Dextrose Prolotherapy versus Low Level Laser Therapy (LLLT) for Management of Temporomandibular Joint Disorders (TMD): Clinical Randomized controlled Study

Document Type : Original Article

Authors

1 Associate Professor of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University

2 Lecturer of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University

3 Associate Professor of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Ahram Canadian University

Abstract

Objective: To compare the effects of dextrose prolotherapy and low level laser therapy in terms of the pain (VAS) and maximum interincisal opening (MIO) in treatment of temporomandibular disorders.
Patients and Methods: Twenty patients (10 males & 10 females) with temporomandibular disorders TMD participated in this clinical trial. All patients were randomly divided into two equal groups. In dextrose group; 12.5% Dextrose was injected into 3 targeted areas, the posterior joint space, the anterior disc attachment and superior attachment of masseter muscle. Dextrose prolotherapy was performed at 2 weeks, and 4 weeks intervals. In laser group; semi conductive (diode) gallium arsenide (Ga As) laser was utilized in this study. The therapeutic LLLT application was performed 3 times per week for four consecutive weeks. The primary outcome measure was the severity of the pain at rest assessed with visual analogue scale (0-10 cm). The secondary outcome measure was Maximum interincisal opening (MIO). All the evaluations in both groups were done at baseline, 2 weeks, and 4 weeks subsequent to the treatment.
Results :The results demonstrated insignificant difference between the means of dextrose prolotherapy and laser groups in terms of VAS (at rest), MIO degree values before treatment (base line) (p>0.05). When the changes in the groups after treatment were compared, there was no significant difference between the means of dextrose and laser groups regarding VAS (at rest) after 2 weeks and 4 weeks (p- value>0.05). However, there was a statistical significant difference (P-value = 0.001) between the means of both groups regarding MIO after 2 weeks and 4 weeks (P-value <0.001). The improvement in maximum interincisal opening was greater in the group that submit to dextrose prolotherapy in comparison to the laser group (p<0.05).
Conclusions: In temporomandibular disorders dextrose prolotherapy is more efficient in improving maximum interincisal opening in comparison to low level laser therapy. However, both treatments have the same effect in reducing pain at rest.

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