Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Introduction: Hyaluronic acid, steroids and blood products are popularly injected into the temporomandibular joint (TMJs) to relieve pain and increase the extent of mandibular abduction. The purpose of this review is to identify other injectable substances and to evaluate them in the above-mentioned domains. Material and methods: The review included articles describing clinical trials of patients treated with intra-articular injections with or without arthrocentesis. Results: The following emerging substances were initially evaluated to be effective in treating TMJ pain and increasing the amplitude of mandibular abduction: analgesics, dextrose with lidocaine, adipose tissue, nucleated bone marrow cells and ozone gas. Discussion: Better effects of intra-articular administration are achieved by preceding the injection with arthrocentesis. Conclusions: The most promising substances appear to be bone marrow and adipose tissue.