The effectiveness of prolotherapy in patients with painful temporomandibular subluxation; randomized controlled trials

Objective: To investigate the effectiveness of dextrose prolotherapy on pain, maximum mouth opening (MMO) and quality of life in patients, who have temporomandibular dysfunction (TMD) with painful temporomandibular subluxation. Patients and Methods: 60 patients with a history of painful subluxation and temporomandibular hypermobility were included in our prospective, randomized and controlled study. Patients were randomized into two groups. Prolotherapy was injected to the prolotherapy group (PG, n = 30) while sham injection was applied to the control group (KG, n = 29). Home exercise program and patient education were given to both groups. Patients were evaluated with range of motion, severity of jaw pain during rest and activity, pressure pain threshold (PPT), daily life activity visual analogue scale, measuring quality of life and oral health impact scale short form (OHIP-14) scores. The evaluations were made before the treatment, at the 1st and 3rd months after the treatment. Statistical tests were conducted at the 0.05 significance level for all outcome measures. Results: Prolotherapy treatment was found to be effective in reducing the maximum mouth opening (MMO) (57.4mm ± 2.5mm vs. 54.6mm ± 3.4mm), reducing resting and activity jaw pain, also improving the effects of daily living activities compared to placebo treatment at he 3 month follow up (p <0.05). This clinical improvement was not observed in the 1 month follow-up. There was no significant difference between PG and CG groups in the lateral joint motion, proturusion measurement, PPT measurement and OHIP-14 scores. Conclusion: In our study, prolotherapy has been shown to be effective in patients who have TMD with painful temporomandibular subluxation. Prolotherapy decreases the pain symptoms and positively affects the quality of life by restricting MMO and preventing hypermobility. It seems reasonable to addition of dextrose prolotherapy to treatment in patients with resistant to conservative treatment.