Home Articles List Article Information
Alexandria Dental Journal
Journal Archive
Volume Volume 49 (2024)
Volume Volume 48 (2023)
Volume Volume 47 (2022)
Volume Volume 46 (2021)
Volume Volume 45 (2020)
Volume Volume 44 (2019)
Volume Volume 43 (2018)
Volume Volume 42 (2017)
Volume Volume 41 (2016)
Volume Volume 40 (2015)
ELwerfelli, A., Kalil, A., Abdullah, N. (2019). CLINICAL EVALUATION OF DEXTROSE PROLOTHERAPY FOR MANAGEMENT OF TEMPOROMANDIBULAR JOINT DISORDER. Alexandria Dental Journal, 44(3), 1-7. doi: 10.21608/adjalexu.2019.63548
Adel M. ELwerfelli; Abd Elaziz F. Kalil; Nevein S. Abdullah. "CLINICAL EVALUATION OF DEXTROSE PROLOTHERAPY FOR MANAGEMENT OF TEMPOROMANDIBULAR JOINT DISORDER". Alexandria Dental Journal, 44, 3, 2019, 1-7. doi: 10.21608/adjalexu.2019.63548
ELwerfelli, A., Kalil, A., Abdullah, N. (2019). 'CLINICAL EVALUATION OF DEXTROSE PROLOTHERAPY FOR MANAGEMENT OF TEMPOROMANDIBULAR JOINT DISORDER', Alexandria Dental Journal, 44(3), pp. 1-7. doi: 10.21608/adjalexu.2019.63548
ELwerfelli, A., Kalil, A., Abdullah, N. CLINICAL EVALUATION OF DEXTROSE PROLOTHERAPY FOR MANAGEMENT OF TEMPOROMANDIBULAR JOINT DISORDER. Alexandria Dental Journal, 2019; 44(3): 1-7. doi: 10.21608/adjalexu.2019.63548

CLINICAL EVALUATION OF DEXTROSE PROLOTHERAPY FOR MANAGEMENT OF TEMPOROMANDIBULAR JOINT DISORDER

Article 1, Volume 44, Issue 3, December 2019, Page 1-7  XML PDF (487.42 K)
Document Type: Original Article
DOI: 10.21608/adjalexu.2019.63548
View on SCiNiTO View on SCiNiTO
Authors
Adel M. ELwerfelli email 1; Abd Elaziz F. Kalil2; Nevein S. Abdullah2
1BDS, Faculty of Dentistry, Tripoli University, Libya
2Professor of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt.
Abstract
INTRODUCTION: Temporomandibular disorders (TMDs) are clinically significant conditions which can be a source of acute or chronic orofacial pain and dysfunction including limitation of mandibular movement. Simple lysis and lavage in the upper joint space which washes out inflammatory mediators were found to be highly effective in reestablishing normal maximum interincisal opening (MIO), jaw function and relieving the symptoms despite the disc position not have been corrected. OBJECTIVES: To evaluate the efficiency of arthrocentesis, used normal saline, followed by injection of dextrose 50%, in a single injection protocol, for management of patients with TMDs. MATERIALS AND METHODS: This study was conducted on fourteen TMD patients have been diagnosed on the bases of the clinical data and MRI findings. The selected patients were divided equally into two groups, each group comprising of seven patients. The group-A: has been treated by arthrocentesis followed by 2 ml of dextrose 50% injected into the superior compartment of TMJ. The group-B: has been treated with arthrocentesis alone. All patients have been evaluated at the end of the 24 hours, 1st, 2nd, 3rd, 4th, 5th and 6th weeks postoperatively. RESULTS: unassisted mouth opening showed an increase at all time intervals. There was a significant improvement in pain, the range of motion, joint effusion and joint sounds. CONCLUSIONS: Arthrocentesis followed by 50% dextrose injection is superior to arthrocentesis alone in reducing impairment in patients with TMDs on its clinical outcome.
Keywords
range of motion; Arthrocentesis; intra-articular injection; Maximum interincisal opening; Dextrose prolotherapy
References
  1. Juniper RP. The pathogenesis and investigation of TMJ dysfunction. Brit J Oral Maxillofac Surg. 1987; 25:105-12.
  2. Stegenga B, de Bont LG, Boering G, van Willigen JD. Tissue responses to degenerative changes in the temporomandibular joint: A review. J Oral Maxillofac Surg. 1991; 49:1079-88.
  3. Milam SB. Molecular biology of temporomandibular joint disorders: proposed mechanisms of disease. J Oral Maxillofac Surg. 1995; 53:1448-54.
  4. Nitzan DW. The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: a theoretical concept. J Oral Maxillofac Surg. 2001; 59:36-45.
  5. Nitzan DW. Adhesive force: the underlying cause of the disc anchorage to the fossa and/or eminence in the temporomandibular joint-a new concept. Int J Oral Maxillofac Surg. 2002; 31:94-9.
  6. Wilkes CH. Internal derangements of the temporomandibular joint: pathological variation. Arch Otolaryngol Head Neck Surg. 1989; 115:469-77.
  7. Dolwick MF, Kaytzberg RW, Helms CA. Internal derangement of the temporomandibular joint. Fact or fiction. J Prosthet Dent. 1983; 49:415-8.
  8. Farrar WB. Characteristics of the condylar path in internal derangement of the TMJ. J Prosthet Dent. 1978; 39:319- 23.
  9. Nitzan D, Dolwick M, Martinez G. Temporomandibular Joint Arthrocentesis: A Simplified Treatment for Severe Limited Mouth opening. J Oral Maxillofac Surg. 1991; 11:1163-7.
  10. Yura S, Totsuka Y. The relationship between the effectiveness of arthrocentesis under sufficient pressure and conditions of the temporomandibular joint. J Oral Maxillofac Surg. 2005; 63:225-8.
  11. Yura S, Yoshikawa T, Inoue N. Can arthrocentesis release intracapsular adhesions; Arthroscopic findings before and after irrigation under sufficient hydraulic pressure. J Oral Maxillofac Surg. 2003; 61:1253-6.
  12. Stegenga B. Nomenclature and classification of temporomandibular joint disorders. J Oral Rehabi 2010; 37:760–765.
  13. Sato J, Segami N, Nishimura M, Demura N, Yoshimura H, Yoshitake Y, et al. Expression of interleukin-6 in synovial tissues in patients with internal derangement of the temporomandibular joint. Br J Oral Maxillofac Surg. 2003; 41:95-101.
  14. Sato J, Segami N, Nishimura M, Kaneyama K, Demura N, Yoshimura H. Relation between the expression of vascular endothelial growth factor in synovial tissues and the extent of joint effusion seen on magnetic resonance imaging in patients with internal derangement of the temporomandibular joint. Br J Oral Maxillofac Surg. 2003; 41:88-94.
  15. Kaneyama K, Segami N, Nishimura M, Sato J, Fujimura K, Yoshimura H.The Ideal lavage volume of Bradykinin, Interleukin-6 and protein from the temporo- mandibular joint by arthrocentesis. J Oral Maxillofac Sug. 2004; 62:657-61.
  16. Al-Belasy FA, Dolwick MF. Arthrocentesis for the treatment of temporomandibular joint closed lock: A review article. Int J Oral Maxillofac Surg. 2007; 36:773- 82.
  17. Said S. Comparison of arthrocentesis with and without injection of sodium hyaluronate in the management of temporomandibular joint disorders. Master Thesis. Alexandria University, 2010.
  18. Lotfy S. Comparative study between low and high molecular weight hyaluronic acid injections after arthrocentesis in the treatment of temporomandibular joint disorders. Master Thesis. Alexandria University 2014.
  19. EL-said S. comparative study of arthrocentesis with or without using piroxicam in the management of temporomandibular joint disorders. Master Thesis. Alexandria University, 2015.
  20. Ethunandan M, Wilson AW. Temporomandibular joint arthrocentesis- more questions than answers. J Oral Maxillofac Surg. 2006; 64:952-5.
  21. Nabil L. Clinical Assessment of Arthrocentesis using ozonized water with sodium hyaluronate injection in the management of TMJ Disorders. Master Thesis. Alexandria University; 2008.
  22. Reeves K, Rabago D. Dextrose prolotherapy, A narrative review of basic science, clinical research, and best treatment recommendations. Phys Med Rehabil Clin N Am. 2016; 27:783-823.
  23. Arati S. Neeli M, Kotrashetti S, Baliga S. Arthrocentesis for the Treatment of Internal Derangement of the Temporomandibular Joint. J Maxillofac Oral Surg. 2010; 9:350-4.
  24. Kumar R, Pallagatti S, Sheikh S, Mittal A, Gupta D, Gupta S. Correlation Between Clinical Findings of Temporomandibular Disorders and MRI Characteristics of Disc Displacement. The open Dentistry J, 2015, 9: 273-81
  25. Katzberg RW, Westesson PL, Tallents RH, Drake CM. Orthodontics and temporo- mandibular joint internal derangement. Am J Orthod Dentofacial Orthop. 1996 May;109:515-20.
  26. Shaffer SM, Brismée JM, Sizer PS, Courtney CA. Temporomandibular disorders Part 1: anatomy and examination/ diagnosis. J Man Manip Ther. 2014; 22:2-12.
  27. Rabago D, Slattengren A, Zgierska A. Prolotherapy in primary care practice. Prim Care J. 2010; 37:65-80.
  28. 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.
  29. Hakala RV, Ledermann KM. The use of prolotherapy for temporomandibular joint dysfunction. J Prolother. 2010; 2:439-46.
  30. Kaneyama K, Segami N, Nishimura M, Fujimura K, and Yoshimura H. The ideal,lavage volume for removing bradykinin, interlukin-6, and protein from the temporomandibular joint by arthrocentesis. J Oral Maxillofac Surg 2004; 62: 657-661.
  31. Belasy FA, Dolwick MF. Arthrocentesis for the treatment of temporomandibular joint closed lock: a review article Int J Oral Maxillofac Surg 2007 Sep;36 (9):773-82.
  32. Russell JW, Golovoy D, Vincent AM, Mahendru P, Olzmann JA, Mentzer A, et al. High glucose-induced oxidative stress and mitochondrial dysfunction in neurons. Fed Am Soci Experi Biol (FASEB) J. 2002; 16:1738-48.
  33. Stecker MM, Stevenson M. Effect of glucose concentration on peripheral nerve and its response to anoxia. Muscle Nerve J. 2014; 49:370-7.
  34. Carvajal W, Laskin DM. Long-term evaluation of arthrocentesis for the treatment of internal derangements of the temporomandibular joint. J Oral Maxillofac Surg 2000; 58: 852-55.
  35. Vankdoth A, Talla H, vijayalaxmi N, Madhulatha G. Prolotherapy- A venturing Treatment for the Temporomandibular joint disorder. Inter Scientific Study J. 2014; 1:27-30.
  36. Hauser RA, Hauser MA, Blakemore KA. Dextrose prolotherapy and pain of chronic TMJ dysfunction. Pract Pain Manag. 2007; 7:49-55.
  37. Mobasheri A. Glucose: an energy currency and structural precursor in articular cartilage and bone with emerging roles as an extracellular signaling molecule and metabolic regulator. Front Endocrinol. 2012; 3:1-10.
  38. Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clin Med Insights Arthritis Musculoskelet Disord 2016 Jul; 7:139-59.
  39. Kim HJ, Jeong T, Kim WS, Park YS. Comparison of histological changes in accordance with the level of dextrose-concentration in experimental Prolotherapy model. J Korean Acad Rehab Med. 2003;27:935-40.
  40. Hauser RA, Maddela HS, Alderman D, Baehnisch G, Banner R, Blakemore PJ, et al. The case for prolotherapy: Journal of Prolotherapy International Medical Editorial Board Consensus Statement on the Use of Prolotherapy for Musculoskeletal Pain. J Prolotherapy 2011 Dec;3:744-64.
Statistics
Article View: 450
PDF Download: 1,343