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espanolTemporomandibular disorders (TMD) embraces a number of clinical problems involving the masticatory muscles, the temporomandibular joint (TMJ) and associated structures. TMD treatment options include hyaluronic acid (HA) injections that have been used with different concentrations, molecular weight and injection protocol, which could vary the efficacy profile in the TMD treatment results. Objective: Discover through a systematic review the best HA application protocol for the treatment of TMD. Method: A search was performed in Pubmed, Medline, Scopus, Cochrane, Dentistry & Oral Science Source, Complementary Index and Academic search complete, The search included terms such as “hyaluronic acid”, “temporomandibular disorders”, and “arthrocentesis with hyaluronic acid” in randomized clinical trials with human subjects from up to ten years ago. Of the 71 articles screened, 22 articles were included in the PRISMA flow-diagram and were assessed with the Jadad scale. Results: Treatment modalities consisted of the following: four studies in HA versus other types of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), betamethasone, tenoxicam or oral glucosamine; two studies in arthrocentesis plus HA versus arthrocentesis with platelet rich plasma (PRP); and one study in plasma rich in growth factor (PRFC); four studies in arthrocentesis plus HA versus arthrocentesis with saline or ringer’s lactate solution; three studies in arthrocentesis plus HA versus arthrocentesis alone; six studies in cyclic applications of HA; and two studies in cycles of HA injections versus occlusal splint therapy. The follow-up period for most studies was up to 12 months. Conclusion: The protocols based on cyclic applications of injections of HA, demonstrated better results in the relief of long-term symptoms of TMD. espanolLos trastornos temporomandibulares constituyen una entidad clinica que involucra la articulacion temporomandibular, los musculos masticatorios y estructuras circundantes. Entre las opciones de tratamiento, el acido hialuronico (AH) se ha utilizado en variadas concentraciones, peso molecular y protocolos de inyeccion, lo que podria variar el perfil de eficacia en los resultados del tratamiento de TTM. Objetivo: Descubrir mediante una revision sistematica el mejor protocolo de aplicacion de AH para el tratamiento de TTM. Metodo: Se realizo una busqueda en Pubmed, Medline, Scopus, Cochrane, Dentistry & Oral Science Source, Complementary Index y Academic search complete, con las palabras: “acido hialuronico”; “Artrocentesis acido hialuronico”; “trastornos temporomandibulares” considerando ensayos clinicos aleatorizados en humanos hasta con diez anos de antiguedad, se preseleccionaron 71 articulos y a traves del diagrama de flujo prisma se seleccionaron 22 articulos evaluados en la escala Jadad. Resultados: Las modalidades de tratamiento incluyeron: AH versus AINES, betametasona, tenoxicam o glucosamida oral (4 estudios); artrocentesis mas AH versus artrocentesis con plasma rico en plaquetas (2 estudios) y plasma rico en factor de crecimiento (1 estudio); artrocentesis mas AH versus artrocentesis con solucion salina o lactato de ringer (4 estudios); artrocentesis mas AH versus artrocentesis sola (3 estudios); aplicaciones ciclicas de AH (6 estudios); y ciclos de inyecciones de AH versus terapia de ferula oclusal (2 estudios). El periodo de seguimiento para la mayoria de estudios fue hasta de 12 meses. Conclusion: Los protocolos basados en aplicaciones ciclicas de inyecciones de AH, demostraron mejores resultados en el alivio de los sintomas de TTM a largo plazo.

Eficacia del ácido hialurónico en el tratamiento de los trastornos temporomandibulares. Revisión sistemática