Intra-articular platelet-rich plasma injection versus hydrocortisone with local anesthetic injections for temporo mandibular disorders

Jayant Prakash; Dhaniram Talukder; Krunal Desai; Tarun K Singh; Reena Bagde; Gagandeep S Randhawa; Shambhavi Jha; Kapil Paiwal

doi:10.6026/97320630018991

Intra-articular platelet-rich plasma injection versus hydrocortisone with local anesthetic injections for temporo mandibular disorders

Bioinformation. 2022 Oct 31;18(10):991-997. doi: 10.6026/97320630018991. eCollection 2022.

Authors

Jayant Prakash¹, Dhaniram Talukder², Krunal Desai³, Tarun K Singh⁴, Reena Bagde⁵, Gagandeep S Randhawa⁶, Shambhavi Jha⁷, Kapil Paiwal⁸

Affiliations

¹ Department of Dentistry, Sadar Hospital, Muzaaffarpur-842001, Bihar, India.
² Department of Prosthodontics and Crown and Bridge, DJ college of dental sciences and research, Modinagar, U.P, India.
³ NYU College of Dentistry, 345 E. 24th Street (corner of First Avenue), New York, NY 10010.
⁴ Department of Dentistry, AIIMS, Bathinda, India.
⁵ Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Deemed to be University Dental college and Hospital, Sector 7CBD Belapur, Navi Mumbai, 400614, India.
⁶ Department of Oral and Maxillofacial Surgery, Ahmedabad Dental College and Hospital, Ahmedabad, India.
⁷ New Horizon Dental College and Research Institute, Sakri, Bilaspur (C. G) 495001, India.
⁸ Department of Oral Pathology and Microbiology, Daswani Dental College & Research Center, Kota,India.

Abstract

Disorders of temporomandibular joint (TMDs) are characterised by a variety of symptoms, including discomfort in the orofacial region, muscle tenderness, restricted jaw motion and noise at the joint. Additional neurological symptoms such as headaches, vertigo, heaviness, and altered vision may also coexist with TMDs. Because prostaglandin production is a critical mediator of inflammatory reaction and is inhibited by corticosteroids, they have anti-inflammatory effects. Platelet rich plasma popularly considered as PRP is a concentration of platelets and related growth factors that may have therapeutic effects by attracting, promoting, and differentiating cells as well as redesigning tissue. 64 joints totaling 40 individuals with temporomandibular joint problems were split into two categories (Category A and Category B). PRP was applied to category A's (36 joints of 20 patients) joints, while Group B's joints received hydrocortisone combined with local anaesthetic (28 joints of 20 patients). Patients were evaluated for tenderness, , maximum inter incisal opening (MIO) and clicking sound at TMJ prior to and following treatment at intervals of one week, one month and 6 months of the first week and third month. When there was comparison of outcomes in study participants receiving injections of platelet rich plasma and study participants receiving injections of hydrocortisone with local anesthetic then it was found that although both type of study participants got reduction in pain, increased opening of mouth and reduction in clicking sound however the difference between two groups was not significant statistically. There was no statistically significant difference between injections of platelet rich plasma and hydrocortisone with local anesthetic solution regarding outcomes in disorders of temporomandibular joint, however the results were slightly better in study participants receiving platelet rich plasma injections. This study demonstrated that while treating patients with TMJ issues, local anaesthesia combined with hydrocortisone as well as intra-articular injection of PRP help in reduction in pain, increase mouth opening, and minimize joint sound. Additionally, it was discovered that intra-articular injection of PRP was more successful in treating patients in this trial than local anaesthetic combined with hydrocortisone.

Keywords: Hydrocortisone with local anesthetic; Intra-articular injection; platelet-rich plasma injection; temporomandibular disorders.