Comparison of Efficacy between Corticosteroid and Platelet Rich Plasma Injection (Intraarticular) Therapies in Patients with Temporomandibular Joint Disorders under the Guidance of Ultrasonography
Dr. Nimish Agarwal
Post Graduate¹, Reader², Prof & Head³, Senior Lecturer, Post Graduates, Assistant Professor Department of Oral & Maxillofacial Surgery, 1-4 Department of Pediatrics & Preventive Dentistry, Department of Dentistry, Teerthanker Mahaveer Dental College & Research Centre, Moradabad, (U.P.) 1-3, Shree Bankey Bihari Dental College & Research Centre, (U.P) 4-5, Assam Medical College & Hospital, Dibrugarh
ABSTRACT Aim: To compare the efficacy between corticosteroid and platelet rich plasma injection (Intraarticular) therapies in patients with temporomandibular joint disorders under the Guidance of Ultrasonography. Methods: Twenty-two patients with complaint of reduced mouth opening, joint noise, pain, jaw deviation, not responding to medicinal treatment and coming under group II/III of RDC/TMD were included. Patients were divided into 2 groups i.e. Group I patients who underwent Arthrocentesis followed by Injection of 2 ml PRP (study group) and Group II patients who underwent Arthrocentesis followed by conventional corticosteroid Injection of 2.63mg Betamethasone sodium phosphate 2ml (control group). Follow up was scheduled at 1 week, 1 month and 3 months of the procedure to assess pain, interincisal opening, movements (lateral and protrusive movements), clicking sound and presence or absence of joint tenderness on palpation. Results: Both the groups showed significant improvement in painless mouth opening, lateral movements towards unaffected side and reduction in pain complaint. The mean retrusive movements after procedure at 3 month was significantly more in Group I as compared to Group II. The distribution of clicking sounds, pain and joint tenderness after procedure at 1 week and 1 month was significantly more in Group II as compared to Group I. Conclusion: PRP therapy could be considered as an excellent alternative minimally invasive treatment modality for the management of TMD in near future.
Introduction: Temporomandibular joint (TMJ) is a compound joint, including temporal bone, mandible, numerous musculatures, articular disc and ligaments¹. Temporomandibular joint disorders (TMDs) are progressive painful conditions and can manifest as limited range of mandibular motion, deviation or deflection upon mouth opening, locking of mouth, joint tenderness and clicking or crepitus 2. According to data, TMDs are found in 40-60% of general population, are more common in females and commonly affects 20 to 40 years of age group3,4. The treatment of the TMDs is controversial, which has been divided into three categories: nonsurgical, minimally invasive and surgical. Nonsurgical methods have reported to cure 70% of TMDs, and these generally include soft food diet, behaviour modification, pharmacotherapy, physiotherapy, inter-occlusal splints and transcutaneous electrical nerve stimulation therapy5.6. Minimally invasive therapies include arthrocentesis, arthroscopic lysis and lavage and intra-articular injections of steroids, hyaluronic acid (HA) or material with regenerative properties