Is dextrose prolotherapy beneficial in the management of temporomandibular joint internal derangement? A systematic review.

OBJECTIVE: To highlight the current knowledge of the efficacy of dextrose as a prolotherapy agent in managing temporomandibular joint internal derangement (TMJ-ID). METHODS: A "Population, Intervention, Comparison, Outcome" (PICO) strategy was executed using an electronic search through PubMed/MEDLINE, Cochrane databases, and Google Scholar from their inception to August 2022. Only randomized clinical trials investigating the treatment of TMJ-ID with hypertonic dextrose prolotherapy (HDPT) were included. Two independent reviewers assessed the eligibility of the studies with subsequent data extraction. RESULTS: The systematic search identified 392 studies, and only 8 articles were considered eligible for selection, with a total of 286 patients; 72% were females, and 28% were males. The extracted data showed positive effects of dextrose on joint pain and maximum mouth opening (MMO) with high patient satisfaction. CONCLUSION: HDPT can be effective in relieving TMD symptoms as it reduces pain, improves joint dysfunction, and increases MMO up to 12 months.

Registration of maxillomandibular relationship through a fully digital workflow for complete-mouth rehabilitation with screw-retained fixed implant-supported prostheses: A clinical report.

Digital recording of the maxillomandibular relationship by using intraoral scanning in completely edentulous patients for computer-aided design and computer-aided manufacture implant-supported prostheses can be challenging. This clinical report describes the fabrication of complete-arch, screw-retained implant-supported prostheses in a completely edentulous patient with a fully digital workflow.

Promising minimally invasive treatment modalities for symptomatic temporomandibular joint disc displacement with reduction: a randomized controlled clinical trial.

BACKGROUND: Pain and clicking are the primary complaints in patients suffering from temporomandibular joint disc displacement with reduction (DDwR), negatively affecting the patients' quality of life, making the treatment essential. This prospective randomized controlled trial (RCT) was conducted to evaluate the effectiveness of botulinum toxin type-A (BTX-A) and low level laser therapy (LLLT) in comparison to anterior repositioning appliance (ARA) for the treatment of DDwR. METHODS: A total of 27 patients were randomly allocated to 3 groups; ARA (control group), BTX-A, and LLLT; with 9 patients each. All patients were evaluated before and 3 months after the treatment using a visual analogue scale (VAS) and magnetic resonance imaging (MRI). RESULTS: At 3 months follow-up, all groups showed a significant reduction in pain assessed by VAS (P = 0.007). Measured on MRI, there was a significant improvement in disc position and joint space index (JSI) in BTX-A group (P < 0.001, P = 0.011) and LLLT group (P = 0.002, P = 0.017) in comparison to the control group (P = 0.087, P = 0.066) respectively. As for time of recovery, a statistically significant difference was observed in BTX-A group (P < 0.001) and LLLT (P < 0.001) group in comparison to ARA group, which showed the most prolonged duration for reduction of DDwR symptoms. CONCLUSION: We concluded that BTX-A and LLLT could be considered effective alternative treatment modalities to ARA regarding reducing joint pain, clicking, and improving disc position in patients with symptomatic DDwR. TRIAL REGISTRATION: This prospective double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05194488, 18/1/2022.