Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock in adolescents and young adults

Abstract

Background Temporomandibular joint (TMJ) ‘closed lock’ is a clinical condition causing TMJ pain and limited mouth opening (painful locking). Recent studies suggest an increasing prevalence of degenerative joint disease associated with the onset of TMJ closed lock in adolescents and young adults. Early interventions are recommended, but the curative effect of standard therapies remains controversial. In this retrospective study, an alternative method of non-surgical treatment of TMJ closed lock is presented, and its long-term efficacy has been observed. Methods Forty adolescents and young adults, aged 16 to 30 years old, with distinct combination of symptoms of TMJ closed lock, were enrolled. Patients received anesthetic blockages of the auriculotemporal nerve, then performed mandibular condylar movement exercise for 10 min, and subsequently received hypertonic dextrose prolotherapy in retro-discal area of TMJ. Clinical assessments at baseline and at follow-up (2 weeks, 2 months, 6 months, and 5 years) included intensity and frequency of TMJ pain, mandibular range of motion, TMJ sounds, and impairment of chewing. Results Cone beam CT images of the TMJs revealed joint space changes in all patients and degenerative bone changes in 20% (8/40) of the patients. The patients were diagnosed as having disc displacement without reduction with limited opening. Successful reduction of displaced disc had been achieved in the treatment. And pain at rest and pain on mastication had substantially decreased in all patients and mandibular function and mouth opening had significantly improved since 2 weeks’ follow-up. The overall success rate kept at a high level of 97.5% (39/40) at 6 months and 5 years’ follow-up. Conclusions The technique combining mandibular condylar movement exercise with auriculotemporal nerve block and dextrose prolotherapy is straightforward to perform, inexpensive and satisfactory to young patients with TMJ closed lock.

Efficacy of dextrose prolotherapy for the management of chronic temporomandibular disorders

“…In the prolotherapy group, the pain of the TMJ decreased gradually from the first week up to the second month and the difference was significant (p < 0.05). The mean value of pain score decreased from 3.9 at baseline to 0.5 at two months, these findings agreed with the results of (Zhou, Xue, & Liu, 2021), in their study after two weeks follow up period the pain of the TMJ of 37 patient was recovered, and at six months follow up period 39 patients have no pain. Also agreed with (Ungor et al, 2013) they used arthrocentesis first and then used prolotherapy with dextrose solution, the mean of pain score decreased from 1.9 preoperatively to 0.9 at three months follow up period.…”

Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized Controlled Trial

“…Several studies have examined the effects of conservative therapies, such as oral nonsteroidal anti-inflammatory drugs, orthodontics, electrotherapy, physical therapy, occlusal splints, oxygen-ozone therapy, and extracorporeal shockwave therapy (ESWT) in patients affected by TMD [13][14][15][16][17][18][19][20][21][22][23]. Among them, ESWT has been demonstrated to be effective in reducing pain and improving the function of the stomatognathic system; however, this treatment is relatively slow in relieving pain for patients and needs additional functional therapy to preserve the long-term therapeutic result [23].…”

Ultrasound Imaging of Facial Vascular Neural Structures and Relevance to Aesthetic Injections: A Pictorial Essay

“…The transducer is placed in the horizontal plane slightly anterior to the tragus. The short axis of the auriculotemporal nerve can be observed adjacent to the superior temporal artery ( Figure 16 ) [ 40 ].…”