Comparison of intra-articular injection of plasma rich in growth factors versus hyaluronic acid following arthroscopy in the treatment of temporomandibular dysfunction: A randomised prospective study

Fernández-Ferro, M.; Sanromán, J. Fernández; Carrión, Andrés Blanco; Costas-López, Alberto; López-Betancourt, Annahys; Arenaz-Búa, Jorge; Marinescu, Bogdan Stavaru

doi:10.1016/j.jcms.2017.01.010

Cited by 74 publications

(84 citation statements)

References 35 publications

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“…When limited mouth opening is the primary symptom, there is no preference between PRP and HA as an additive after arthrocentesis. This agrees to a large extent with the results reported by Fernández-Ferro et al 30 Finally, it should be noted that the present study has some limitations. Firstly, our sample size was too small to achieve definitive conclusions.…”

Section: Discussionsupporting

confidence: 93%

Management of patients with disk displacement without reduction of the temporomandibular joint by arthrocentesis alone, plus hyaluronic acid or plus platelet-rich plasma

Toameh¹,

Alkhouri²,

Karman³

2019

Dent. Med. Probl.

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Background. Disk displacement without reduction (DDwoR) is one of the most common temporomandibular joint disorders (TMDs); it can manifest itself in joint pain and limited mouth opening. Nowadays, many arthrocentesis techniques are used with no consensus on which technique is optimal. Objectives. The aim of this study was to investigate the efficacy of 3 techniques in the treatment of TMD known as DDwoR and to compare them in order to determine whether one is superior to the others. Material and methods. A prospective study was conducted between May 2015 and June 2018. The sample consisted of 30 adult patients (6 males and 24 females; mean age: 38.87 ±6.40 years) with DDWoR, confirmed with magnetic resonance imaging (MRI). The patients were randomly divided into 3 groups according to the treatment technique applied: arthrocentesis only (control); arthrocentesis plus hyaluronic acid (HA); and arthrocentesis plus platelet-rich plasma (PRP). The maximum mouth opening (MMO) as well as pain intensity and masticatory efficiency on a visual analog scale (VAS) were measured at the time of diagnosis (baseline) and at 1-month, 3-month, 6-month, and 9-month follow-up appointments. The significance level was set at 0.05 for all statistical tests. Results. The 3 techniques resulted in significant improvement in MMO and all VAS parameters. The one-way analysis of variance (ANOVA) revealed significant differences (p < 0.05) in the variables between the 3 groups. The increase in MMO in the PRP and HA groups was significantly greater than in the case of the control group, whereas no significant difference was found between the PRP and HA groups. The pain intensity and masticatory efficiency results were significantly better in the PRP group than in the HA group or the control group; at the same time, no significant differences were noted between the HA group and the control group. Conclusions. Despite the fact that patients benefited from all of the 3 techniques, arthrocentesis plus PRP appeared to be superior to arthrocentesis plus HA or arthrocentesis alone.

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Section: Discussionsupporting

confidence: 93%

Management of patients with disk displacement without reduction of the temporomandibular joint by arthrocentesis alone, plus hyaluronic acid or plus platelet-rich plasma

Toameh¹,

Alkhouri²,

Karman³

2019

Dent. Med. Probl.

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“…Sixteen studies had high risk of bias (Figure ) and were excluded from analysis (Table ). The remaining 41 studies rated as medium or low risk of bias were included in the qualitative analysis for the individual groups: 15 studies on patients classified as TMD‐joint , nine on patients classified as TMD‐muscle and 17 on patients with BMS .…”

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Häggman‐Henrikson

Alstergren

Davidson

et al. 2017

J of Oral Rehabilitation

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This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients ≥18 years with chronic (≥3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.

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“…Moreover, PRP has long-term analgesic effects in most patients with painful TMJ [69,70]. Nevertheless, a randomized clinical trial in patients with TMJ osteoarthritis suggests that arthrocentesis plus PRP injections is not superior to arthrocentesis alone or combined with HA injection, and PRP does not add any significant improvement to clinical outcomes after surgery in patients with advanced internal derangement of the TMJ [71,72]. Thus, PRP injection should not be considered as a first-line treatment for TMD, and arthrocentesis plus HA injection would appear to be more acceptable [73].…”

Section: Intraarticular Delivery Of Platelet-rich Plasmamentioning

confidence: 99%

“…Thus, PRP injection should not be considered as a first-line treatment for TMD, and arthrocentesis plus HA injection would appear to be more acceptable [73]. Nevertheless, other authors observed that PRP performed well than HA in the treatment of TMJ osteoarthritis in terms of pain reduction for the treatment of reducible disc displacement of the TMJ [68,72,74]. Future studies will focus on the synergistic actions of HA and PRP in the treatment of TMJ osteoarthritis as in other joints.…”

Section: Intraarticular Delivery Of Platelet-rich Plasmamentioning

confidence: 99%

Nonsurgical Strategies for the Treatment of Temporomandibular Joint Disorders

Cabrera-Freitag¹,

Cobo²,

Muriel³

et al. 2019

Cartilage Tissue Engineering and Regeneration Techniques

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Temporomandibular disorders are common maxillofacial disturbs of different etiologies (traumatic, inflammatory, degenerative, or congenital) that course with pain and dysfunctions of the temporomandibular joint. The treatment of these disorders includes systematically administered drugs (especially nonsteroid antiinflammatory drugs and corticoids), physical therapies, and minimally invasive therapies that require intraarticular injections. These techniques are directed to clean or drain the articular cavity, to deliver intraarticularly drugs, biologically active compounds (as platelet-rich plasma), or to enhance lubrication (hyaluronic acid). Moreover, minimally invasive strategies are used in regenerative medicine for to deliver cells and stem cells, and nano-or micro-biomaterials. Surgery of temporomandibular disorders is only used in grave diseases that require arthrodesis or remotion of the temporomandibular joint. This review updates the nonsurgical therapeutic strategies to treat temporomandibular disorders, focusing the attention in the articular delivery or hyaluronic acid and platelet-rich plasma, two minimally invasive widely used at present.

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Comparison of intra-articular injection of plasma rich in growth factors versus hyaluronic acid following arthroscopy in the treatment of temporomandibular dysfunction: A randomised prospective study

Cited by 74 publications

References 35 publications

Management of patients with disk displacement without reduction of the temporomandibular joint by arthrocentesis alone, plus hyaluronic acid or plus platelet-rich plasma

Management of patients with disk displacement without reduction of the temporomandibular joint by arthrocentesis alone, plus hyaluronic acid or plus platelet-rich plasma

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Nonsurgical Strategies for the Treatment of Temporomandibular Joint Disorders

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