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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.

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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Platelet-rich plasma: evidence to support its use.富血小板血浆:支持其应用的证据。
J Oral Maxillofac Surg. 2004 Apr;62(4):489-96. doi: 10.1016/j.joms.2003.12.003.

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