Temporomandibular Joint Disc Displacement
Conditions
Brief summary
Pain and trismus are of the prime concerns for the patients in case of Anterior disc displacement ADD of temporomandibular joint (TMJ). In the recent times, PRP has has produced promising results in management of TMDs. It has potential healing properties on new bone and cartilage through the recruitment, proliferation, migration, and differentiation of cells and its tissue remodelling, matrix production, and chondrogenic differentiation properties. It also increases the production of hyaluronic acid by synoviocytes. Needle injury also produces immediate analgesia without hypesthesia, mainly on the painful spot making it effective for the pain reduction and improved mouth opening. Similar effect of dry needling can also be expected in the joint space where it may induce a transient inflammatory cascade leading to healing of the damaged tissue. So, the Present study is designed to evaluate the efficacy of PRP for the treatment of ADD of TMJ.
Detailed description
Study Design: Randomized clinical trial Study Duration: This study will be completed in 1 year 3 months (3 months for patient recruitment, 9 months for study including treatment and follow up and 3 months for data compilation). Population: Patients suffering from Anterior Disc Displacement will be recruited in study from regular OPD of the Department of Oral Medicine and Radiology. Sample size: Sample size consists of 39 patients in each group. Methods: PRP will be performed in test group while dry needling will be performed in control group.
Interventions
PROCEDUREDry Needling
Dry Needling will be done for the patients with ADD of TMJ in the retrodiscal tissue and superior joint space .
PROCEDUREPRP
Patients with ADD are administered with 1ml of PRP into the retrodiscal tissue and the superior joint space. PRP will be prepared by method proposed by Okuda et al., 2003. Reinjection will be given after 2 weeks if required.
Sponsors
Postgraduate Institute of Dental Sciences Rohtak
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
\- 1. Patients diagnosed with Anterior disc displacement clinically according to TMD/RDC criteria (2013-14). 2\. Patients diagnosed with Anterior disc displacement confirmed using Magnetic Resonance Imaging.
Exclusion criteria
* 1\. Patients with phobia to needles 2. Patients who have undergone previous treatment for anterior disc displacement in past 6 months 3. Patients with active infection at the site of injection 4. Patients on anticoagulant medication 5. Pregnancy/ Lactation 6. Patients with healing disorder or systemic disease where healing response is compromised 7. Patients with epilepsy/seizures 8. Patients with bleeding and clotting disorder 9. Patients with malignancy 10. Patients with uncontrolled para-functional habits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | 2 weeks | To evaluate the intensity of pain before and after the treatment (Visual Analogue Scale score). |
| Mouth opening and Functional movements | 2 weeks | To evaluate the maximal mouth opening and functional movements before and after the treatment (millimetre). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Joint sounds | 2 weeks | To evaluate the changes in joint sounds before and after the treatment (present or absent ). |
| Pain medication | 2 weeks | To evaluate the need for pain medicine utilization (number of tablets). |
| Patient satisfaction | 2 weeks | To evaluate patient satisfaction before and after treatment (Likerts scale) in both groups |
| Sleep pattern | 2 weeks | To evaluate sleep pattern before and after treatment (Visual Analogue Scale score) in both groups |
Countries
India
Contacts
Primary ContactDr.Ambika Gupta, MDS
Outcome results
None listed