Park Jun-Sang, Ku Jeong-Kui, Kim Young-Kyun, Yun Pil-Young
Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
J Korean Assoc Oral Maxillofac Surg. 2024 Oct 31;50(5):259-264. doi: 10.5125/jkaoms.2024.50.5.259.
Dextrose prolotherapy is one of the most promising minimally invasive interventions for temporomandibular disorder (TMD), particularly in refractory cases where other conservative treatments have failed. The purpose of this study was to demonstrate the efficacy of a new treatment, temporomandibular joint (TMJ) prolotherapy, in patients with TMD to alleviate symptoms.
A retrospective analysis was conducted on TMD patients with chronic pain who did not respond to conventional treatments. TMJ prolotherapy was performed using hypertonic dextrose in the TMJ area, targeting the retrodiscal attachment tissue, anterior disc attachment tissue, lateral capsule, origin of the masseter muscle, and the stylomandibular ligament. Pain or discomfort intensity in the TMJ was evaluated using a numerical rating scale (NRS). Maximum mouth opening and subjective satisfaction were also analyzed.
Nineteen patients (6 males, 13 females, average age 43 years) participated in this study. All patients experienced pain improvement with a maximum of three prolotherapy sessions. The initial mean NRS was 5.7, which ultimately decreased to a final mean TMJ discomfort score of 1.7 postintervention. The patients' maximum mouth opening increased from an initial 34.5 mm to 38.8 mm, and they reported positive satisfaction with the prolotherapy treatment. The clinical outcomes were positive regardless of main origin of TMD symptoms.
Hypertonic TMJ prolotherapy is an effective minimally invasive intervention for TMJ disorders with chronic pain.
葡萄糖注射疗法是治疗颞下颌关节紊乱病（TMD）最有前景的微创干预措施之一，尤其适用于其他保守治疗无效的难治性病例。本研究的目的是证明一种新的治疗方法——颞下颌关节（TMJ）注射疗法对TMD患者缓解症状的疗效。
对常规治疗无效的慢性疼痛TMD患者进行回顾性分析。在TMJ区域使用高渗葡萄糖进行TMJ注射疗法，靶点为盘后附着组织、盘前附着组织、外侧关节囊、咬肌起点和茎突下颌韧带。使用数字评分量表（NRS）评估TMJ的疼痛或不适强度。还分析了最大开口度和主观满意度。
19名患者（6名男性，13名女性，平均年龄43岁）参与了本研究。所有患者在最多三次注射疗法治疗后疼痛均有改善。初始平均NRS为5.7，干预后最终平均TMJ不适评分降至1.7。患者的最大开口度从初始的34.5毫米增加到38.8毫米，他们对注射疗法治疗表示满意。无论TMD症状的主要来源如何，临床结果均为阳性。
高渗TMJ注射疗法是治疗伴有慢性疼痛的TMJ疾病的一种有效的微创干预措施。
