Tenoxicam 20mg powder and solvent for solution for injection vials

Objectives: This systematic review was designed to summarize randomized controlled trials of intra-articular administration of non-steroidal anti-inflammatory drugs (NSAIDs) for temporomandibular disorders. Methods: Randomized controlled trials regarding intra-articular injections of non-steroidal anti-inflammatory drugs for temporomandibular disorders were included in the review. The final search was conducted on 16 June 2024 in the Bielefeld Academic Search Engine, PubMed, and Scopus databases. Results: Of the 173 identified studies, 6 were eligible for review. In trials comparing arthrocentesis alone to arthrocentesis with NSAIDs, slight differences in joint pain were noted. For tenoxicam, differences were under 1 point on a 0-10 scale after 4 weeks, with inconsistent results. Piroxicam showed no significant difference, and pain levels were minimal in both groups. For maximum mouth opening (MMO), tenoxicam showed no significant difference. Piroxicam increased MMO by nearly 5 mm, based on one small trial with bias concerns. Conclusions: Currently, there is no strong scientific evidence supporting the injection of NSAIDs into the temporomandibular joint to relieve pain or increase jaw movement. Preliminary reports on piroxicam with arthrocentesis and tenoxicam or diclofenac without rinsing justify further research.

Abstract licence: CC BY

ObjectiveThis systematic review and meta-analysis aimed to evaluate the most effective minimally invasive intra-articular procedure for reducing pain and improving maximum mouth opening (MMO) in individuals diagnosed with painful articular TMD, specifically TMJ osteoarthritis and/or internal derangement.Materials and methodsOnly randomized clinical trials (RCTs) assessing the efficacy of minimally invasive procedures, such as arthrocentesis and intra-articular injection (IAI), were included. The meta-analysis included seven studies with a 6-month follow-up, while 23 studies with different follow-up periods were evaluated qualitatively.ResultsThe meta-analysis showed that IAI with tenoxicam was the most effective procedure for pain reduction, with the highest [7.44 mean difference (MD); 6.28-8.60 confidence interval (CI)], followed by opioids (5.93; 5.03-6.83), the combination of hyaluronic acid (HA) with platelet-rich plasma (PRP) (5.10; 4.52-5.68), and PRP alone (4.99; 3.13-6.85). For improvement in MMO, tenoxicam had the highest MD (+11.50 mm; 15.47-7.53), followed by PRP (+10.46 mm; 14.89-6.02) and the HA-PRP combination (+10.10 mm; 11.89-8.31).ConclusionsTenoxicam showed promising results for pain reduction and improvement in MMO, although the evidence remains limited, followed by opioids and the combination of HA and PRP with arthrocentesis. Further high-quality studies are needed to confirm their clinical applicability.

Abstract licence: CC BY