Is dextrose prolotherapy superior to placebo for the treatment of temporomandibular joint hypermobility? A randomized clinical trial

The efficacy of dextrose prolotherapy over placebo for temporomandibular joint hypermobility: A systematic review and meta‐analysis

“…Full texts of eight articles were screened of which five were excluded because they did not fulfil the inclusion criteria. Finally, three studies were included in the systematic review …”

“…Additional radiographic evidence was utilised by Refai et al . (plain radiographs) and Kilic et al (Cone beam computed tomography) to diagnose the disorder. Detailed characteristic of individual studies is presented in Table .…”

“…Pathogenesis of TMJ hypermobility is commonly associated with trauma, abnormal chewing movements, poor development of the articular fossa, weakness or laxity of the TMJ ligament and joint capsule, and excessive activity of the lateral pterygoid and infrahyoid muscles due to drugs such as phenothiazine or diseases characterised with general joint laxity (Ehlers‐Danlos syndrome, Marfan syndrome and juvenile rheumatoid arthritis) …”

“…Surgical approaches included capsular plication, lateral pterygoid myotomy, scarification of the temporalis tendon, condylectomy, reduction of the articular eminence (eminectomy) and augmentation the articular eminence (miniplates, implants) . Conservative treatment approaches included intermaxillary fixation, intracapsular injection of sclerosing solutions (alcohol), intramuscular injection of botulinum toxin, intra‐articular injections of autologous blood and prolotherapy …”

“…Various agents have been used for prolotherapy including psyllium seed oil, dextrose and combinations of dextrose, glycerine and phenol . However, hypertonic dextrose is commonly used, as it is inexpensive, readily available and reported to be safe . While a number of trials have been conducted on the effects of dextrose prolotherapy on TMJ hypermobility, there is no level 1 evidence available for its use.…”