Cover Image

Evaluation Of Platelet-Rich Plasma Effect On Treatment Of Temporomandibular Joint Anterior Disc Displacement

Mustafa Galal Khallaf, Andrew J. Sidebottom, Hussien farouk Elrawy, Mohamed Salah Elmasry

Abstract


The use of Platelet-Rich-Plasma (PRP) may provide a new and improved treatment option for early and late  Temporomandibular Joint (TMJ) disc displacement. However, there are no long-term studies on its use in TMJ arthritis in the literature. The present study evaluate 28 patients with different degrees of disc displacement over a period of time. These patients had experienced no pain reduction following conservative approaches (including splint therapy) and  minimally invasive arthrocentesis treatment. All patients had evidence of disc displacement associated with pain and discomfort, and sometimes clicking. The patients were without systemic joint disease, septicarthritis, or autoimmune arthritis. Only patients who had not responded to conservative therapy were included in the present study. Pain intensity was recorded for each patient using a 0-10 VAS scale. Maximum Inter-incisal Opening (MIO) was also recorded. This assessment was performed at the pretreatment stage and then examinations 3,6,9,12 months respectively after administration of two intra-articular injections of autologous PRP.The results after 12 months revealed that intra-articular injection of autologous PRP appeared to be an effective treatment method for patients with disc displacement in this study. At the 12-months follow-up, all patients  improved their mouth opening significantly. The majority of the PRP patients  showed decreased pain. The average pain score before PRP administration was 7.5, while 3 months after PRP administration the pain score was 4.2. The pain score continued to decrease, reaching nearly 2 after 6 months and  0.5 by the end of 12 months. In conclusion, the use of PRP was found to be an effective and predictable treatment option for disc displacement.

Keywords


Platelet-rich plasma; Temporomandibular joint; disc displacement

References


Zhang S, Gersdorff N, FrahmJ. Real time magnetic resonance imaging of temporomandibular joint dynamics. The Open Medical Imaging Journal. 2011, 5:1-7

Juniper R. The pathogenesis and investigation of tmj dysfunction. Brit J Oral MaxillofacSurg. 1987, 25:105-112

Stegenga B, DebontL, Boering G, Van Willigen J. Tissue responses to degenerative changes in the temporomandibular joint: a review. J Oral MaxillofacSurg. 1991, 49:1079-1088

Milam S, Schmitz J. Molecular biology oftemporomandibular joint disorders: proposed mechanisms of disease. J Oral MaxillofacSurg. 1995, 53:1448-54

NitzanD.Theprocess of lubrication impairment and its involvement in tempo romandibular joint disc displacement: a theoretical concept. J Oral MaxillofacSurg. 2001, 59:36-45

Nitzan D, Etsion I. Adhesive force: the underlying cause of the disc anchorage to the fossa and/or eminence in the temporomandibular joint—a new concept.Int J Oral MaxillofacSurg. 2002, 31:94-99

Barkin S, Weinberg S. Internal derangment of the tempromandibularjoint ; the role of artheroscopic surgery and artherocentesis. J Can Den Assoc.2011, 66 :199-203

Alpaslan C, Kahraman S, Güner B, Cula S. Does Theuse of soft or hard splints affect the short-term outcome of temporomandibular joint arthrocentesis.Int J Oral Maxillofal Surg. 2008, 37:424-427

Mercuri L. Internal derangement outcomes reporting. J Oral Maxillofac Surg. 2010, 68:377-398

10-.Varghese M, George A, Keshava P, Puthanveedu R. Pterygoidplate disjunction: minimally invasive treatment for internal derangement of the temporomandibular joint. Asian J Oral Maxillofac Surg. 2005, 17:247-255

Rohit S. Pterygoid disjunction forinternal derangement of temporomandibular joint.J Maxillofac Oral Surg. 2011, 10: 142-147

Lewis E, Dolwick M, Abramowicz S, Reeder S. Contemporary imaging of the temporomandibular joint. Dent Clin North Am. 2008, 52:879-890

Nitzan D, Dolwick M, MartinzG.Tepromandibularjointartherocentesis:simplified treatment for sever, limited mouth opening. J Oral MaxillofacSurg. 1991:49:1163-1166

Alpslan G, Alpaslan C. Efficacy of tmjartherocentesis with and without injection of sodium hyaluronate in treatment of internal derangements. J Oral Maxillofacial Surg. 2001:59 :613-618

DimitroulisG,Dolwick M, Martinze A. Tempromandibularjoint artherocentesis and lavage for treatment of closed lock:a follow up study.Br J Oral Maxillofacial Surg. 1995:33:23-26

Goudot P, Jaquinet A. Improvement of pain and function after artheroscopy and artherocentesis of tempromandibularjoint: a comparative study. J Cranio-MaxillofacSurg. 2000, 28:39-43

Nizan D, Dolwick M, Heft M. Artheroscopiclavage and lysis of tepromandibularjoint: a change in prespective. J Oral MaxillofacSurg. 1990, 48:798-901

Nitzan D. ArthrocentesisFor Managementof severe closed lock of the tempromandibular joint. J Oral MaxillofacSurgClin North Am. 1994, 6:245-248

Sugisaki M, Ikai A, Tanabe H. Dangerous angles and depths for middle ear and middle cranial fossa injury during arthroscopy of the temporomandibularjoint. J Oral MaxillofacSurg. 1995, 53:803-810

Ohnishi M. Clinical application of arthroscopy in the temporomandibular joint diseases. Bull Tokyo Med Dent Univ. 1980, 27:141-150

Kobayashi K, Yuasa M, Imanaka M, Igarashi C, Yamamoto A. Development of interventional radiology for the internal derangements of the temporomandibular joint. Dent Jpn1. 999, 35:97-99

Honda K, Hamada Y, Ejima K, Tsukimura N, Kino K. Interventional radiology of synovial chondromatosis in the temporoman-dibular joint using a thin arthroscope. DentomaxillofacRadiol. 2008, 37:232-235

Nardini G, Stifano M, Brombin C, Salmaso L, Manfredini D. A one year series ofarthrocentesis with hyaluronic acid injection for temporomandibular joint osteoarthritis. Oral SurgOral Med Oral Pathol Oral RadiolEndod. 2007 , 103:14-22

Dionne R. Pharmacological treatments fortemporomandibular disorder. Oral Surg Oral Med, Oral Pathol, Oral Radiol, Endod. 1997, 83:134-136

Fader K .Pressurized infusion of sodium hyaluronate for closed lock of the temporomandibular joint. part.i: a case study. J CraniomandibPrac. 2005, 11: 68-73

Dimitroulis G, Dolwick M. Temporomandibulardisorders.surgical treatment.Aust Dent J. 1996, 44:16-20

Ferrari M, Rørvik M, Haanæs H, Teige J.New technique forhemo-dilution, preparation of autologous platelet-rich plasma and intraoperative blood salvage in cardiac surgery. Int J Artif Organs.1987, 10:47-50

Lucarelli E, Beccheroni A, Donati D. Platelet-derived growth factors enhance proliferation of human stromal stem cells. Biomaterials. 2003, 24: 3095-3100

Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis:apilot study. Am J Phys Med Rehabil. 2010, 89:961-969

Sampson S, Gerhardt M, Mandelaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008, 1:165-174

Sánchez M, Anitua E, Azofra J, Aguirre JJ, Andia I.Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee oa: a retrospective cohort study. ClinExpRheumatol. 2008, 26: 910-913

Bjørnland T, Gjaerum AA, Møystad A.osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate. J Oral Rehabil. 2008, 34: 583-589

Møystad A, Mork-Knutsen BB, BjørnlandT.Injectionof sodium hyaluronate compared to a corticosteroid in the treatment of patients with temporomandibular joint osteoarthritis: a ct evaluation. JOral Surg Oral Med Oral Pathol Oral RadiolEndod. 2008, 105: 53-60

Pujol JP, Chadjichristos C, Legendre F, Bauge C, Beauchef G, Et Al.Interleukin-1 and transforming growth factor-beta 1 as crucial factors in osteoarthritic cartilage metabolism. Connect Tissue ResJTissEng.2008, 49: 293-297

Massague´ J. The transforming growth factor-beta family.Annu Rev Cell Biol6: J Exp Med.1990, 3, 597-641

Prakash S, Thakur A.Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011, 10: 45-49

Park YG, Han SB, Song SJ, Kim TJ, Ha CW.Platelet-rich plasma therapy for knee joint problems: review of the literature, current practice and legal perspectives in korea. Knee SurgRelat Res. 2012, 24: 70-78

Li M, Zhang C, Ai Z, Yuan T, Feng Y, EtAl.Therapeutic effectiveness of intra-knee-articular injection of platelet-rich plasma on knee articular cartilage degeneration. IntJOrtho.2011, 25: 1192-1196

Lyras D, Kazakos K, Verettas D, Polychronidis A, Simopoulos C, Et Al.Immunohistochemicalstudy of angiogenesis after local administration of platelet-rich plasma in a patellar tendon defect. IntOrthopJ.2010, 34: 143-48

Lippross S, Moeller B, Haas H, Tohidnezhad M, Steubesand N, Et Al. Intraarticularinjection of platelet-rich plasma reduces inflammation in a pig model of rheumatoid arthritis of the knee joint. Arthritis RheumJ.2011, 63: 3344-3353

Liu J, Yuan T, Zhang C.Effectof platelet-rich plasma on synovitis of rabbit knee. IntJOrthopedics. 2012, 25: 285-290

Sun Y, Feng Y, Zhang CQ, Chen SB, Cheng XG (2010) Theregenerative effect of platelet-rich plasma on healing in large osteochondral defects. IntOrthop.2010, 34: 589-597

Ying B, Chen K,Man C, Feng G. Effect of different doses of transforming growth factors‚on cartilage and subchondral bone in osteoarthritic temporomandibular joints. Br J Oral MaxillofacSurg. 2013, 51: 241-246

44-.Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Et Al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports TraumatolArthrosc.2011, 19: 528-535

45- Napolitano M, Matera S, Bossio M, Crescibene A, Costabile E, Et Al. Autologous platelet gel for tissue regeneration in degenerative disorders of the knee. Blood Transfus.2012, 10:72-77

46-Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Et Al. Plateletrich Plasma Intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. J Arthroscopy. 2011, 27: 1490-501

47-Floryan KM, Berghoff WJ. Intraoperative use of autologous platelet-rich and platelet-poor plasma for orthopedic surgery patients. AORN J.2004, 80: 668-74,675-678


Full Text: PDF

Refbacks

  • There are currently no refbacks.


AJOMS (ISSN 2572-5823) Copyright © 2012-2019. All rights reserved. Published by Ivy Union Publishing, 3204 Valley Rush Dr, Apex, North Carolina 27502, United States