Clinical effectiveness of polynucleotides TMJ Injections compared to physiotherapy. A 3 months randomized clinical trial

IntroductionJoint visco-supplementation is an effective therapeutic approach against signs and symptoms of osteoarthrosic/arthritic degeneration of mandibular condyle. Supplements of choice are usually delivered inside TMJs through intra-articular infiltrations. The present study aims to assess the clinical effectiveness of peri-capsular injections of polinucleotides (PN) and hyaluronic acid (HA).Materials and methods60 patients suffering from TMJ osteoarthrosis were recruited and divided in 2 groups (test group: n=30, peri-capsular injections; control group: n=30, self-delivered physiotherapeutic exercises). For each patient, maximum opening, right and left lateral excursion and VAS were recorded at 4 different timepoints by a blinded investigator. Paired Student's t-test was used to compare the consecutive measurements of the parameters evaluated within the groups. Unpaired student's t-test was used for between-group comparisons.ResultsAll investigated parameters displayed a progressive clinical improvement in both groups, which was more accentuated in test group. The decrease of VAS score differed significantly between groups (p<0.0001); The maximum opening showed a continuous increase from baseline (37.70±8.33 mm) to T3 (39.68±7.64 mm), reflecting a progressive improvement, but it was not statistically significant (P=0.089 at T3 respect to T0).ConclusionPN HA peri-capsular injections represent a minimally invasive treatment option effective in reducing pain and improving mandibular kinematic.