Evaluation of prolotherapy in comparison with occlusal splints in treating internal derangement of the temporomandibular joint - A randomized controlled trial.

PURPOSE: The aim of this study was to compare the efficacy of dextrose prolotherapy with that of occlusal splints in treating internal derangement of the temporomandibular joint. PATIENTS AND METHODS: A total of 34 patients with temporomandibular joint internal derangement classed as Wilkes stages II or III were recruited for the study, and were randomly divided into study and control groups with 17 patients each. The patients in these control and study groups were treated with splints and prolotherapy, respectively. Outcome parameters, such as pain, mouth opening, clicking and deviation, were assessed using the Helkimo clinical dysfunction index for a review period of 1 year. RESULTS: Nine patients in the study group had complete absence of pain, compared with only one patient in the control group. The results showed that patients who received prolotherapy demonstrated improvement in pain (p < 0.001), mouth opening (p = 0.032), and clicking (p < 0.001), but no significant difference in deviation was observed between the groups after 1 year (p = 0.862). CONCLUSION: Prolotherapy was found to be superior in providing long-term clinical relief, with reduction in pain and clicking along with improved mouth opening.

Effectiveness of knotless suture as a wound closure agent for impacted third molar - A split mouth randomized controlled clinical trial.

AIM AND OBJECTIVE: This study was aimed to compare the effectiveness of 3-0 knotless barbed suture (polydioxanone) with 4-0 polyglactin 910 (vicryl) in achieving wound closure after impacted mandibular third molar surgery. MATERIALS AND METHODS: Patients with bilateral mandibular third molar impaction of similar difficulty index enrolled in the split mouth study. Wound closure was done using 3-0 knotless suture (30 × 30 cm) for the study group and 4-0 polyglactin 910 (vicryl) for the control group following extraction. Samples were allocated on the basis of simple randomization. The clinical outcome parameters that were measured were (1) time taken to achieve wound closure and hemostasis (2) postoperative mouth opening (3) swelling and (4) Pain. Data analysis involved descriptive statistics and paired t-tests (p < 0.05). IBM SPSS software (v.20.0) was used. RESULT: A total of 25 patients participated in the study (14 males and 11 females) with the mean age of 25.6 years. The mean time taken for wound approximation was 2.45 min and 4.1480 min (p-0.026) for the study and control groups respectively. The difference in mouth opening (p-0.015), VAS score(p-0.24), and swelling (p-0.041) were statistically significant on the first post-operative day in the study group than the control group indicating reduction in pain (p < 0.0001), swelling (p-0.033) and improvement in mouth opening (p < 0.0001) on seventh post-operative day in the study group compared to the control group. CONCLUSION: Knotless suture is an effective alternative to conventional sutures for intra oral wound closure as it reduces suturing time, facilitates effective wound closure and minimises knot related complications.