The effect of dextrose concentration on the outcome of prolotherapy for the treatment of temporomandibular joint hypermobility / Dina Mohamed Mohamed ; Supervised Hamida Refai Hassanein , Ragab Radwan Elbeialy

Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Oral and Maxillofacial Surgery

Prolotherapy, the rehabilitation of ligaments or tendons by induced proliferation of cells using dextrose, is being practiced with increasing popularity for the treatment of TMJ dislocation. However, the role of the used proliferant concentration on the clinical outcome of prolotherapy has not yet identified. Therefore, it was the purpose of this work to assess the effects of different concentrations of non-inflammatory dextrose on the clinical outcome of TMJ prolotherapy in a randomized, prospective double- blind study. Sixteen patients with a diagnosis of TMJ subluxation were included in this study. Their ages ranged from 18 - 43 years, with an average of 29 years. They were one male and 15 female. After accepting to be enrolled in the present study, each patient was randomly assigned into 1 of 2 equal groups. This group assignment was kept blinded to the supervisors and research candidate. Group A: The injected solution consisted of 2ml of 5% dextrose and 1ml of 2% mepivacaine. Group B: The injected solution consisted of 2ml of 10% dextrose and 1ml of 2% mepivacaine. All patients were examined clinically at each injection appointments before injection procedure and three months after the last injection appointment. The outcome measures included pain intensity as expressed by the numerical rating scale, maximal mouth opening, frequency of luxation and joint clicking sound. At the end of the study, pain on rest and function scores, MMO, and the prevalence of clicking were significantly decreased in both groups. TMJ locking were not observed in 10% dextrose group at the end of the study and significantly decreased in 5% dextrose group after the 1st injection. Comparison between the two groups in the present study revealed insignificant statistical difference in all the evaluated parameters by the end of the study. However, the 5% dextrose group showed initial beneficial effect in the term of significant lower means in pain score on function at the 2nd and 3rd visits and frequency of luxations at the 4th visit compared to 10% dextrose group. While at the 4th visit, 10% dextrose group showed lower means in pain score on function and in MMO compared to 5% dextrose group. Conclusions: The results of this study show that even isotonic dextrose prolotherapy is effective in rehabilitating subluxated TMJ

Issued also as CD