Comparative study between Sodium hyaluronic acid and dextrose prolotherapy in management of Temporo-mandibular joint internal derangement.

Abstract

Introduction: Internal derangements of TMJ were nonsurgical treated in initial stages with medications, physiotherapy and occlusal splints. Intra articular injection of corticosteroids alone or after arthrocentesis provides long-term palliative effects on clinical signs and subjective symptoms of TMJ pain. Aim: The study was done to compare between hyaluronic acid and dextrose prolotherapy in management of temporomandibular joint internal derangement. Patients and methods: The present study included 30 adult patients suffering from internal derangement of Temporo-mandibular joint were selected from outpatient clinic, oral and maxillofacial surgery department in faculty of dentistry, Suez Canal University as well as October 6 university. Group I: Composed of 15 patients (10 females, 5 males) where hyaluronic acid was injected intra-articular. Group II: Composed of 15 patients (9 females, 6 males) where dextrose prolotherapy was injected (4 times) at 2 weeks, 4 weeks and 6 weeks intervals over a total of 12 weeks. Results: No difference between Group I and II; both showed the highest mean MIO values. Group I and Group II; both showed lower mean of VAS scores after 12 months compared to pre-operative measurement. After 6 months, Group II showed the highest prevalence of deviation followed by Group I. Conclusion: Sodium hyaluronic acid and Prolotherapy is a successful technique to improve maximum inter-incisal opening as well as assisted interincisal opening and improved higher significant changes in pain intensity.