hyaluronate with high molecular weight) on experimental osteoarthritis induced by intra-articularly applied papain in rabbits[J]. Nippon Yakurigaku Zasshi,1992 ;100( 1 ) :67-76.
- 26. [20]Neo H, IsmimaruJI, Kurita K, Goss AN. The effect ofhyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep[J]. J Oral Maxillofac Surg, 1997; 55(10):1 114-1 119.
- 27. [21]Zhang SZ; Wu YH. The effect of sodium hyaluronate on the rabbit osteoarthrosis[J]. Shanghai J Stomatol, 2003; 12 (3):187-190.
- 28. 張世周,吳益華.透明質酸鈉對兔顳下頜關節骨病的作用[J].上海口腔醫學,2003;12(3):187-190.
- 29. [22]Rydel NW, Butler J, Balazs EA. Hyaluronic acid in synovial fluid VI. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of arthritis in track horses[J]. Acta Veterinaria Scandinavica, 1970(2) ;11:139-155.
- 30. [23]Peyron JG, Balazs EA. Preliminary clinical assessment of Nahyaluronate injection into human arthritic joints [ J ]. Pathologieet Biologie, 1974 ;22 (8) :731.
- 31. [24]Kopp S, Wenneberg B. Injektion av healonid i kakled-En prelininar rapport [ M ]. Report Series, Department of Stomatognathic Physiology, Goteborg University, 1979.
- 32. [25]Kopp S, Wenneberg B, Haraldson T, Carlsson GE. The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction [ J ]. J Oral Maxillofac Surg, 1985;43(6) :429-35.
- 33. [26]Kopp S, Carlsson GE, Haraldson T, Wenneberg B. Longterm effect of intra-articular injecttion of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis[J]. J Oral Maxillofa Surg,1987 ;45(11 ) :929-935.
- 34. [27]McCanin JP, Balazs EA, de la Rua H. Preliminary studies on the use of a viscoelastic solution in arthroscopic surgery of the terporomandibular joint[J ]. J Oral Maxillofac Surg, 1989;47:1 161-1 168.
- 35. [28]Kopp S, Akerman S, Nilner M. Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injectious on rheumatoid arthritis [ J ]. J Craniomandibul Disord :Facial & Oral Pain,1991 ;5:231-8.
- 36. [29]Bertolari CN, Gay T, Clark GT, Rendell J, Shetty V, Liu C, Swann DA. Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind,placebo controlled clinical trial [ J ]. J Oral and Maxillofac Surg, 1993 ;51 (3) ;232-242.
- 37. [30]Gu ZY, GuoQ, Wu QL, Xie ZJ. The effect of sodiur hyaluronate in treating temporomandibuiar joint disturbance syndrome[J]. Chin J Dental Material and Devices,1997; 6(2):58-9.
- 38. 谷志遠,郭琦,吳求亮,謝志堅.透明質酸鈉在治療顥下頜關節紊亂綜合征中的作用[J].口腔材料器械雜志1997;6(2):58-59.
- 39. [31]Gu Z, Wu Q, Zhang Y, Zhang Z, Sun K. Visco-supplementation therapy in internal derangement of temporomandibular joint[J]. Chin Med J (Eng),1998; 111(7) :656-9.
- 40. [32]Qian DY. Hyaluronase in treating temporomandibular joint disorders [ J ]. JHengyang Medical College, 1999; 27(2) :139-140.
- 41. 蹇敦羽.透明質酸治療顳下頜關節紊亂綜合征[J]衡陽醫學院學報1999;27(2):139-140.
- 42. [33]Chu JQ, Hu QG. Using arthrocentesis and hyaluronate to treat non-reducing disc displacement of the temporomandibular joint [ M ] . in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Preceedings of the Third National Symposium on Advancement of Basic R. esearch and Clinical Studies on Temporomandibular Diseases, Xiamen,China, 2001:73.
- 43. 儲嘉琪,胡勤鋼.顳頜關節灌洗加透明質酸治療不可復性盤前移[M].見:中華口腔醫學顳下頜關節病學組.全國第三屆顳下頜關節紊亂病專題研討會顳下頜關節病基礎與臨床進展論文匯編.廈門,2001:73.
- 44. [34]Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders [ M ]. in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Proceedings of the Third National Symposium on Advancement of Basic Research and Clinical Studies on Temporomandibular Diseases, Xiamen, China, 2001:73.
- 45. 齊東元,潘巨利,劉成海.透明質酸鈉關節腔注射治療關節盤不可復性前移位[M].見:中華口腔醫學顳下頜關節病學組.全國第三屆顳下頜關節紊亂病專題研討會顳下頜關節病基礎與臨床進展論文匯編.廈門,2001:73.
- 46. [35]Alpaslan GH, Alpaslan C. Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements[J]. J Oral and Maxillofac Surg, 2001 ;59(6) :613-618.
- 47. [36]Hepguler S, Akkoc YS, Pehlivan M, Ozturk C, Celebi G,Saracoglu A, Ozpinar B. The efficacy of intra-articular sodium hyaluronate in patients with recucing displaced disc [J ]. J Oral Rehabil, 2002 ;29 ( 1 ) :80-86.
- 48. [37]Shi ZD, Yang F, Zhang JY, Shi B. Randomized controlled trial of sodium hyaluronate for degenerative disorders of the temporomandibular joint. Chinese Journal of Reparative and Reconstructive Surgery. 2002; 16 ( 1 ): 11-15.
- 49. 史宗道,楊峰,張靜儀,史冰透明質酸鈉治療顳頜關節退行性關節病臨床隨機對照研究[J].中國修復重建外科雜志,2002;16(1):11-15.
- 50. [38]Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders[ J ] . J Modern Stomatol, 2003;17(1) :91.
- 51. 齊東元,潘巨利,劉成海.透明質酸鈉關節腔注射治療顙下頜關節盤不可復性前移位.現代口腔醫學雜志2003;17(1):91.
- 52. [39]Peng GG, LiJP, WuJW, Lin M, ChenJF, Li J,Xian D, He GY, Fu Z, Wang WH. The short-term effect of intra-articular injections of sodium hyaluronate on temporomandibular joint interal derangement [ J ]. J Clin Stomatol, 2002 ;18 (5) :372-373.
- 53. 彭國光,李嘉朋,吳俊偉,林銘,陳巨峰,李捷,冼淡,何國燕,傅忠,王維煥.關節上腔留注透明質酸鈉治療TMJID的療效觀察[J].臨床口腔醫學雜志2002;18(5):372-373.
- 54. [40]Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique [ J ]. J Craniomandibul Disorders:Facial & Oral Pain, 1992;6(4) :301-355.
- 55. [41]Stegenga B, de Bont LG, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. 2 Specific diagnostic criteria[J]. Cranio,1992;10(2):107-116.
- 56. [42]List T, Dworkin SF. Research diagnostic criteria for TMJ guidelines[J]. J Orofac Pain, 1996; 10 ( 3 ) :240-253.
- 57. [43]Clarke M, Oxman AD, editors. Assessment of study quality.Cochrane Reviewers’ Handbook 4.0 [ updated July 1999 ]Review Manager ( RevMan) [ Computer Program]. Version 4.0. Oxford, England: The Cochrane Collaboration, 1999.
- 58. [44]Balazs EA. Analgesic effect of elastoviscous hyaluronan solutions and the treatment of arthritic pain [ J ]. Cells Tissues Organs, 2003;174(1-2) :49-62.

