Autologous Blood Injections in Temporomandibular Hypermobility: A Systematic Review

Abstract

The injection of autologous blood (AB) is one of the methods of treatment of recurrent dislocations in the temporomandibular joints (TMJs). Due to the low invasiveness of this technique, it is reasonable to evaluate it in accordance with the standards of evidence-based medicine. The purpose of this systematic review is to identify primary studies on AB injection for the treatment of TMJ hypermobility and assess the therapy for effectiveness. This systematic review was conducted in accordance with the current “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” guidelines. Controlled randomized trials comparing dislocation episode rates, range of motion in the TMJ, or articular pain intensity were adopted as the eligibility criteria. Final searches were conducted on 11 June 2023 using Bielefeld Academic Search Engine, Elsevier Scopus, and the National Library of Medicine: PubMed. Trials were assessed using the “Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence” scale and “A revised Cochrane risk-of-bias tool for randomized trials”. The results of the individual studies were tabulated, syntheses were illustrated in graphs. Twenty two studies involving 982 patients were included in the qualitative analysis, of which seven studies involving 390 patients were subject to quantitative analysis. None of the included randomized controlled trials presented a high risk of bias, 75% of them raised some concerns. In a three-month observation, administration of AB was more efficient in limiting temporomandibular dislocations than hypertonic dextrose (1 study, 32 patients, relative risk = 0.33, odds ratio = 0.29) and no difference in outcomes was observed between intracavitary and pericapsular administration compared to pericapsular injection alone (2 studies, 70 patients, relative risk = 1.00, odds ratio = 1.00). Injections of AB into the temporomandibular joints are effective in preventing further TMJ dislocation episodes in 75–94% of patients. This study received no funding.

Temporomandibular Disorders Management—What’s New? A Scoping Review

“…These encompass analgesic agents, dextrose coupled with lidocaine, adipose tissue, hematopoietic stem cells, and ozone. Administering arthrocentesis before the injection appears to augment the efficacy of intra-articular delivery, with bone marrow and adipose tissue showing the most promising results [ 85 ]. Among individuals diagnosed with temporomandibular joint osteoarthritis (TMJ-OA), arthrocentesis has demonstrated efficacy in significantly alleviating pain and enhancing mandibular functionality.…”

“…Pharmacological agents commonly employed in TMD treatments encompass NSAIDs, opioids, CCS, muscle relaxants, antidepressants, anticonvulsants, and benzodiazepines [ 28 , 47 , 62 , 69 , 82 , 84 , 85 , 98 , 99 , 100 , 101 , 102 ]. Regarding pain management in TMDs, some evidence suggests that NSAIDs can be considered as an initial approach for alleviating joint and muscle pain in TMD patients [ 99 , 100 ].…”

Temporomandibular Joint Injections and Lavage: An Overview of Reviews

“…Depending on the injectable substance used, injection treatment provides pain relief and increases the range of mandibular mobility or reduces the frequency of episodes of TMJ habitual dislocations [6][7][8]. Rinsing of the TMJs is performed as an independent procedure or precedes the injection of the active substance [9].…”