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Efficacy of dextrose prolotherapy on temporomandibular disorder: a retrospective study

  • Jun-Sang Park (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Jeong-Kui Ku (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Young-Kyun Kim (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Pil-Young Yun (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital)
  • Received : 2024.05.23
  • Accepted : 2024.06.07
  • Published : 2024.10.31

Abstract

Objectives: Dextrose prolotherapy is one of the most promising minimally invasive interventions for temporomandibular disorder (TMD), particularly in refractory cases where other conservative treatments have failed. The purpose of this study was to demonstrate the efficacy of a new treatment, temporomandibular joint (TMJ) prolotherapy, in patients with TMD to alleviate symptoms. Materials and Methods: A retrospective analysis was conducted on TMD patients with chronic pain who did not respond to conventional treatments. TMJ prolotherapy was performed using hypertonic dextrose in the TMJ area, targeting the retrodiscal attachment tissue, anterior disc attachment tissue, lateral capsule, origin of the masseter muscle, and the stylomandibular ligament. Pain or discomfort intensity in the TMJ was evaluated using a numerical rating scale (NRS). Maximum mouth opening and subjective satisfaction were also analyzed. Results: Nineteen patients (6 males, 13 females, average age 43 years) participated in this study. All patients experienced pain improvement with a maximum of three prolotherapy sessions. The initial mean NRS was 5.7, which ultimately decreased to a final mean TMJ discomfort score of 1.7 post-intervention. The patients' maximum mouth opening increased from an initial 34.5 mm to 38.8 mm, and they reported positive satisfaction with the prolotherapy treatment. The clinical outcomes were positive regardless of main origin of TMD symptoms. Conclusion: Hypertonic TMJ prolotherapy is an effective minimally invasive intervention for TMJ disorders with chronic pain.

Keywords

References

  1. Rajapakse S, Ahmed N, Sidebottom AJ. Current thinking about the management of dysfunction of the temporomandibular joint: a review. Br J Oral Maxillofac Surg 2017;55:351-6. https://doi.org/10.1016/j.bjoms.2016.06.027
  2. Abouelhuda AM, Khalifa AK, Kim YK, Hegazy SA. Non-invasive different modalities of treatment for temporomandibular disorders: review of literature. J Korean Assoc Oral Maxillofac Surg 2018;44:43-51. https://doi.org/10.5125/jkaoms.2018.44.2.43
  3. Yilmaz O, Candirli C, Balaban E, Demirkol M. Evaluation of success criteria for temporomandibular joint arthrocentesis. J Korean Assoc Oral Maxillofac Surg 2019;45:15-20. https://doi.org/10.5125/jkaoms.2019.45.1.15
  4. Hakala RV. Prolotherapy (proliferation therapy) in the treatment of TMD. Cranio 2005;23:283-8. https://doi.org/10.1179/crn.2005.040
  5. Dasukil S, Shetty SK, Arora G, Degala S. Efficacy of prolotherapy in temporomandibular joint disorders: an exploratory study. J Maxillofac Oral Surg 2021;20:115-20. https://doi.org/10.1007/s12663-020-01328-9
  6. Moon SY, Lee ST, Ryu JW. Ultrasound-guided platelet-rich plasma prolotherapy for temporomandibular disorders. J Oral Med Pain 2014;39:140-5. https://doi.org/10.14476/jomp.2014.39.4.140
  7. Zhou H, Xue Y, Liu P. Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock in adolescents and young adults. Head Face Med 2021;17:11. https://doi.org/10.1186/s13005-021-00261-7
  8. Refai H, Altahhan O, Elsharkawy R. The efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: a preliminary prospective, randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 2011;69:2962-70. https://doi.org/10.1016/j.joms.2011.02.128
  9. Mustafa R, Gungormus M, Mollaoglu N. Evaluation of the efficacy of different concentrations of dextrose prolotherapy in temporomandibular joint hypermobility treatment. J Craniofac Surg 2018;29:e461-5. https://doi.org/10.1097/scs.0000000000004480
  10. Louw WF, Reeves KD, Lam SKH, Cheng AL, Rabago D. Treatment of temporomandibular dysfunction with hypertonic dextrose injection (prolotherapy): a randomized controlled trial with long-term partial crossover. Mayo Clin Proc 2019;94:820-32. https://doi.org/10.1016/j.mayocp.2018.07.023
  11. Reeves KD, Hassanein KM. Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity. Altern Ther Health Med 2003;9:58-62.
  12. Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med 2000;6:68-74, 77-80.
  13. Khan SA, Kumar A, Varshney MK, Trikha V, Yadav CS. Dextrose prolotherapy for recalcitrant coccygodynia. J Orthop Surg (Hong Kong) 2008;16:27-9. https://doi.org/10.1177/230949900801600107
  14. Rabago D, Slattengren A, Zgierska A. Prolotherapy in primary care practice. Prim Care 2010;37:65-80. https://doi.org/10.1016/j.pop.2009.09.013
  15. Siadat AH, Isseroff RR. Prolotherapy: potential for the treatment of chronic wounds? Adv Wound Care (New Rochelle) 2019;8:160-7. https://doi.org/10.1089/wound.2018.0866
  16. Hauser RA, Hauser MA, Blakemore KA. Dextrose prolotherapy and pain of chronic TMJ dysfunction. Pract Pain Manag 2007;7:49-55.
  17. Hakala RV, Ledermann KM. The use of prolotherapy for temporomandibular joint dysfunction. J Prolotherapy 2010;2:439-46.