Effect of individualized comprehensive physiotherapy versus hyaluronic acid therapy in older patients with temporomandibular joint osteoarthritis.

ABSTRACT

STATEMENT OF PROBLEM: Few studies have compared the efficacy of physiotherapy and hyaluronic acid injection therapy on temporomandibular joint osteoarthritis (TMJ-OA). Research on older patients with TMJ-OA is also scarce. PURPOSE: The purpose of this clinical study was to compare the efficacy of individualized comprehensive physiotherapy and intra-articular hyaluronic acid injection therapy in older patients with moderate or severe pain caused by TMJ-OA. MATERIAL AND METHODS: Participants with TMJ-OA (aged ≥60 years) were enrolled. The improvements in the numeric rating scale pain score, maximum active mouth opening (MAO), joint sound, and jaw functional limitation scale (JFLS) were analyzed for between-group differences using the independent samples t test or Mann-Whitney U test (α=.05). RESULTS: A total of 141 participants (physiotherapy, n=71; hyaluronic acid injection, n=70) were selected for the final analysis. Pain intensity, MAO, joint sound, and JFLS scores improved in both groups at the 2-week, 1-month, and 3-month follow-ups (P<.001). The injection group demonstrated greater improvement in mouth opening pain at the 2-week follow-up and in joint sound at the 3-month follow-up, whereas the physiotherapy group exhibited greater improvement in mastication pain at the 3-month follow-up. At the 2-week, 1-month, and 3-month follow-ups, the physiotherapy group showed higher improvement in MAO and JFLS scores compared with the injection group (P<.05). CONCLUSIONS: Individualized comprehensive physiotherapy and intra-articular hyaluronic acid injection therapy significantly improved pain intensity, MAO, and JFLS scores in older participants with TMJ-OA. As a noninvasive therapy, individualized comprehensive physiotherapy provides better improvement in mastication pain control, mouth opening, and mandibular function.