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关节穿刺术后富血小板血浆与透明质酸治疗颞下颌关节盘紊乱的疗效:一项随机对照试验

Efficacy of Platelet-Rich Plasma Versus Hyaluronic Acid Following Arthrocentesis for Temporomandibular Joint Disc Disorders: A Randomized Controlled Trial.

作者信息

Jacob Shiju Mathew, Bandyopadhyay Tapas Kumar, Chattopadhyay Prabodh Kumar, Parihar Vinay Singh

机构信息

Department of Oral and Maxillofacial Surgery, Army Dental Center (Research & Referral), C/O Army Hospital (Research & Referral), Delhi Cantt, New Delhi, India.

Present Address: Department of Oral and Maxillofacial Surgery, Military Dental Center, Meerut, 250001 India.

出版信息

J Maxillofac Oral Surg. 2022 Dec;21(4):1199-1204. doi: 10.1007/s12663-021-01519-y. Epub 2021 Feb 8.

DOI:10.1007/s12663-021-01519-y
PMID:36896087
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9989114/
Abstract

PURPOSE

Injection of intra-articular medicaments is an accepted therapy for temporomandibular joint disorders (TMDs). This study compares the efficacy of arthrocentesis followed by platelet-rich plasma (PRP) as compared to hyaluronic acid (HA) injections for TMDs unresponsive to conservative therapy. PRP injection following arthrocentesis was hypothesized to be better compared to arthrocentesis alone or when combined with HA injection.

METHODS

Forty-seven patients with TMDs enrolled in an RCT were randomly assigned to three groups: Group A-PRP, Group B-HA or Group C-control group of arthrocentesis alone. Pre-operative evaluation and post-operative changes at 1-, 3-, 6-month intervals were assessed for improvement in pain, maximum mouth opening, joint sounds and excursive movements. Statistical significance was set at value < 0.05.

RESULTS

Post-operative joint sounds were present in three out of 16 patients in Group A; six out of 15 patients in Group B and eight out of 16 patients in Group C at 6-month follow-up. For the remaining outcome variables, no statistical difference between groups was observed.

CONCLUSION

Both medicaments produced significant clinical improvements when compared to the control group. When comparing PRP against HA, none showed superiority over the other.: CTRI/2019/01/017076.

摘要

目的

关节腔内注射药物是治疗颞下颌关节紊乱病(TMDs)的一种公认疗法。本研究比较了关节穿刺后注射富血小板血浆(PRP)与注射透明质酸(HA)治疗对保守治疗无反应的TMDs的疗效。假设关节穿刺后注射PRP比单纯关节穿刺或与HA联合注射效果更好。

方法

47例TMDs患者纳入一项随机对照试验,随机分为三组:A组-PRP组,B组-HA组,C组-单纯关节穿刺对照组。在术前评估以及术后1个月、3个月、6个月时评估疼痛、最大开口度、关节弹响和动度的改善情况。设定统计学显著性水平为P值<0.05。

结果

在6个月随访时,A组16例患者中有3例存在术后关节弹响;B组15例患者中有6例,C组16例患者中有8例。对于其余结局变量,各组之间未观察到统计学差异。

结论

与对照组相比,两种药物均产生了显著的临床改善。当比较PRP与HA时,两者均未显示出优于对方。试验注册号:CTRI/2019/01/017076。

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本文引用的文献

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Is arthrocentesis plus platelet-rich plasma superior to arthrocentesis plus hyaluronic acid for the treatment of temporomandibular joint osteoarthritis: a randomized clinical trial.关节穿刺术联合富血小板血浆治疗颞下颌关节骨关节炎是否优于关节穿刺术联合透明质酸:一项随机临床试验
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Intra-articular platelet-rich plasma injection for the treatment of temporomandibular disorders and a comparison with arthrocentesis.关节腔内注射富血小板血浆治疗颞下颌关节紊乱病及其与关节腔穿刺术的比较
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Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†.颞下颌关节紊乱病(DC/TMD)的诊断标准(临床与研究用):国际 RDC/TMD 联合会*和口腔颌面痛特别兴趣小组†的推荐标准。
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Int J Oral Maxillofac Surg. 2009 Aug;38(8):827-34. doi: 10.1016/j.ijom.2009.03.715. Epub 2009 Apr 29.
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Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation.缓冲富血小板血浆可增强间充质干细胞的增殖和软骨形成分化。
Tissue Eng Part C Methods. 2009 Sep;15(3):431-5. doi: 10.1089/ten.tec.2008.0534.
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Magnetic resonance imaging in the diagnosis of intra-articular adhesions of the temporomandibular joint.磁共振成像在颞下颌关节关节内粘连诊断中的应用
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Effectiveness of autologous preparation rich in growth factors for the treatment of chronic cutaneous ulcers.富含生长因子的自体制剂治疗慢性皮肤溃疡的有效性。
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Evaluation of internal derangement of the temporomandibular joint by panoramic radiographs compared with magnetic resonance imaging.全景X线片与磁共振成像对颞下颌关节内紊乱的评估比较
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Platelet-rich plasma: evidence to support its use.富血小板血浆:支持其应用的证据。
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