Intra-articular platelet-rich-plasma injection as a therapeutic method for temporomandibular joint disorders: a case report

• Mathilde Bottlaender Tellechea ; Bruno Macedo de Sousa ^[1] ; Nansi Lopez-Valverde ^[2] ; Maria João Rodrigues ^[1]
  1. [1] Universidade de Coimbra

     Universidade de Coimbra

     Coimbra (Sé Nova), Portugal

     
  2. [2] Universidad de Salamanca

     Universidad de Salamanca

     Salamanca, España

     
• Localización: Labor dental clínica: Avances clínicos en odontoestomatología, ISSN 1888-4040, Vol. 23, Nº. 1, 2022, págs. 42-47
• Idioma: inglés
• Enlaces
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• Resumen
  • English

    Objectives This case-report presents the evolution of temporomandibular joint (TMJ) arthralgia/pain and mouth opening in a 47-year-old patient treated with intra- articular injections of platelet-rich-plasma (PRP) at the initial stage, one month, three months, six months, one year and three years after procedure.

    Methodology Patient’s peripheral blood from the ulnar vein was collected into a glass tube with sodium citrate as an anticoagulant, mixed using rotating movements and centrifuged at 3200 rpm for 12 minutes. After careful aspiration of PRP into a syringe, 2mL of it were injected into the TMJs after local disinfection and anesthesia. The exact puncture point was determined by drawing the canthal‐tragus line and measuring 10 mm from the tragus and 2 mm below the line.

    The zygomatic arch was palpated and the patient was asked to open his mouth to move the condyle anteriorly.

    The needle was positioned from the outside in, from top to bottom and from back to front.

    Results Initial pain level by the visual analogue scale (VAS) was seven and initial mouth-opening without pain (MOWP) was 17 mm. One month later, pain level had dropped to VAS one and MOWP had increased to 43mm. At three months post-op, pain level had diminished to VAS zero and MOWP increased to 48mm. The exact same results were observed at six months, one year and two years after the procedure.

    Conclusions In this particular case, PRP was effective in reducing TMJ pain/arthralgia and increasing MOWP in a mid-term and long-term follow-up. However, due to this article’s design, the results achieved cannot be extrapolated to every case of TMJ disorders.

  • português

    Objetivos Neste caso-clínico apresenta-se a evolução de artralgia da articulação temporo-mandibular TMJ) e abertura bucal num paciente de 47 anos tratado com injeções de plasma rico em plaquetas (PRP) na fase inicial e um mês, três meses, seis meses, um ano e dois anos após o procedimento.

    Metodologia Foi realizada a colheita de sangue periférico do paciente da veia ulnar para um tubo de vidro com citrato de sódio como agente anticoagulante. Estes foram misturados com movimentos rotatórios e os tubos centrifugados a 3200rpm durante 12 minutos.

    Após aspiração cautelosa do PRP para uma seringa, 2mL deste foram injetados nas TMJs do paciente, após desinfeção e anestesia locais.

    Resultados A dor inicial pela escala visual analógica (VAS) era de sete e a abertura bucal sem dor (MOWP) de 17mm. Após um mês, a dor decresceu para um na VAS e a MOWP aumentou para 43mm. Três meses após o procedimento, a dor diminuiu para zero na VAS e a MOWP para 48mm, valores que se mantiveram seis meses, um ano e dois anos após a injeção intra-articular de PRP.

    Conclusões Neste caso específico, o PRP foi eficaz na redução de artralgia temporo-mandibular e no aumento da MOWP num seguimento a médio e longo-termo.

    No entanto, devido ao design deste artigo, os resultados obtidos não podem ser extrapolados para todo e qualquer caso de disfunção temporo- mandibular.