Saramantos Antonios, Kyrgidis Athanassios, Venetis Gregorios, Hatziantoniou Georgios, Chrysostomidis Anestis, Sardeli Chrysanthi, Tilaveridis Ioannis
Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, Specialized Cancer Treatment and Reconstruction Center, General Hospital of Thessaloniki "George Papanikolaou", 57010 Thessaloniki, Greece.
Laboratory of Oral & Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Clin Pract. 2025 Feb 27;15(3):51. doi: 10.3390/clinpract15030051.
Temporomandibular disorders (TMDs) encompass a group of conditions characterized by anatomical, histological, and/or functional abnormalities that affect the muscular and/or articular components of the temporomandibular joint. Prolotherapy is an injectable treatment modality for chronic musculoskeletal pain that involves dextrose solution administration in the joint. To summarize, the aims involve considering the existing quality of clinical evidence on the efficacy of prolotherapy versus placebo and other active comparators, such as autologous blood products or botulinum toxin, in improving the outcomes of TMDs. A literature search in MEDLINE, Scopus, and Cochrane databases was performed, following the PRISMA statement guidelines, to identify randomized controlled trials (RCTs) of patients with TMDs receiving prolotherapy. The maximal incisor opening (MIO), visual analogue score (VAS) for pain, and frequency of dislocations were analyzed as the outcomes. The weighted mean difference was used to pool outcomes. The risk of bias was recorded for the included studies. Six studies comparing prolotherapy to placebo were identified. Prolotherapy is uniformly more efficient in reducing the VAS for pain when compared to the placebo (mean difference = 1.20, 95%CI: 0.56-1.84, < 0.001). Perceived jaw mobility was improved among prolotherapy patients, (mean difference = 0.47, 95%CI: 0.05-0.90, = 0.003) when compared to the placebo. A beneficial effect for prolotherapy with regard to MIO (mean difference = 0.84, 95%CI: -2.12-3.80, = 0.58) was not confirmed. Prolotherapy appears to be more efficient than autologous blood products in reducing VAS for pain (mean difference = 0.49, 95%CI: 0.11-0.87, = 0.01). Prolotherapy was found to be more effective in reducing pain, MIO, and clicking when compared to an occlusal splint in a single study. Prolotherapy is also a promising modality for TMDs, despite the limited number of randomized clinical trials. Existing evidence supports its use to reduce TMD-related pain, even against other modalities. Further research is needed to better describe the benefit of prolotherapy for other outcomes.
颞下颌关节紊乱病（TMDs）是一组以解剖学、组织学和/或功能异常为特征的疾病，这些异常会影响颞下颌关节的肌肉和/或关节组成部分。注射疗法是一种用于治疗慢性肌肉骨骼疼痛的注射治疗方式，涉及在关节内注射葡萄糖溶液。总之，目的是考虑现有关于注射疗法与安慰剂及其他活性对照物（如自体血制品或肉毒杆菌毒素）在改善TMDs治疗效果方面疗效的临床证据质量。按照PRISMA声明指南，在MEDLINE、Scopus和Cochrane数据库中进行文献检索，以确定接受注射疗法的TMDs患者的随机对照试验（RCTs）。将最大切牙开口度（MIO）、疼痛视觉模拟评分（VAS）和脱位频率作为分析结果。采用加权平均差来汇总结果。记录纳入研究的偏倚风险。确定了六项比较注射疗法与安慰剂的研究。与安慰剂相比，注射疗法在降低疼痛VAS方面始终更有效（平均差 = 1.20，95%CI：0.56 - 1.84，P < 0.001）。与安慰剂相比，注射疗法患者的下颌可动度感觉有所改善（平均差 = 0.47，95%CI：0.05 - 0.90，P = 0.003）。未证实注射疗法对MIO有有益作用（平均差 = 0.84，95%CI： - 2.12 - 3.80，P = 0.58）。在减轻疼痛VAS方面，注射疗法似乎比自体血制品更有效（平均差 = 0.49，95%CI：0.11 - 0.87，P = 0.01）。在一项单一研究中发现，与咬合板相比，注射疗法在减轻疼痛、MIO和弹响方面更有效。尽管随机临床试验数量有限，但注射疗法对TMDs也是一种有前景的治疗方式。现有证据支持其用于减轻与TMD相关的疼痛，甚至优于其他治疗方式。需要进一步研究以更好地描述注射疗法对其他结局的益处。
