Optimal Therapeutic Strategy for Temporomandibular Joint Osteoarthritis: A Comparative Analysis of Multimodal Intra-Articular Pharmacotherapies
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Abstract
Background: Temporomandibular joint (TMJ) osteoarthritis (OA) is a degenerative condition causing pain, limited jaw movement, and joint noises. This study compares the efficacy of four treatment protocols
Objectives: To evaluate and compare clinical outcomes (pain reduction, functional improvement) across treatment groups, stratified by age, sex, and OA severity, and to identify the most effective therapeutic approach.
Methods: A prospective analysis of 40 patients (10 per group) treated in Yemen was conducted. Data included demographics, clinical symptoms, radiographic findings, treatment protocols (intra-articular injections every 6 weeks for 3 months), and 9-month follow-up outcomes. Statistical analysis compared recovery rates (complete/partial/no improvement) across groups and subgroups (age, sex).
Results: Group 1 (Tramadol): 70% showed significant improvement (40% complete, 30% partial). Females (60%) responded slightly better than males. Group 2 (Tramadol-Meloxicam): 80% improvement (60% complete, 20% partial). Males (65%) had higher complete recovery rates. Group 3 (triple therapy): 90% improvement (70% complete, 20% partial), with the best outcomes in patients aged 40–60. Group 4 (Meloxicam): 80% improvement (60% complete, 20% partial), but with lower efficacy in severe OA cases. Females (55%) and patients aged 50–60 (65%) showed higher complete recovery rates. Severe unilateral OA had poorer outcomes (30% partial improvement).
Conclusion: This study provides evidence-based support for multimodal intra-articular pharmacotherapy in TMJ OA management. The significant efficacy of the triple-drug protocol suggests synergistic analgesic and anti-inflammatory effects, particularly beneficial for moderate-severe cases (highly recommended and effective in refractory cases). These findings advocate for personalized treatment algorithms incorporating combination therapies.
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TMJ osteoarthritis, intra-articular injections, tramadol, meloxicam, diclofenac, clinical outcomes.
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