关键词: 透明质酸纳, 颞下颌关节紊乱, 颞下颌关节盘, Meta分析, 系统评价

Abstract:

Objective To assess the efficacy and safety of hyaluronate sodium（HS） for internal derangement of temporomandibular joint by means of systematic review on relevant randomized controlled trials. Methods After identifing the study question of the efficacy and safety of HS for internal derangement of temporomandibular joint, Medline, Cochrane Controlled Trials Register, EMBASE, OPEN SIGLE and CBM were searched electronically till October 3rd 2010. Hand -searching covering 19 dental journals in Chinese were also performed. Risk of bias assessment, with Cochrane Collaboration’s tool, and data extraction of included studies were conducted by two reviewers in duplicate. Meta analysis was done with Revman 5.0.23 and the quality of evidence was evaluated by GRADE. Results 10 randomized controlled trials met the eligibility criteria and were included. All these studies had unclear risk of bias. When compared with negative control, HS showed a significant advantage on maximal mouth opening in short and long term（P<0.05）, and clinical overall assessment in short term（P<0.05）, but its effect on pain control and long term effect on clinical overall assessment had no extra benefit（P>0.05）. Additionally, when compared with glucocorticoids, the participants who received HS injection would get a better clinical overall assessment in short term and less adverse drug reactions（P<0.05）, but presented a similar temporomandibular joint pain relief and maximal mouth opening （P>0.05）. Conclusion To a certain extent, HS had good efficacy and better safety than controls when treating internal derangement of temporomandibular joint. However, as the quality of some included studies were limited, more randomized controlled trials are needed to reinforce the conclusion.

Key words: hyaluronate sodium, temporomandibular joint dysfunction syndrome, temporomandibular joint disk, Meta analysis, systematic evaluation