OSTEOARTRİTİK EKLEMLERDE HİPERTONİK DEKSTROZ PROLOTERAPİNİN KLİNİK ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Year 2017, , 161 - 166, 03.12.2017

Songül Cömert Kılıç

https://doi.org/10.17567/ataunidfd.381335

Abstract

Amaç: Bu çalışmada temporomandibular eklem (TME)
osteoartriti ve TME hipermobilitesi olan erişkin hastalarda dekstroz
proloterapinin uzun dönemde klinik etkinliği değerlendirilmiştir.

Gereç ve Yöntem: Bu çalışma, hem
klinik inceleme ile hem de konik ışınlı bilgisayarlı tomografi (CBCT) ile
teşhis edilen, 14 dejeneratif ve hipermobil ekleme sahip 11 erişkin hasta
üzerinde yürütülmüştür. 2 ml %30’luk dekstroz, 2 ml salin ve 1 ml % 2’lik
artikain veya mepivakain karışımlarından oluşan 1 ml dekstroz enjeksiyonları
aylık olarak toplamda 3 seans olarak üst eklem boşluğu, üst ve alt kapsüler
ligament, posterior disk ligamenti ve stylomandibular ligament olmak üzere 5
ayrı alana enjekte edildi. Sonuç değişkenlerini görsel analog skala (VAS)
değerlendirmeleri ve maksimum interinsizal açıklık (MIA) değerleri
oluşturmaktadır. Klinik değerlendirmeler, tedavi başlangıcında (T0), son
enjeksiyon tedavisinden hemen sonra (T1) ve 12 ay sonra (T2) kaydedildi.

Bulgular: Eklem sesi, MIA ve ağrı şikayetleri
tedavi- den hemen sonra önemli ölçüde azalmıştır. MIA değer- leri, tedavi
sonrası 12 aylık takip periyodunda başlangıç değerlerine geri dönmüştür.
Çiğneme etkinliğinde tedavi sonrasında ve takip periyodu süresince
istatistiksel olarak anlamlı bir fark görülmemiştir.

Sonuç: Bu çalışma bulguları, TME osteoartriti
ve TME hipermobilitesine sahip semptomatik hastalarda, tekrarlayan dekstroz
proloterapi enjeksiyonlarının eklem sesi ve ağrı şikâyetlerinde önemli klinik
iyileşmeler sağlayabildiğini göstermiştir.

Anahtar Kelimeler: Dekstroz proloterapi,
TME hipermobilitesi, TME Osteoartriti

AN ASSESSMENT OF CLINICAL EFFICACY OF HYPERTONIC
DEXTROSE PROLOTHERAPY ON OSTEOARTHRITIC TEMPOROMANDIBULAR JOINTS

ABSTRACT

Aim: In this study,
long-term clinical efficacy of hypertonic dextrose prolotherapy was assessed on
patients with both temporomandibular joint osteoarthritis and hypermobility.

Material and
Method: This study was carried out on 11 adult patients, whom
had 14 temporomandibular joint with both osteoarthritis and hypermobility
diagnosed with clinical examination and CBCT evaluations. Participants received
1- ml injections of dextrose solution in each of the five injection areas at
three sessions, each a month apart; this solution consisted of 2 ml 30%
dextrose, 2 ml saline, and 1 ml 2% articaine or mepivacaine. The prepared
solutions were injected into five areas according to the treatment protocol, in
the following order: posterior disk attachment, superior joint space, superior
and inferior capsular attachments, and stylo-mandibular ligament. The outcome
variables were visual analogue scale (VAS) evaluations and maximum
inter-incisal opening (MIO). Outcome variables were recorded preoperatively,
immediately after injection and at 12 months postoperatively.

Results: MIO, general pain complaints and joint sounds decreased significantly in
after injections, but MIO returned to baseline values after 12 months
postoperatively. Masticatory efficiency showed insignificant changes after
injection and during 12 months follow-up period.

Conclusion: Findings of the present study suggest that repeating dextrose
prolotherapy may provide improvements on general pain complaints and joint
sounds of the patients had both temporomandibular joint osteoarthritis and
hypermobility

Key Words: Dextrose prolotherapy, TME hypermobility, TME Osteoarthritis

Keywords

Dekstroz proloterapi, TME hipermobilitesi

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