High-Concentration 35 Kda Hyaluronic Acid Fragment Gel Nighttime Occlusive Application for Rapid Relief of Temporomandibular Joint Pain and Associated Muscle Over-Tension: A Case Series Study

Temporomandibular joint disorder (TMD) is characterized by jaw joint pain and muscle over-tension, often accompanied by bruxism or jaw clenching, severely impacting quality of life. This exploratory case series evaluated the efficacy of 10% high-concentration 35 kDa hyaluronic acid fragment gel (HA35 Gel) as a nighttime occlusive treatment for TMD-related symptoms. Seven adult participants with TMD (6 males, 1 female; mean age 36.4±2.8 years) applied ≥6.5 mL HA35 Gel to the TMJ area nightly, occluded with plastic wrap/skin protection film for 8-12 hours. Pain and muscle tension were assessed via a 0-10 numerical rating scale (NRS) at baseline, 60 seconds post-treatment, and 12 hours post-treatment. Results showed rapid, significant improvements: pain scores decreased from 4±0.8 (baseline) to 0.1±0.3 at 60 seconds and 0.0±0.0 at 12 hours; muscle tension scores declined from 3.0±0.8 to 0.4±0.7 and 0.0±0.0, respectively. No adverse reactions were reported, indicating good tolerance. This non-invasive method provides rapid (within 60 seconds) and sustained (≥12 hours) relief, offering a novel clinical option for TMD. Further validation in large-scale controlled studies is warranted.