Adverse events of intra-articular temporomandibular joint injections: a systematic search and review

Temporomandibular joint (TMJ) disorders manifest as joint pain and limited mobility of the mandible. Treatment options include arthrocentesis and intra-articular drug administration. Adverse events associated with such interventions are rarely described in separate articles and may be overlooked when presented in clinical trial reports. Their identification in the medical literature is difficult due to the need to develop a rich set of keywords. This systematic search and review aims to identify and map adverse events associated with injections into the TMJ. Primary clinical trials of TMJ disorders treated with joint irrigation and/or drug administration were included. Data were extracted using a predesigned form and presented in text, tables, and graphs. A total of 58 adverse events were identified, more than half of which were pain and/or swelling. Overall, 14 types of events were classified into 3 categories (distant, local, and articular), none of which were fatal or life-threatening. These were, in order of most frequently diagnosed: pain and/or swelling (52%), ear pressure (5%), eyelid paresthesia (5%), periarticular tissue atrophy (5%), generalized rash (4%), hypoesthesia (4%), open bite (4%), skin hypopigmentation (4%), headache (3%), local rash (3%), malocclusion (3%), mandibular hypomobility (3%), TMJ noises (3%), and fever (2%).