Abstract：
OBJECTIVE: To perform a scoping review to identify the available evidence regarding intra-articular injections in the inferior joint space (IJS) of the temporomandibular joint (TMJ).
METHODS: An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: \"Arthrocentesis\", \"injection\", \"joint injection\", \"technique\", \"Temporomandibular joint\", \"Temporomandibular joint disorder\". Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. Only articles with full-text access were included.
RESULTS: Thirteen articles were included for analysis-one technical note, three cadavers studies, one animal study, two case reports, five randomised clinical trials and one retrospective study; studies were classified as \'patients-based studies\' and \'non-patients-based studies\'. Most \'patients-based studies\' show moderate or high risk of bias. Techniques were categorised as \'anatomical technique\' and \'image-guided technique\'. Most \'patients-based studies\' show favourable outcomes such as pain reduction, increase in maximum mouth opening, improvement in quality of life and improvement in TMJ dysfunction indexes for the treatment of arthrogenic TMDs. Comparisons between superior and IJS injections are scarce. On the other hand, \'non-patients-based\' studies show that image-guided or ultrasound-checked injection techniques achieved a higher effectiveness for needle location than anatomical (or blind) techniques.
CONCLUSIONS: The amount of available evidence is scarce, heterogeneous in design, and most \'patients-based studies\' show moderate or high risk of bias, which demands the generation of new research to obtain definitive conclusions. The tendency observed suggests that intra-articular injections for the IJS of the TMJ are able to relieve TMJ pain, increase mouth opening and improve TMJ dysfunction, and image-guided injection techniques seem to be more effective than anatomical techniques to locate the needle in the IJS.
METHODS: An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: \"Arthrocentesis\", \"injection\", \"joint injection\", \"technique\", \"Temporomandibular joint\", \"Temporomandibular joint disorder\". Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. Only articles with full-text access were included.
RESULTS: Thirteen articles were included for analysis-one technical note, three cadavers studies, one animal study, two case reports, five randomised clinical trials and one retrospective study; studies were classified as \'patients-based studies\' and \'non-patients-based studies\'. Most \'patients-based studies\' show moderate or high risk of bias. Techniques were categorised as \'anatomical technique\' and \'image-guided technique\'. Most \'patients-based studies\' show favourable outcomes such as pain reduction, increase in maximum mouth opening, improvement in quality of life and improvement in TMJ dysfunction indexes for the treatment of arthrogenic TMDs. Comparisons between superior and IJS injections are scarce. On the other hand, \'non-patients-based\' studies show that image-guided or ultrasound-checked injection techniques achieved a higher effectiveness for needle location than anatomical (or blind) techniques.
CONCLUSIONS: The amount of available evidence is scarce, heterogeneous in design, and most \'patients-based studies\' show moderate or high risk of bias, which demands the generation of new research to obtain definitive conclusions. The tendency observed suggests that intra-articular injections for the IJS of the TMJ are able to relieve TMJ pain, increase mouth opening and improve TMJ dysfunction, and image-guided injection techniques seem to be more effective than anatomical techniques to locate the needle in the IJS.
摘要：
目的：进行范围审查，以确定有关颞下颌关节（TMJ）下关节间隙（IJS）关节内注射的可用证据。
方法：PubMed的电子搜索，WebofScience和Scopus数据库使用以下术语进行：“关节穿刺术”，\"注射\",“关节注射”，\"技术\",“颞下颌关节”，“颞下颌关节紊乱症”。在应用纳入/排除标准后，从记录中获得全文文章。仅包括具有全文访问权限的文章。
结果：包括13篇文章进行分析-一个技术说明，三个尸体研究，一项动物研究，两个病例报告,五项随机临床试验，和一项回顾性研究；研究分为“基于患者的研究”和“基于非患者的研究”。大多数“基于患者的研究”显示中度或高度偏倚风险。技术分为“解剖技术”和“图像引导技术”。大多数“基于患者的研究”显示出良好的结果，例如减轻疼痛，增加最大张口，生活质量的改善和TMJ功能障碍指数的改善，用于治疗关节源性TMD。优等注射和IJS注射之间的比较很少。另一方面,“非基于患者的”研究表明，图像引导或超声检查的注射技术比解剖（或盲目）技术对针定位具有更高的有效性。
结论：现有证据很少，设计异构，大多数“基于患者的研究”显示出中等或高的偏倚风险，这要求产生新的研究以获得明确的结论。观察到的趋势表明，关节内注射TMJ的IJS能够缓解TMJ疼痛，增加张口，改善TMJ功能障碍，和图像引导的注射技术似乎比解剖技术更有效地定位IJS中的针。
方法：PubMed的电子搜索，WebofScience和Scopus数据库使用以下术语进行：“关节穿刺术”，\"注射\",“关节注射”，\"技术\",“颞下颌关节”，“颞下颌关节紊乱症”。在应用纳入/排除标准后，从记录中获得全文文章。仅包括具有全文访问权限的文章。
结果：包括13篇文章进行分析-一个技术说明，三个尸体研究，一项动物研究，两个病例报告,五项随机临床试验，和一项回顾性研究；研究分为“基于患者的研究”和“基于非患者的研究”。大多数“基于患者的研究”显示中度或高度偏倚风险。技术分为“解剖技术”和“图像引导技术”。大多数“基于患者的研究”显示出良好的结果，例如减轻疼痛，增加最大张口，生活质量的改善和TMJ功能障碍指数的改善，用于治疗关节源性TMD。优等注射和IJS注射之间的比较很少。另一方面,“非基于患者的”研究表明，图像引导或超声检查的注射技术比解剖（或盲目）技术对针定位具有更高的有效性。
结论：现有证据很少，设计异构，大多数“基于患者的研究”显示出中等或高的偏倚风险，这要求产生新的研究以获得明确的结论。观察到的趋势表明，关节内注射TMJ的IJS能够缓解TMJ疼痛，增加张口，改善TMJ功能障碍，和图像引导的注射技术似乎比解剖技术更有效地定位IJS中的针。
