Comparative Study Between 2 Types of Prolotherapy in Treatment of Chronic Recurrent Temporomandibular Joint Dislocation

Abstract

INTRODUCTION:Temporomandibular Joint (TMJ) dislocation when condyles travel anterior to articular eminence. It may be reducible or irreducible. Chronic recurrent TMJ dislocation was treated by surgical and nonsurgical methods. Minimally invasive methods include injection of sclerosing agents intra-articular and extra-capsular or botulinum toxin to the surrounding muscles. Prolotherapy is a method of strengthening lax ligaments by injecting various types of sclerosing or proliferant solutions such as ethanolamine oleate 5%, autologus blood and others. It is also known as "ligament sclerotherapy" or "regenerative injection therapy" OBJECTIVES: the study aimed to compare 2 types of prolotherapy (autologous blood & ethanolamine Oleate sclerosing agent) injection in treatment of chronic recurrent temporomandibular joint dislocation. . Thirty patients with chronic recurrent temporomandibular joint dislocation were chosen with certain inclusion and exclusion criteria. Fifteen participants were injected with ethanolamine oleate compared with fifteen patients were injected with autologous blood and were followed-up for six months. The participated patients were assessed at the pre-and post-treatment stages by evaluating pain and mandibular range of motion clinically and radiographically using Magnatic Resonance Imaging (MRI) to evaluate condyle-articular eminence relation in opening and closing mouth. RESULTS: There was no significant difference between both prolotherapies in treating chronic recurrent temporomandibular joint dislocation. CONCLUSIONS: Ethanolamine oleate and autologus blood injection are simple, safe and cost-effective treatment for management of chronic recurrent temporomandibular joint dislocation.

Comparison of autologous blood prolotherapy and 25% dextrose prolotherapy for the treatment of chronic recurrent temporomandibular joint dislocation on the basis of clinical parameters: A retrospective study

“…Cömert Kiliç et al [ 14 ] found out significant improvement in the lateral motion of the mandible with 12.5% dextrose prolotherapy. Khamis et al [ 25 ] has also shown improvement in protrusive and right lateral movement with autologous blood prolotherapy.…”

A novel autohemotherapy protocol for chronic recurrent temporomandibular joint dislocation in a mentally disabled individual: A case report

“…Scar formation and contraction are acceptable. [5] The autologous blood injection is a sclerosant/ proliferant solution based on hypothesis, in which mandibular movements are restricted by inducing fibrosis in superior joint space and pericapsular tissues by injecting autologous blood into TMJ. [10] In the present case report, the mandibular range of motion was reduced after autologous blood injection in TMJ.…”

“…These treatment modalities can be classified into surgical (invasive) and non-surgical (conservative) methods. [5] Non-surgical methods comprise physiotherapy, occlusal splint, and avoidance of yawning, laughing which can cause large-mouth-opening, prescribing muscle relaxants and soft diet, injection of sclerosing agents such as 5% sodium morrhuate and 5% ethanolamine oleate (EO), autohemotherapy into the TMJ pericapsular tissues and injection of botulinum toxin into the masticatory muscles. [6,7] Prolotherapy is a method of strengthening lax ligaments by injecting various types of sclerosing or proliferant solutions.…”

“…Autologous blood and EO are used as proliferant solutions. [5,8] The classical surgical protocol includes the mechanical tightening of the capsule, the fastening of the joint parts, the creation of mechanical interference in the condylar parts, the elimination of interference in the condylar path by eminectomy, reduction of lateral pterygoid muscle pull by myotomy with simultaneous implantation of a silastic sheet, capsular plication, and temporalis tendon scarification. Redirection of the temporalis tendon, deepening of the glenoid fossa by resection of the disc, and condylotomy are the other surgical (invasive) regime used for the management of chronic recurrent TMJ dislocation.…”

Evaluation of the effects of polidocanol injection in the treatment of temporomandibular joint hypermobility - A prospective study

“…[ 5 ] The injection of sclerosing agent for this purpose has been reported with varying success rates. There are some sclerosing agents that have been used for TMJ hypermobility, some of which are ethanolamine oleate,[ 6 ] and OK-432,[ 7 ] sodium psylliate (sylnasol),[ 8 ] but there are hardly any studies on the usage of polidocanol – a well-known sclerosing agent which does not have much side effects and is inexpensive.…”