Cezairli Burak, Sivrikaya Efe Can, Omezli Mehmet Melih, Ayranci Ferhat, Seyhan Cezairli Neslihan
1 Department of Oral Maxillofacial Surgery, Ordu University , Ordu, Turkey .
2 Department of Orthodontics, Faculty of Dentistry, Ordu University , Ordu, Turkey .
J Altern Complement Med. 2017 Oct;23(10):771-777. doi: 10.1089/acm.2017.0068. Epub 2017 Oct 10.
Arthrocentesis and prolotherapy are nonsurgical treatments for temporomandibular joint (TMJ) diseases. This study aimed to evaluate the treatment of hypermobility, pain, and displacement of the TMJ by consecutively performing arthrocentesis and prolotherapy in the same session.
In this study, 10 adults with disc displacement and painful, hypermobile TMJ were selected. Arthrocentesis and prolotherapy were consecutively performed using a 30% dextrose solution that was simultaneously injected into five areas: posterior disc attachment, superior joint space, superior and inferior capsular attachments, and stylomandibular ligament. Paired t-test, McNemar test, and chi-square test were used to assess the maximum mouth opening, clicking sounds, pain, and subluxation of the TMJ. Patients with rheumatoid arthritis and parafunctional habits such as teeth clenching and grinding and biting of the cheeks or any other objects and those who had undergone surgery were excluded from this study.
A total of 10 participants (36.20 ± 7.06 years old, 7 women and 3 men) received a single treatment session of combined arthrocentesis and prolotherapy at the same office visit. Subluxation frequency and pain significantly decreased after the first week of treatment (p < 0.05). Subluxation also decreased at the 3-month follow-up (p < 0.05). Clicking sound values did not significantly change at any of the follow-up time points. Maximum mouth opening values decreased at all follow-up time points compared to baseline (p < 0.05).
A single session of combined arthrocentesis and prolotherapy to treat symptomatic TMJ safely and significantly improved the subluxation and pain after 1 week and subluxation after 3 months compared to baseline status. The maximum mouth opening significantly decreased at all follow-up time points. Future studies assessing multiple treatment sessions are warranted.
关节穿刺术和注射疗法是非手术治疗颞下颌关节（TMJ）疾病的方法。本研究旨在评估在同一会诊中连续进行关节穿刺术和注射疗法对TMJ活动过度、疼痛和移位的治疗效果。
本研究选取了10例患有盘状移位且TMJ疼痛、活动过度的成年人。使用30%葡萄糖溶液连续进行关节穿刺术和注射疗法，该溶液同时注射到五个区域：盘后附着、上关节腔、上下关节囊附着以及茎突下颌韧带。采用配对t检验、McNemar检验和卡方检验来评估TMJ的最大开口度、弹响、疼痛和半脱位情况。排除患有类风湿性关节炎、有磨牙症和紧咬牙等副功能习惯（如紧咬脸颊或其他物体）以及曾接受过手术的患者。
共有10名参与者（年龄36.20±7.06岁，7名女性和3名男性）在同一次门诊接受了单次关节穿刺术和注射疗法联合治疗。治疗第一周后，半脱位频率和疼痛显著降低（p<0.05）。在3个月随访时半脱位情况也有所改善（p<0.05）。在任何随访时间点，弹响值均无显著变化。与基线相比，所有随访时间点的最大开口度值均降低（p<0.05）。
单次关节穿刺术和注射疗法联合治疗有症状的TMJ，与基线状态相比，在1周后能安全且显著改善半脱位和疼痛情况，3个月后能改善半脱位情况。所有随访时间点的最大开口度均显著降低。有必要开展评估多次治疗的未来研究。
