THE CLINICAL EFFICIENCY OF PLATELET RICH PLASMA IN THE TREATMENT OF TEMPOROMANDIBULAR JOINT DISORDERS | ||||
| Alexandria Dental Journal | ||||
| Article 1, Volume 41, Issue 3, December 2016, Page 226-231 PDF (947.29 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2016.58021 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Elham F Hassan1; Tarek M Ali2; Nevien Abdulla2 | ||||
| 1Clinical Instructor in Oral & Maxillofacial surgery department, Faculty of Dentistry, Asyut University | ||||
| 2- Professor of Oral & Maxillofacial Surgery, Faculty of Dentist, Alexandria University. | ||||
| Abstract | ||||
| INTRODUCTION: Temporomandibular joint dysfunction (TMD) is a clinically significant condition which can be a source of acute or chronic orofacial pain and dysfunction including limitation of mandibular movement. Platelet-rich plasma (PRP) is a blood product that allows in a simple, low cost, and minimally invasive way to obtain a concentration of many growth factors when activated. Many researchers proved PRP safety and efficacy in the management of musculo articular disorders. OBJECTIVES: to evaluate the efficiency of intra-articular PRP injection in comparison with conventional arthrocentesis in the treatment of TMD. MATERIALS AND METHODS: Twenty patients suffering from TMD were included in the study diagnosed according to The Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD) and divided into two groups as follow; ten patients underwent intra-articular injections of 2 ml PRP into the temporomandibular joint (TMJ) (study group) and the other ten patients were treated by the conventional arthrocentesis using Ringer’s solution (control group). The patients were clinically evaluated preoperatively and postoperatively at the intervals of 1week, 3, and 6 months. RESULTS: The differences between the two groups in all the measured parameters were statistically insignificant throughout the postoperative period. But PRP group showed superior result than arthrocentesis group regarding pain and tenderness, and inferior result in clicking. CONCLUSIONS: PRP injection is a safe and effective method in the treatment of TMDs. | ||||
| Keywords | ||||
| TMJ; TMDs; PRP; Arthrocentesis | ||||
| References | ||||
|
1. Miloro M, Ghali GE, Peter EL, Peter DW. Peterson’s Principles of Oral and Maxillofacial Surgery. 2nd ed. London: BC Decker Inc Hamilton; 2004. 2. Cooper BC, Kleinberg I. Establishment of a temporomandibular physiological state with neuromuscular orthosis treatment affects reduction of TMD symptoms in 313 patients. Cranio 2008; 26: 104-17. 3. Manfredini, D, Marini M, Pavan C, Pavan L, Guarda- Nardini L. Psychosocial profiles of painful TMD patients. J Oral Rehabil 2009; 36:193-8. 4. Andersson L, Kahnberg K, Pogrel MA. Oral and Maxillofacial Surgery.UK: Wiley-Blackwell; 2011. 5. Burnouf T, Goubran HA, Chen TM, El-Ekiaby M, Radosevic. Blood-derived biomaterials and platelet growth factors in regenerative medicine. Blood Reviews 2013; 27:77-89. 6. Ferrari M, Zia S, Valbonesi M, Henriquet F, Venere G, Spagnolo S, et al. A new technique for hemodilution, preparation of autologous platelet-rich plasma and intraoperative blood salvage in cardiac surgery.Int J Artif Organs. 1987; 10: 47-50. 7. Brennan PA, Ilankovan V. Arthrocentesis for temporomandibular joint pain dysfunction syndrome. J Oral Maxillofac Surg 2006; 64: 949-51. 8. Lana J, Weglein A, Vicente E, Perez A, Rodrigues A, Luzo  et al. Platelet-rich Plasma: Regenerative Medicine: Sports Medicine, Orthopedic, and Recovery of Musculoskeletal Injuries. New York: Springer Science& Business Media; 2014. 9. AnituaE.Plasmarichingrowthfactors:Preliminaryresult of use in preparation of future sites of implants. Int J Oral Maxillofac Implants 1999; 14:529-35. 10.Cerza F, Carnì S, Carcangiu A, Di Vavo I, Schiavilla V, Pecora, A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am. J. Sports Med 2012; 40: 2822-7. 11.Akeda K, An H, Okuma M, Attawia M, Miyamoto K, Thonar E, et al. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation. Osteoarthritis and Cartilage Journal 2006; 14:1272-80. 12. Xie X, Zhang C, Tuan RS. Biology of platelet-rich plasma and its clinical application in cartilage repair and matrix biosynthesis. Arthritis Research & Therapy 2014; 16:204- 19. 13.Mazzocca AD, Mc Carthy BR, Intravia J, Beitzel K, Apostolakos J, Cote MP, et al. An in vitro evaluation of the anti-inflammatory effects of platelet-rich plasma, ketorolac, and methyl prednisolone. J Arthroscopy 2013; 29:675-83. 14. Van Osch GJ, Bernsen MR, van Buul GM, Koevoet WL, Kops N, Bos PK, Verhaar JA, et al. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes. Am J Sports Med 2011; 39:2362-70. 15. Machoň V, Řehořová M, Šedý J, Foltán R. Platelet-Rich Plasma in Temporomandibular Joint Osteoarthritis Therapy: A 3-Month Follow-Up Pilot Study. J Arthritis 2013; 2: 112. 16. Pihut M, Szuta M, Ferendiuk E, Zeńczak, Więckiewicz D. Evaluation of Pain Regression in Patients with Temporomandibular Dysfunction Treated by Intra- Articular Platelet-Rich Plasma Injections: A Preliminary Report. Biomed Res Int 2014; 2014:132369. 17. Hall, Michael P, Band P, Meislin, R, Jazrawi L, Cardone D. Platelet-rich plasma: Current concepts and application in sports medicine. JAAOS 2009; 17: 602-8. 18. Cantu R, Steffe J. Rehabilitation: for the post-surgical orthopedic patient. In Soft tissue healing considerations after surgery.3rd ed. St Louis: Mosby; 2001. 19. Lana J. F, Weglein A, Vicente E, Perez A, Rodrigues A, Luzo Â. C. et al. Platelet-rich Plasma: Regenerative Medicine: Sports Medicine, Orthopedic, and Recovery of Musculoskeletal Injuries. New York: Springer Science& Business; 2013. 20.Sharma S.M, Dhruvit T. clinical efficacy of autologous concentrate platelets in treatment of TMJ disorders- apilot study. Nitte University J of Health Science .2014; 4:70-4. 21.De Leeuw, Reny, and Gary D. Klasser. Orofacial pain: guidelines for assessment, diagnosis, and management. 4th ed. Chicago: Quintessence; 2008. 22. Tozoglu, S, Al-Belasy F A, and Dolwick M. A. review of techniques of lysis and lavage of the TMJ. Br J Oral Maxillofac Surg 2010; 3:1-8. 23.ELNager Y, Shawky N, Ragaey H, Abd El-latief G. the study of the effect of arthocentesis on muscle activiy using electromyogram. Theses for master degree in Oral & Maxillofacial Surgery. Alexandria University, 2010. 24.EL-said S, Shawky N, Ragaey H. Comparative study of arthrocentesis with or without using piroxicam in the management of temporomandibular joint disorders. Theses for master degree in Oral & Maxillofacial Surgery. Alexandria University, 2015. 25. Nitzan DW, Dolwick MF, Martinez GA. Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg 1991; 49: 1163-7. 26. Botelho A, De Arruda Veiga M. Influence of sex on temporomandibular disorder pain: a review of occurrence and development. Braz J Oral Sci 2008; 7: 1631-5. 27. Yoda T, Imai H, Shinjyo Y, Sakamoto I, Abe M, Enomoto S. Effect of arthrocentesis on TMJ disturbance of mouth closure with loud clicking: a preliminary study. J Craniomandibular Pract 2002; 20: 18-22. 28. Anitua E. Plasma rich in growth factors: Preliminary result of use in preparation of future sites of implants. Int J Oral Maxillofac Implants 1999; 14:529-35. 29.Chomicki P, Zakrzewski P, Pomianowski S, Bindas P. Platelet concentrates, as new and promising agent in the orthopedic surgery- an introduction. Progres of Medical Science 2010; 23: 153-7. 30. Ficek K, Ficek A. Platelet rich plasma application in a bone loss case. Medical Cases 2013; 4: 175-9. 31.Iwanaga T, Shikichi M, Kitamura H, Yanase H, Nozawa- Inoue K. Morphology and functional roles of synoviocytes in the joint. Arch Histol Cytol. 2000; 63:17-31. 32. Hegab AF, Ali HE, Elmasry M, Khallaf MG. Platelet-Rich Plasma Injection as an Effective Treatment for Temporomandibular Joint Osteoarthritis. J Oral Maxillofac Surg 2015; 73:1706-13. 33. Hanci M, Karamese M, Tosun Z, Aktan T, Duman S, Savaci N. Intra-articular platelet-rich plasma injection for the treatment of temporomandibular disorders and a comparison with arthrocentesis. J Craniomaxillofac Surg 2015; 43:162-6. 34.Moon S, Lee S, Ryu J. Ultrasound-guided Platelet-rich Plasma Prolotherapy for Temporomandibular Disorders. J Oral Med Pain 2014; 39: 140-5. 35. Alpaslan GH, Alpaslan C. Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in the treatment of internal derangements. J Oral Maxillofac Surg 2001; 59:613-8. 36.Simsek M. Bilateral platelet rich plasma injections with assisted techniques for temporomandibular joint disorders. Eur Res J 2016; 2: 42-5. | ||||
|
Statistics Article View: 358 PDF Download: 728 |
||||
