Evaluation of pain regression in patients with temporomandibular dysfunction treated by intra-articular platelet-rich plasma injections: a preliminary report

M Pihut, M Szuta, E Ferendiuk, D Zeńczak-Więckiewicz, M Pihut, M Szuta, E Ferendiuk, D Zeńczak-Więckiewicz

Abstract

Objective: The objective of this study was to evaluate the regression of temporomandibular pain as a result of intra-articular injections of platelet-rich plasma (PRP) to patients with temporomandibular joint dysfunction previously subjected to prosthetic treatment.

Materials and methods: The baseline study material consisted of 10 patients, both males and females, aged 28 to 53 years, previously treated due to painful temporomandibular joint dysfunction using occlusal splints. All patients were carried out to a specialist functional assessment of the dysfunction using the Polish version of the RDC/TMD questionnaire axis I and II. Intra-articular injections were preceded by a preparation of PRP. The injection sites were determined by the method used during arthroscopic surgical procedures. Following aspiration, 0.5 mL of plasma was injected into each temporomandibular joint.

Results: The comparison of the intensity of pain during all examinations suggests a beneficial effect of the procedure being performed as the mean VAS score was 6.5 at examination I, 2.8 at examination II, and 0.6 at examination III.

Conclusion: Application of the intra-articular injections of platelet-rich plasma into the temporomandibular joints has a positive impact on the reduction of the intensity of pain experienced by patients treated for temporomandibular joint dysfunction.

Figures

Figure 1
Figure 1
Disposable closed set for blood collection.
Figure 2
Figure 2
Scheme of place for intra-articular injection.
Figure 3
Figure 3
Values of pain scoring in the subsequent studies presented graphically.
Figure 4
Figure 4
Average values of pain scoring in the subsequent studies in the statistical calculation, presented graphically.

References

    1. Okeson J. Management of Temporomandibular Disorders and Occlusion. 7th edition. San Diego, Calif, USA: Elsevier; 2013.
    1. Pihut M, Gierowski J, Palusiński Ł. Depresion diagnosis in the group of patient treated prosthodontically due to temporomandibular joint dysfunction. E-Dentico. 2013;5(45):70–75.
    1. Grey R, Davies S, Quayle A. The clinical guide to temporomandibular disorders. The clinical guide series. British Dental Journal. 2003:23–60.
    1. Pihut M, Majewski P, Wisniewska G, Reron E. Auriculo-vestibular symptoms related to structural and functional disorders of stomatognatic system. Journal of Physiology and Pharmacology. 2011;62(2):251–256.
    1. Pihut M. The Effectiveness of Prosthetic and Pharmacological Masseter Muscle Relaxation as Alternative Treatment for Temporomandibular Joint Dysfunction. Krakow, Poland: Monograph; 2012.
    1. Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dental Clinics of North America. 2013;57(3):465–2004.
    1. Wiȩckiewicz M, Paradowska A, Kawala B, Wiȩckiewicz W. SAPHO syndrome as a possible cause of masticatory system anomalies—a review of the literature. Advances in Clinical and Experimental Medicine. 2011;20(4):521–525.
    1. Pihut M, Wiśniewska G, Majewski S. Active repositioning of temporomandibular disc displacement without reduction. Journal of Stomatology. 2013;66(5):650–662.
    1. Branco L, Santis T, Alfaya T, Goday C, Fraqoso Y, Bussadori S. Association between headache and temporomandibular joint disorders in children and addolscennts. Journal of Oral Science. 2013;55(1):39–43.
    1. Manfredini D, Marini M, Pavan C, Pavan L, Guarda-Nardini L. Psychosocial profiles of painful TMD patients. Journal of Oral Rehabilitation. 2009;36(3):193–198.
    1. Lewandowski L. The management of some temporomandibular joints diseases with intra-articular administration of medicines. Polish Journal of Stomatology. 2006;59(4):266–271.
    1. Cerza F, Carnì S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. The American Journal of Sports Medicine. 2012;40(12):2822–2827.
    1. Albanese A, Licata ME, Polizzi B, Campisi G. Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration. Immunity and Ageing. 2013;10(1, article 23)
    1. Bava ED, Barber FA. Platelet-rich plasma products in sports medicine. The Physician and Sportsmedicine. 2011;39(3):94–99.
    1. McCarrel TM, Mall NA, Lee AS, Cole BJ, Butty DC, Fortier LA. Considerations for the use of platelet-rich plasma in orthopedics. Sports Medicine. 2014
    1. Chomicki-Bindas P, Zakrzewski P, Pomianowski S. Platelet concentrates, as new and promising agent in the orthopedic surgery—an introduction. Progres of Medical Science. 2010;23(2):153–157.
    1. Cavallo C, Filardo G, Mariani E, et al. Comparison of platelet-rich plasma formulations for cartilage healing: an in vitro study. Journal of Bone and Joint Surgery American Volume. 2014;96(5):423–429.
    1. Cieślik-Bielecka A, Bielecki T, Gaździk TS, Cieślik T. Growth factors in the platelet-rich plasma as autogenic material which stimulates bone healing processes. Polish Journal of Stomatology. 2006;59(7):510–517.
    1. Bielecki TM, Gaździk TS, Arendt J, Szczepański T, Król W, Wielkoszyński T. Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances. The Bone and Joint Journal. 2007;89(3):417–420.
    1. Cenni E, Fotia C, Rustemi E, et al. Idiopathic and secondary osteonecrosis of the femoral head show different thrombophilic changes and normal or higher levels of platelet growth factors. Acta Orthopaedica. 2011;82(1):42–49.
    1. Fallouh L, Nakagawa K, Sasho T, et al. Effects of autologous platelet-rich plasma on cell viability and collagen synthesis in injured human anterior cruciate ligament. Journal of Bone and Joint Surgery. American Volume. 2010;92(18):2909–2916.
    1. Civinini R, Macera A, Nistri L, Redl B, Innocenti M. The use of autologous blood-derived growth factors in bone regeneration. Clinical Cases in Mineral and Bone Metabolism. 2011;8(1):25–31.
    1. Ohrbach R, Gonzalez Y, List T, Michelotti A, Schiffman E. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Clinical Examination Protocol.
    1. Lobbezoo F, van Selms MKA, John MT, et al. Use of the research diagnostic criteria for temporomandibular disorders for multinational research: translation efforts and reliability assessments in The Netherlands. Journal of Orofacial Pain. 2005;19(4):301–308.
    1. Cole BJ, Seroyer ST, Filardo G, Bajaj S, Fortier LA. Platelet-rich plasma: where are we now and where are we going? Sports Health. 2010;2(3):203–210.
    1. del Fabbro M, Bortolin M, Taschieri S, Weinstein R. Is platelet concentrate advantageous for the surgical treatment of periodontal diseases? A systematic review and meta-analysis. Journal of Periodontology. 2011;82(8):1100–1111.
    1. Filardo G, Kon E, Di Martino A, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskeletal Disorders. 2012;13, article 229
    1. Stopa Z, Wanyura H, Pączek L, Samolczyk-Wanyura D. The level of cytokines and proteolitic enzymes in the articular synovial fliude and blood serum of patients with temporomandibular joint disease. Polish Journal of Stomatology. 2010;67(7):429–443.
    1. Kostrzewa-Janicka J, Anulewicz A, Mierzwińska-Nastalska E. Macroscopic and microscopic morphological aspects of temporomandibular joint—an overview. Dental Prosthodontics. 2007;57(2):97–104.
    1. Di Matteo B, Filardo G, Lo Presti M, Kon E, Marcacci M. Chronic anti-platelet therapy: a contraindication for platelet-rich plasma intra-articular injections? European Review for Medical and Pharmacological Sciences. 2014;18(1):55–59.
    1. Miernik M, Wiȩckiewicz M, Paradowska A, Wiȩckiewicz W. Massage therapy in myofascial TMD pain management. Advances in Clinical and Experimental Medicine. 2012;21(5):681–685.
    1. Wiȩckiewicz W, Bieniek A, Wiȩckiewicz M, Sroczyk Ł. Interdisciplinary treatment of basal cell carcinoma located on the nose—review of literature. Advances in Clinical and Experimental Medicine. 2013;22(2):289–293.
    1. Giannotti E, Koutsikos K, Pigatto M, Rampudda ME, Doria A, Masiero S. Medium-/long-term effect of a specific exercise protocol combined with patient educatioin on spine mobility, chronic fatigue, pain, aerobioc fitness and level of disability in fibromyalgia. BioMed Research International. 2014;2014:9 pages.474029
    1. Zandifar A, Asgari F, Haghoost F, et al. Reliability and validity of the migraine disability assessment scale among migraine and tension type headache in Iranian patients. BioMed Research International. 2014;2014:7 pages.978064
    1. Ficek K, Ficek-Kiesler A. Platelet rich plasma application in a bone loss case. Medical Cases. 2013;4:175–179.
    1. Hall MP, Band PA, Meislin RT, Jazrawi LM, Cardone DA. Platelet-rich plasma: Current concepts and application in sports medicine. Journal of the American Academy of Orthopaedic Surgeons. 2009;17(10):602–608.
    1. Hamid MS, Yusof A, Ali MRM. Platelet-rich plasma ( PRP ) for acute muscle injury: a systematic review. PLoS ONE. 2014;9(2)e90538
    1. Hamilton BH, Best TM. Platelet-enriched plasma and muscle strain injuries: challenges imposed by the burden of proof. Clinical Journal of Sport Medicine. 2011;21(1):31–36.
    1. Jang S-J, Kim J-D, Cha S-S. Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. European Journal of Orthopaedic Surgery & Traumatology. 2013;23(5):573–580.
    1. Kon E, Filardo G, Di Martino A, Marcacci M. Platelet-rich plasma (PRP) to treat sports injuries: evidence to support its use. Knee Surgery, Sports Traumatology, Arthroscopy. 2011;19(4):516–527.
    1. Mei-Dan O, Lippi G, Sánchez M, Andia I, Maffulli N. Autologous platelet-rich plasma: a revolution in soft tissue sports injury management? Physician and Sportsmedicine. 2010;38(4):127–135.
    1. Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthopedic Journal. 2012;32:150–163.
    1. Nagraba Ł, Mitek T, Stolarczyk A, Deszczyński J. Tennis elbow—prospects for a new method of treatment (Platelet Rich Plasma) Artroskopia i Chirurgia Stawów. 2008;4(3):35–44.
    1. Nagraba Ł, Mitek T, Stolarczyk A, Nowak P. Efficacy of Platelet Rich Plasma (PRP) in muscle injuries. Artroskopia i Chirurgia Stawów. 2009;5(2):25–29.
    1. Nguyen RT, Borg-Stein J, McInnis K. pplications of platelet-rich plasma in musculoskeletal and sports medicine: an evidence-based approach. PM and R. 2011;3(3):226–250.
    1. Paoloni J, De Vos RJ, Hamilton B, Murrell GAC, Orchard J. Platelet-rich plasma treatment for ligament and tendon injuries. Clinical Journal of Sport Medicine. 2011;21(1):37–45.
    1. Pelletier MH, Malhotra A, Brighton T, Walsh WR, Lindeman R. Platelet function and constituents of platelet rich plasma. International Journal of Sports Medicine. 2013;34(1):74–80.
    1. Peters JE. Therapeutic musculoskeletal injection: what is current practice? What is the evidence? Minnesota Medicine. 2010;93(12):40–42.
    1. Pifer MA, Maerz T, Baker KC, Anderson K. Matrix metalloproteinase content and activity in low-platelet, low-leukocyte and high-platelet, high-leukocyte platelet rich plasma (PRP) and the biologic response to PRP by human ligament fibroblasts. The American Journal of Sports Medicine. 2014;42(5):1211–1218.
    1. Sundman EA, Cole BJ, Karas V, et al. The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. American Journal of Sports Medicine. 2014;42(1):35–41.
    1. Szypuła J, Kédziora J. The use of platelet rich plasma in treatment of chronic inflammation of bones. Polski Merkuriusz Lekarski. 2009;27(158):132–135.
    1. Tohidnezhad M, Wruck CJ, Slowik A, et al. Role of platelet-released growth factors in detoxification of reactive oxygen species in osteoblasts. Bone. 2014;65:9–17.
    1. Whitman DH, Berry RL, Green DM. Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. Journal of Oral and Maxillofacial Surgery. 1997;55(11):1294–1299.
    1. Wnuk T, Blacha J, Mazurkiewicz T, Olchowik G. Allogenic platelet's growth factors increased achilles tendon callus strength in rats. Bulletin of the Veterinary Institute in Pulawy. 2011;55(2):323–326.
    1. Wrotniak M, Bielecki T, Gaździk TS. Current opinion about using the platelet-rich gel in orthopaedics and trauma surgery. Ortopedia Traumatologia Rehabilitacja. 2007;3(6):227–238.
    1. Volpi P, Quaglia A, Schoenhuber H, et al. Growth factors in the management of sport-inducedtendinopathies: Results after 24 months from treatment. A pilot study. Journal of Sports Medicine and Physical Fitness. 2010;50(4):494–500.
    1. de Vos RJ, Weir A, van Schie HTM, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. The Journal of the American Medical Association. 2010;303(2):144–149.
    1. Daif ET. Autologous blood injection as a new treatment modality for chronic recurrent temporomandibular joint dislocation. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2010;109(1):31–36.
    1. Willits K, Kaniki N, Bryant D. The use of platelet rich plasma in orthopedic injuries. Sport Medicine and Arthroscopy Review. 2013;21(4):225–230.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir