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J Oral Rehabil. 2019 Jan;46(1):5-13. doi: 10.1111/joor.12718. Epub 2018 Oct 10.

Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia-A multicentre randomised controlled trial.

Author information

1
Department of Orofacial Pain and Jaw Function, Västmanland County Hospital, Västerås, Sweden.
2
Centre for Clinical Research, Uppsala University, Västerås, Sweden.
3
Clinic of Orofacial Pain, Sahlgrenska Academy and Public Dental Health, Gothenburg, Sweden.
4
Department of Orofacial Pain and Jaw Function, Postgraduate Dental Education Center, Örebro, Sweden.
5
Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.

Abstract

BACKGROUND:

Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation.

OBJECTIVE:

The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain.

METHODS:

This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population.

RESULTS:

In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812). Treatment-related adverse events were doubled in the methylprednisolone group.

CONCLUSION:

Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia.

KEYWORDS:

arthralgia; corticosteroids; injection; intra-articular; pain management; temporomandibular joint

PMID:
30240024
DOI:
10.1111/joor.12718

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