Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Chęciński, Maciej; Chęcińska, Kamila; Nowak, Zuzanna; Sikora, Maciej; Chlubek, Dariusz

doi:10.3390/jcm11092305

Cited by 22 publications

(45 citation statements)

References 103 publications

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“…The most commonly used methods for treating TMD include pharmacotherapy, physiotherapy, splint therapy, surgery, and intra-articular injections [ 4 , 5 ]. The latter may be rinsing of the joint cavity (called arthrocentesis), intra-articular administration of autogenous blood products (e.g., platelet-rich plasma (PRP) or injectable platelet-rich fibrin (I-PRF)), and drugs, e.g., hyaluronic acid (HA) or corticosteroids [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Good results of HA supplementation to the inside of the joint cavity may justify intra-articular injections in order to supplement and improve the composition of the synovial fluid [ 4 , 9 , 10 , 11 ]. Lavage of the articular cavity also reduces pain and improves mandibular mobility, possibly by reducing inflammatory mediators [ 4 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

Sikora

Sielski²,

Chęciński³

et al. 2022

JCM

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Background: Temporomandibular joint disorders (TMDs) are manifested, inter alia, by pain and limited scope of the mandibular abduction. Among the treatment strategies for these ailments, intra-articular injections of autologous blood preparations, including platelet-rich plasma (PRP), are administered. This prospective case series was aimed at assessing the effectiveness of repeated platelet-rich plasma (PRP) administration to the TMJ cavities in terms of reducing articular pain and increasing the mobility of the mandible. Material and methods: 40 consecutive patients diagnosed with TMJ pain qualified for the case series. The entire treatment program consisted of five PRP administrations and a summary appointment. Regression was analyzed for (1) intensity of spontaneous pain; (2) effectiveness of spontaneous pain relief; (3) mastication efficiency values; (4) painless mandibular abduction; (5) maximum mouth opening. The correlations between the abovementioned variable series were analyzed. Results: The mean spontaneous pain decreased consistently with successive PRP administrations in line with the regression model: −0.4x + 4.2 (R2 = 0.98). Articular pain improvement was reported in 71% of joints treated. Improvement in chewing quality at the end of the entire injection cycle was found in 63% of patients. The equations for the linear regression models for painless mandibular abduction (five applications of PRP) and maximum mouth opening (the first four applications of PRP) were x + 34 (R2 = 0.89) and 0.6x + 43.6 (R2 = 0.96), respectively. Improvement in these domains was found in 78% and 53% of patients, respectively. The strongest correlations were found between pain and chewing efficiency (−0.95), pain and painless mandible abduction (−0.96), and painless mandibular abduction and mastication efficiency (0.94). Conclusion: PRP injections into TMJ cavities should be considered as a low invasive, highly accessible form of treatment for various TMDs causing pain and mandible movement limitation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

Sikora

Sielski²,

Chęciński³

et al. 2022

JCM

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“…Patients with OSA or those who have OSA risk factors and at the same time are diagnosed with TMD must not be treated with long-term occlusal splint therapy, because of the above-described side effects. Those patients should be qualified for minimally invasive surgical procedures (arthrocentesis performed alone or in combination with intraarticular injections) [ 30 , 31 ] and/or physiotherapy, depending on the source of pain: TMJs (arthralgia) or adjacent muscles (myalgia).…”

Section: Discussionmentioning

confidence: 99%

Position of the Hyoid Bone and Dimension of Nasopharynx and Oropharynx after Occlusal Splint Therapy and Physiotherapy in Patients Diagnosed with Temporomandibular Disorders

Derwich¹,

Pawłowska

2022

JCM

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Background: The aim of the study was to assess the position of the hyoid bone, as well as the width of the nasopharynx and oropharynx after occlusal splint therapy combined with physiotherapy in patients diagnosed with temporomandibular disorders (TMD). Methods: This was a clinical trial study. The study group consisted of 40 patients diagnosed with TMD, who were qualified for the treatment combining physiotherapy and occlusal splint therapy. Hyoid bone position as well as the width of the nasopharynx and oropharynx were assessed in lateral cephalograms taken before and after the end of the treatment. There were 15 generally healthy participants included into the control group, who had taken lateral cephalograms twice within the period of 1 to 2 years and did not receive any occlusal treatment in the meantime. Results: The position of the hyoid bone was significantly lowered and the dimension of the lower part of the oropharynx was significantly decreased after the end of the long-term occlusal splint therapy combined with physiotherapy in patients diagnosed with TMD. Conclusions: Long-term occlusal splint therapy combined with physiotherapy affected the position of the hyoid bone and the dimension of the lower part of the oropharynx.

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“…[ 32 , 33 ]. Therefore, the effects of administration of various substances into TMJs cavities are being investigated [ 27 , 32 , 33 , 34 , 35 , 36 , 37 ]. The most frequently reported results are from the use of hyaluronan, corticosteroids, blood products, analgesics, and dextrose [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the effects of administration of various substances into TMJs cavities are being investigated [ 27 , 32 , 33 , 34 , 35 , 36 , 37 ]. The most frequently reported results are from the use of hyaluronan, corticosteroids, blood products, analgesics, and dextrose [ 35 ]. The supplementation of hyaluronic acid reduces the friction between the articular surfaces, which limits degenerative changes and alleviates pain [ 26 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

Autologous Stem Cells Transplants in the Treatment of Temporomandibular Joints Disorders: A Systematic Review and Meta-Analysis of Clinical Trials

Chęciński¹,

Chęcińska

Turosz³

et al. 2022

Cells

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This systematic review aims to analyze the outcomes of the treatment of temporomandibular joint (TMJ) articular pain (AP) and restricted maximum mouth opening (MMO) with intra-articular administration of mesenchymal stem cells (MSCs). The inclusion criteria allowed primary studies involving AP and/or MMO pre-treatment and post-intervention values. Medical databases that were covered by ACM Digital, BASE, EBSCOhost, Google Scholar, PubMed, Scopus, and Web of Science engines were searched. The risk of bias was assessed with RoB 2 and ROBINS-I tools. The results were tabulated, plotted, and analyzed for regression. A total of 5 studies involving 51 patients/69 TMJs were identified, and 4 studies on 50 patients/67 TMJs were synthesized. Interventions were each time effective in decreasing AP and increasing MMO in a 6-month follow-up period by an average of about 85% and over 40%, respectively. Regression analysis showed a good fit of the logarithmic model for AP relief (5.8 − 0.8 ln x; R2 = 0.90) and MMO increase (33.5 + 2.4 ln x; R2 = 0.89). The results for AP and MMO were based on 3 studies in 39 patients and 4 studies in 50 patients, respectively, all at high risk of bias. The intra-articular administration of MSCs to TMJs, based on weak evidence, may be highly effective in reducing AP and improving MMO. This study received no funding.

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Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Cited by 22 publications

References 103 publications

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

Position of the Hyoid Bone and Dimension of Nasopharynx and Oropharynx after Occlusal Splint Therapy and Physiotherapy in Patients Diagnosed with Temporomandibular Disorders

Autologous Stem Cells Transplants in the Treatment of Temporomandibular Joints Disorders: A Systematic Review and Meta-Analysis of Clinical Trials

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