RESUMO
BACKGROUND: Temporomandibular joint osteoarthritis (TMJ OA) is a chronic disease that is a consequence of undue occlusal forces and is characterized by irreversible damage to the articular surfaces. Symptomatic slow-acting so-called nutraceutical drugs have been proposed as a treatment for osteoarthritis in comparison to non-steroidal anti-inflammatory drugs (NSAIDs). Oral glucosamine and chondroitin, slow-acting drugs, have been found to reduce pain and in- crease mouth opening in patients with TMJ OA. However, there is limited scientific evidence to confirm their clinical effectiveness. AIM: This systematic review was conducted to bolster the evidence supporting the assessment of the efficacy of glucosamine in the context of temporomandibular joint osteoarthritis (TMJ OA). METHODOLOGY: This review identified four review articles from databases like Medline (via PubMed), Web of Science, Scopus, and EMBASE till September 2023 after screening at the title, abstract, and full-text level. They were assessed for risk of bias with the JBI risk of bias assess- ment tool. RESULT: This review with meta-analysis focused on pooled estimate mean differences, revealing non-significant but discernible effects of glucosamine on maximum mouth opening (SMD = 0.288, p = 0.15) and pain reduction (SMD = 0.217, p = 0.476) in TMJ-related disorders. CONCLUSION: Compared to control groups with ibuprofen and tramadol, glucosamine showed slightly more favourable outcomes. However, the variability in methodology and study characteristics warrants further longitudinal studies to confirm its efficacy.
RESUMO
Osteoarthritis in the temporomandibular joint (TMJ) is a chronic disease characterized by irreversible damage to articular surfaces, including inflammation, loss of articular cartilage, and subchondral bone alterations, which would be radiographically evident only in later stages. Symptomatic slow-acting so-called nutraceutical drugs have been proposed as a treatment for osteoarthritis in comparison to non-steroidal anti-inflammatory drugs (NSAID) because of their appreciable safety profile even in long-term intake. Glucosamine, being one among them, proved highly efficient in knee osteoarthritis. However, its application in TMJ osteoarthritis dates back only to 2001 and is still inconclusive in its efficiency even with systematic reviews, in restoring the structural and functional aspects of damaged TMJ. Glucosamine, being a natural compound and also a contributor to building the matrix of articular cartilage, can be utilized effectively for TMJ osteoarthritis as an adjunct along with other conventional treatment modalities available till now, which also have moderate prognosis in most of the clinical scenarios. This review summarizes data relating to the mechanism of osteoarthritis and its management using glucosamine formulations. The beneficial effects of glucosamine on the pathophysiology of TMJ osteoarthritis are possibly due to its contribution to hyaluronic acid regulation and in establishing a proper balance between anabolism/catabolism in the articular tissues.