Intra-articular injection of sodium hyaluronate(HA) has been widely used in the treatment of temporomandibular disorders(TMD), however, the the exact mechanisms are unclear. In this study, we investigated levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) in the synovial fluid of patients with TMD before and after injection of HA , and evaluate the possible mechanism involved in the therapeutic value of HA.
METHODS:
30 patients were divided into 2 groups, internal derangement(ID) and osteoarthrosis(OA). A pumping procedure was used to take SF from the superior TMJ space before and 2 week after HA treatment. The concentrations of VEGF and FGF-2 in SF were determined using an enzyme-linked immunosorbent assay (ELISA).
RESULTS:
The levels of VEGF in the ID group were 30.85(±36.93) pg/ml before treatment and 18.90(±25.39) pg/ml after treatment. The levels of FGF-2 in the ID group were 30.78(±26.36) and 24.83±(28.29) respectively. The levels of VEGF in the OA group were 44.25(±53.07) pg/ml before treatment and 28.22(±39.02) pg/ml after treatment. The levels of FGF-2 in the OA group were 35.75(±30.87) and 37.86±(26.93) respectively. The level of VEGF was significantly higher before treatment with HA than after treatment. There was no significant difference in the concentration of FGF-2 between before and after treatment.
CONCLUSIONS:
These findings demonstrate that HA may reduce the synovitis and improve the internal state of the temporomandibular joint.