Hyaluronic Acid Evaluation as Adjuvant to Temporomandibular Joint Arthroscopy

NCT ID: NCT04110587

Last Updated: 2019-10-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

54 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-10

Study Completion Date

2019-07-09

Brief Summary

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This study evaluates the addition of hyaluronic acid to temporomandibular joint arthroscopy in the treatment of internal derangements in adults. A participants group will receive temporomandibular joint arthroscopy plus hyaluronic acid, while the other group will receive temporomandibular joint arthroscopy. Hypothesis: hyaluronic acid as an adjunct in temporomandibular joint arthroscopic surgery provides additional benefits in clinical and radiological outcomes in temporomandibular joint internal derangements.

Detailed Description

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Conditions

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Temporomandibular Joint Disc Displacement Temporomandibular Joint Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Treatment allocation was concealed from participants and examiner (using sealed and numbered opaque envelopes by the research coordinator), and the data analyst (by encoded data).

Study Groups

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arthroscopy

Temporomandibular joint arthroscopy is performed under general anesthesia by the same expert temporomandibular joint arthroscopy surgeon. Lysis and Lavage is performed in the upper joint space in all cases. Ringer's lactate is use as irrigation fluid. All participants receive Amoxicillin / Clavulanic Acid, 1g I.V. and Dexamethasone, 4 mg I.V. (Intraoperative); as well as Amoxicillin / clavulanic acid, 500/125 mg / 8h / 5 days by mouth; Diclofenac 100 mg / 12h / 5 days by mouth; and Metamizol 575 mg / 8h by mouth (Post-operatively). Soft diet and a home exercise program are implemented in all patients after 24 hours post-operative.

Group Type PLACEBO_COMPARATOR

Temporomandibular Joint Arthroscopy

Intervention Type PROCEDURE

Lysis and Lavage

Antibiotic therapy

Intervention Type DRUG

Amoxicillin / Clavulanic Acid, 1g I.V. (Intraoperative); as well as Amoxicillin / clavulanic acid, 500/125 mg / 8h / 5 days by mouth (Post-operative).

corticosteroid

Intervention Type DRUG

Dexamethasone, 4 mg I.V. (Intraoperative)

Antiinflammatories

Intervention Type DRUG

Diclofenac 100 mg / 12h / 5 days by mouth (Post-operatively).

Analgesics

Intervention Type DRUG

Metamizol 575 mg / 8h by mouth (Post-operatively)

Exercise program

Intervention Type OTHER

Home exercise program

arthroscopy plus hyaluronic Acid

Temporomandibular joint arthroscopy is performed under general anesthesia by the same expert temporomandibular joint arthroscopy surgeon. Lysis and Lavage is performed in the upper joint space in all cases. Ringer's lactate is use as irrigation fluid. All participants receive Amoxicillin / Clavulanic Acid, 1g I.V. and Dexamethasone, 4 mg I.V. (Intraoperative); as well as Amoxicillin / clavulanic acid, 500/125 mg / 8h / 5 days by mouth; Diclofenac 100 mg / 12h / 5 days by mouth; and Metamizol 575 mg / 8h by mouth (Post-operatively). Soft diet and a home exercise program are implemented in all patients after 24 hours post-operative. An hyaluronic acid injection of 1 mL (Durolane®, 20 mg / mL, Zambon, Barcelona, Spain) at the end of arthroscopy that was only performed in this arm.

Group Type ACTIVE_COMPARATOR

Hyaluronic Acid

Intervention Type BIOLOGICAL

1 mL Hyaluronic Acid Injection (20 mg/mL, 7000 KDa) at the end of arthroscopy .

Temporomandibular Joint Arthroscopy

Intervention Type PROCEDURE

Lysis and Lavage

Antibiotic therapy

Intervention Type DRUG

Amoxicillin / Clavulanic Acid, 1g I.V. (Intraoperative); as well as Amoxicillin / clavulanic acid, 500/125 mg / 8h / 5 days by mouth (Post-operative).

corticosteroid

Intervention Type DRUG

Dexamethasone, 4 mg I.V. (Intraoperative)

Antiinflammatories

Intervention Type DRUG

Diclofenac 100 mg / 12h / 5 days by mouth (Post-operatively).

Analgesics

Intervention Type DRUG

Metamizol 575 mg / 8h by mouth (Post-operatively)

Exercise program

Intervention Type OTHER

Home exercise program

Interventions

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Hyaluronic Acid

1 mL Hyaluronic Acid Injection (20 mg/mL, 7000 KDa) at the end of arthroscopy .

Intervention Type BIOLOGICAL

Temporomandibular Joint Arthroscopy

Lysis and Lavage

Intervention Type PROCEDURE

Antibiotic therapy

Amoxicillin / Clavulanic Acid, 1g I.V. (Intraoperative); as well as Amoxicillin / clavulanic acid, 500/125 mg / 8h / 5 days by mouth (Post-operative).

Intervention Type DRUG

corticosteroid

Dexamethasone, 4 mg I.V. (Intraoperative)

Intervention Type DRUG

Antiinflammatories

Diclofenac 100 mg / 12h / 5 days by mouth (Post-operatively).

Intervention Type DRUG

Analgesics

Metamizol 575 mg / 8h by mouth (Post-operatively)

Intervention Type DRUG

Exercise program

Home exercise program

Intervention Type OTHER

Other Intervention Names

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Sodium Hyaluronate

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of temporomandibular joint internal derangements in Wilkes stages III and IV by magnetic resonance imaging
* Limitation of maximum oral opening or duplication of joint pain by palpation
* lack of response to conservative therapies

Exclusion Criteria

* Any degenerative systemic disease of muscular or joint involvement (rheumatoid arthritis, etc.)
* Previous temporomandibular joint surgical treatment: arthrocentesis, arthroscopy or open surgery
* Infection in Temporomandibular Joint or in puncture site
* Hyaluronic acid or corticosteroids injection in Temporomandibular Joint in previous 6 months
* Pregnant or breastfeeding women
* Participants who refuse to complete the treatment or unavailable to complete the follow-up
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundación de Investigación Biomédica - Hospital Universitario de La Princesa

OTHER

Sponsor Role collaborator

Zambon SpA

INDUSTRY

Sponsor Role collaborator

Universidad Complutense de Madrid

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jorge Cano Sánchez

Role: STUDY_DIRECTOR

Universidad Complutense de Madrid

Julian Campo Trapero

Role: STUDY_DIRECTOR

Universidad Complutense de Madrid

Mario Fernando Muñoz Guerra

Role: STUDY_DIRECTOR

Fundación de Investigación Biomédica - Hospital Universitario de La Princesa

Oscar Gabriel Castaño Joaqui

Role: PRINCIPAL_INVESTIGATOR

Universidad Complutense de Madrid

Locations

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Hospital Universitario de La Princesa

Madrid, , Spain

Site Status

Countries

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Spain

References

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Montero-Martin J, Bravo-Perez M, Albaladejo-Martinez A, Hernandez-Martin LA, Rosel-Gallardo EM. Validation the Oral Health Impact Profile (OHIP-14sp) for adults in Spain. Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E44-50.

Reference Type BACKGROUND
PMID: 19114956 (View on PubMed)

Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994 Mar;11(1):3-11.

Reference Type BACKGROUND
PMID: 8193981 (View on PubMed)

Shi Z, Guo C, Awad M. Hyaluronate for temporomandibular joint disorders. Cochrane Database Syst Rev. 2003;(1):CD002970. doi: 10.1002/14651858.CD002970.

Reference Type BACKGROUND
PMID: 12535445 (View on PubMed)

Wilkes CH. Internal derangements of the temporomandibular joint. Pathological variations. Arch Otolaryngol Head Neck Surg. 1989 Apr;115(4):469-77. doi: 10.1001/archotol.1989.01860280067019.

Reference Type BACKGROUND
PMID: 2923691 (View on PubMed)

Castano-Joaqui OG, Cano-Sanchez J, Campo-Trapero J, Munoz-Guerra MF. TMJ arthroscopy with hyaluronic acid: A 12-month randomized clinical trial. Oral Dis. 2021 Mar;27(2):301-311. doi: 10.1111/odi.13524. Epub 2020 Jul 25.

Reference Type DERIVED
PMID: 32609918 (View on PubMed)

Other Identifiers

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DUROLANE2013

Identifier Type: -

Identifier Source: org_study_id

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