Intra-articular injection of hyaluronic acid for temporomandibular joint osteoarthritis in elderly patients.

BACKGROUND: Preliminary findings gave encouraging results for the use of hyaluronic acid in temporomandibular joints with inflammatory/degenerative processes. This investigation aimed at evaluating retrospectively the efficacy of intra-articular injections of hyaluronic acid in elderly patients (aged >65 years) with osteoarthritis of the temporomandibular joint as compared with those of a group of adult non-elderly patients. MATERIALS AND METHODS: Two groups of patients with Research Diagnostic Criteria for Temporomandibular Disorders axis I group IIIb diagnosis of osteoarthritis, aged over (N=17)/under (N=33) 65 years respectively (elderly/non-elderly groups), underwent a cycle of five injections (one per week) of 1 ml low molecular weight hyaluronic acid and four follow-up assessments after the end of the treatment (at one week, at one month, at three months, at six months). RESULTS: At the end of the treatment period, improvements in the elderly group were significant with respect to baseline values in the minimum and maximum masticatory pain, maximum pain at rest values, and functional limitation scores. In the non-elderly group, significant improvements at the end of treatment were showed in all treatment outcome variables, except than minimum pain at rest values. All improvements were maintained over the six-month span of the follow-up period, and no significant differences were showed between groups for any of the outcome variables, except than functional limitation scores, which improved more in the elderly group. CONCLUSIONS: These findings are not supportive for a difference in efficacy between the elderly patients and the other subjects, even though further works on different age groups are needed before generalization of results.