Treatment of Temporomandibular Dysfunction With Hypertonic Dextrose Injection (Prolotherapy): A Randomized Controlled Trial With Long-term Partial Crossover

Wynand Francois Louw, K. Dean Reeves, Stanley K.H. Lam, An Lin Cheng, David Rabago

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objective: To assess the efficacy and longer-term effectiveness of dextrose prolotherapy injections in participants with temporomandibular dysfunction. Patients and Methods: A randomized controlled trial with masked allocation was conducted from January 14, 2013, through December 19, 2015. Forty-two participants (with 54 joints)meeting temporomandibular dysfunction criteria were randomized (1:1)to 3 monthly intra-articular injections (20% dextrose/0.2% lidocaine or 0.2% lidocaine)followed by as-needed dextrose/0.2% lidocaine injections through 1 year. Primary and secondary outcome measures included a 0 to 10 Numerical Rating Scale score for facial pain and jaw dysfunction; maximal interincisal opening (MIO)measured in millimeters, percentage of joints with 50% or more change (improvement)in pain and function, and satisfaction. Results: Randomization produced a control group with more female participants (P=.03), longer pain duration (P=.01), and less MIO (P=.01). Upon 3-month analysis, including pertinent covariates, dextrose group participants reported decreased jaw pain (4.3±2.9 points vs 1.8±2.7 points; P=.02), jaw dysfunction (3.5±2.8 points vs 1.0±2.1 points; P=.008), and improved MIO (1.5±4.1 mm vs −1.8±5.1 mm; P=.006). Control group participants received dextrose injections beginning at 3 months. No between-group differences were noted at 12 months; pooled data suggested that jaw pain, jaw function, and MIO improved by 5.2±2.7 points (68%), 4.1±2.8 points (64%), and 2.1±5.5 mm, respectively. Pain and dysfunction improved by at least 50% in 38 of 54 (70%)and 39 of 54 (72%)jaws, respectively. Conclusion: Intra-articular dextrose injection (prolotherapy)resulted in substantial improvement in jaw pain, function, and MIO compared with masked control injection at 3 months; clinical improvements endured to 12 months. Satisfaction was high. Trial Registration: clinicaltrials.gov Identifier: NCT01706172

Original languageEnglish (US)
Pages (from-to)820-832
Number of pages13
JournalMayo Clinic Proceedings
Volume94
Issue number5
DOIs
StatePublished - May 2019

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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