Bilateral platelet rich plasma injections with assisted techniques for temporomandibular joint disorders

Abstract

Objectives. Temporomandibular joint (TMJ) disorders are frequently encountered in the population. Pain is the most common complaint. TMJ luxation needs surgical treatment which has many risks. The objective of this study was to treat TMJ disorders with a minimal invasive method, platelet rich plasma (PRP) injection, instead of surgery. Methods. The study included 7 female patients aged 15 to 42 years. Three ml (2 ml into the joint capsule and 1 ml into the pericapsular region) injections were applied in both sides. Two sessions of injections were planned. Three months after the last injection, a questionnaire was carried out. Results. Six of the subjects underwent two injections, and one of them underwent only one injection. Verbal analogue scale score was 7.66±1.3 before the injections, 5.33±2 after the first injection, and 3.33±1.2 after the second injection. Pain decreased significantly after the first and more significantly after the second injection (p=0.017 and p<0.001, respectively). The mean total satisfaction rate was two at the first step (p>0.05) and four at the second step (p=0.017). Conclusions. Findings of our study indicate that PRP may be a useful technique for treatment of TMJ subluxations. The significant reduction in pain after either one or two injections suggests that it might be reasonable to investigate the efficacy and safety of this technique in larger study populations.

Keywords

• platelet rich plasma,temporomandibular joint dislocation; temporomandibular joint pain

References

1. Kahveci R, Simsek ME, Akın S, Ozbek S, Ozgenel GY, Gökmen ZG. Treatment of recurrent temporomandibular joint dislocation. J Maxillofac Oral Surg. 2013 Dec;12(4):379-81.
2. Bayoumi AM, Al-Sebaei MO, Mohamed KM, Al-Yamani AO, Makrami AM. Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation. Int J Oral Maxillofac Surg. 2014 Oct;43(10):1224-8.
3. Candirli C, Korkmaz YT, Yuce S, Dayisoylu EH, Taskesen F. The effect of chronic temporomandibular joint dislocation: frequency on the success of autologous blood injection. J Maxillofac Oral Surg. 2013 Dec;12(4):414-7.
4. Pihut M, Szuta M, Ferendiuk E, Zeńczak-Wieckiewicz 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.
5. Cerza F, Carnı 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 Dec;40(12):2822-7.
6. Albanese A, Licata ME, Polizzi B, Campisi G. Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration. Immun Ageing. 2013 Jun;10(1): 23.
7. Bava ED, Barber FA. Platelet-rich plasma products in sports medicine. Phys Sportsmed. 2011 Dec;39(3):94-9.
8. McCarrel TM, Mall NA, Lee AS, Cole BJ, Butty DC, Fortier LA. Considerations for the use of platelet-rich plasma in orthopedics. Sports Med. 2014 Aug;44(8):1025-36.

9. Chomicki-Bindas P, Zakrzewski P, Pomianowski S. Platelet concentrates, as new and promising agent in the orthopedic surgery—an introduction. Postepy Nauk Medycznych. 2010;23(2):153-57.
10. Cavallo C, Filardo G, Mariani E, Kon E, Marcacci M, Pereira Ruiz MT, et al. Comparison of platelet-rich plasma formulations for cartilage healing: an in vitro study. J Bone Joint Surg Am. 2014 Mar;96(5):423-29.
11. Paoloni J, De Vos RJ, Hamilton B, Murrell GAC, Orchard J. Platelet-rich plasma treatment for ligament and tendon injuries. Clin J Sport Med. 2011 Jan;21(1):37-45.
12. Pelletier MH, Malhotra A, Brighton T, Walsh WR, Lindeman R. Platelet function and constituents of platelet rich plasma. Int J Sports Med. 2013 Jab;34(1):74-80.
13. Schulz S. Evaluation of periarticular autotransfusion for therapy of recurrent dislocations of the temporomandibular joint. Dtsch Stomatol. 1973 Feb;23(2):94-8.
14. Daif ET. Autologous blood injection as a new treatment modality for chronic recurrent temporomandibular joint dislocation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):31-6.
15. Machon V, Abramowicz S, Paska J, Dolwick MF. Autologous blood injection for the treatment of chronic recurrent temporomandibular joint dislocation. J Oral Maxillofac Surg. 2009 Jan;67(1):114-9.
16. Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med. 2011 Jun 15;7:10.
17. Candirli C, Yuce S, Yildirim S, Sert H. Histopathologic evaluation of autologous blood injection to the temporomandibular joint. J Craniofac Surg. 2011 Nov;22(6):2202-4.
18. Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E. Platelets and wound healing. Front Biosci. 2008 May 1;13:3532-48.