Prolotherapy TMJ treatment research

Prolotherapy and arthrocentesis for TMJ

A December 2020 study in the medical journal Cranio, Journal of craniomandibular practice (1) compared the effectiveness of dextrose Prolotherapy in conjunction with arthrocentesis (fluid draining of the TMJ) and dextrose prolotherapy alone in the management of symptomatic TMJ hypermobility.

  • Twenty-four patients suffering from TMJ symptomatic hypermobility received 10% dextrose injections for three sessions at four-week intervals. (Three treatments, one every four weeks).
  • Twelve patients received Prolotherapy alone; the other 12 received Prolotherapy and arthrocentesis The arthrocentesis was only performed once.
  • Patients were evaluated for maximal incisal opening, maximal incisal opening without pain, pain at rest, pain during chewing function, TMJ sound, and locking episode frequency.
  • Results: Pain scores were significantly reduced in both groups, and the locking episode frequency was decreased to a greater extent in the Prolotherapy and arthrocentesis than the Prolotherapy group, at both the short and long terms.
  • Conclusion: Prolotherapy is effective in the management of TMJ hypermobility. However, Prolotherapy with arthrocentesis may be superior to Prolotherapy alone in the management of TMJ hypermobility.

Comparing TMJ treatments: Splints vs. Prolotherapy injections

November  2020: Published in Journal of cranio-maxillo-facial surgery. (2)

Learning points:

Researchers compared the effectiveness of  dextrose prolotherapy and occlusal (mouth) splints in treating internal derangement of the temporomandibular joint.

  • A total of 34 patients with temporomandibular joint internal derangement classed as Wilkes stages II or III were recruited for the study, and were randomly divided into study and control groups with 17 patients each.
    • Wilkes stages for TMJ assessment
      • Wilkes stage II is typically characterized by normal or seemingly normal range of jaw motion with intermittent episodes of pain, jaw locking and clicking.
      • Wilkes stage II is typically characterized by more pain, frequent headaches, loss of range of motion, onset or development of TMJ disc damage and deformity.
  • The patients in these control and study groups were treated with splints and prolotherapy, respectively. Outcome parameters, such as pain, mouth opening, clicking and deviation, were assessed for a review period of 1 year.

Results: Nine patients in the (Prolotherapy) study group had complete absence of pain, compared with only one (splint group) patient in the control group. The results showed that patients who received prolotherapy demonstrated improvement in pain, mouth opening, and clicking, but no significant difference in deviation was observed between the groups after 1 year (p = 0.862).

Conclusion: Prolotherapy was found to be superior in providing long-term clinical relief, with reduction in pain and clicking along with improved mouth opening.

For more information on Prolotherapy for TMJ disorders please see these related articles:

1 Taşkesen F, Cezairli B. Efficacy of prolotherapy and arthrocentesis in management of temporomandibular joint hypermobility. Cranio. 2020 Dec 16:1-9. doi: 10.1080/08869634.2020.1861887. Epub ahead of print. PMID: 33326351.
2 Priyadarshini S, Gnanam A, Sasikala B, Panneerselvam E, Cheeman SR, Mrunalini R, Raja VK. Evaluation of prolotherapy in comparison with occlusal splints in treating internal derangement of the temporomandibular joint–a randomized controlled trial. Journal of Cranio-Maxillofacial Surgery. 2020 Nov 17. [Google Scholar]