Clinical efficacy of a centric relation occlusal splint and intra-articular liquid phase concentrated growth factor injection for the treatment of temporomandibular disorders

Abstract

The agony that accompanies the incidence and symptoms of temporomandibular disorders (TMDs) is an important concern in the oral and maxillofacial region. The objective of this study was to explore the clinical findings after centric relation occlusal splint (CROS) treatment and intra-articular injection treatment with liquid phase concentrated growth factors (LPCGFs) in patients with disc displacement without reduction (DDWOR).The group under investigation of this retrospective cohort study included patients with DDWOR who received treatment from April 2014 until March 2016. The predictor variable was the therapeutic method. The outcome variables included joint crepitus sound, visual analog scale (VAS) of temporomandibular joint (TMJ) arthralgia, TMD-associated headache, myofascial pain with referral, deviation of the mandible during opening (DoM), and maximal interincisal opening (MIO). At the stage of CROS treatment, evaluation of all variables adopted the individual as the unit; at the stage after LPCGF injection, the evaluation of joint sound adopted the joint as the unit, whereas the other variables adopted the individual as the unit.Among the 29 patients, 6 (20.68%) were males and 23 (79.31%) were females. Distribution by age ranged from 15 to 84 years (mean age 39.55 ± 15.49 years). After CROS treatment, except for the joint crepitus sound, which failed to achieve significant improvement (P > 0.05), other symptoms, such as DOM, TMD-associated headache, myofascial pain with referral, TMJ arthralgia, and MIO, all achieved statistically significant improvements (P < 0.05). After 2 mL of LPCGF was injected once after CROS treatment, 26 joint crepitus sound symptoms were relieved (P < 0.001) after an average of 48.5 ± 64.1 days.CROS alone can alleviate TMD clinical symptoms, except for the joint crepitus sound. Approximately 72.2% of joint crepitus sounds could be improved within 48 days, on average, once 2 mL of LPCGF was injected. Comparisons were still required in the future, with the effects of other therapeutic methods.

Effect of arthrocentesis plus platelet-rich plasma and platelet-rich plasma alone in the treatment of temporomandibular joint osteoarthritis

“…Our deduction has been verified in a single-arm study by our research group. [ 15 ] In that study, PRP treatment for TMDs showed satisfactory performance in improving joint sounds, as evidenced by the data that an injection of 2 mL of PRP improved the joint sounds of 23 joints (63.9%) at 12.06 ± 8.54 days after treatment and 26 joints (72.2%) at 48.5 ± 64.1 days after treatment, with no significant relapse of symptoms observed during a follow-up period of 258 days.…”

“…[ 9 ] In recent years, several studies have reported the use of PRP in intra-articular injection to treat temporomandibular disorders (TMDs), which achieved satisfactory outcomes. [ 1 , 6 , 10 – 15 ] However, the treatment methods used in these studies were inconsistent, with some using PRP alone and some using arthrocentesis plus PRP (A+PRP). In addition, these studies mostly used traditional PRP in varying doses, from 0.5 to 2 mL, and with different frequencies, from a single injection to 4 injections.…”

The Application of Intra-Articulr Injections for Management of the Consequences of Disc Displacement without Reduction

“…Similar results were obtained by Giacomello et al [16], who also obtained an improvement in the range of mandibular lowering motion in the treatment of disc dislocation without reduction and the dimensions before and after the treatment significantly varied statistically. Additionally, Delayme et al [11], Ferrnandez-Ferro et al [26], and Yang et al [21] applied PRP with a beneficial effect on the functioning of the TMJs.…”

“…These differences concern the number of revolutions, centrifugation time, preparation of PRP, and the method of injection in the TMJ area. Studies of TMJ injections with PRP and HA have focused on decreased pain after injection in patients with both pain and limited mouth opening, secondary to displacement of the disc without reduction, and other clinical problems, such as arthritis and capsulitis [7,10,12,14,18,21].…”

“…The platelet-rich plasma was cautiously aspirated into a separate syringe. Thus, prepared concentrate was ready for injection into the area of temporomandibular joint [18][19][20][21][22].…”