Prolotherapy versus Arthrocentesis in the Management of a Hypermobile Temporomandibular Joint-A Systematic Review
Background: Prolotherapy and arthrocentesis are non-surgical treatment modalities employed for the conservative management of temporomandibular joint (TMJ) hypermobility which may be diagnosed as luxation or subluxation of the joint. Symptomatic TMJ hypermobility is a crippling condition and demands immediate treatment and subsequent follow up. Aim: The aim of this study is to assess the efficacy of prolotherapy when compared to arthrocentesis as non-surgical management of TMJ hypermobility. Objectives: To evaluate the effectiveness of prolotherapy and arthrocentesis in the management of TMJ hypermobility. Methods: Electronic databases of PubMed, Google Scholar and Cochrane central register of controlled trials were searched for related studies along with search of relevant journals. Title and abstract scanning was done to evaluate for inclusion. Bibliography of identified studies was scanned to include studies published outside the electronic database. Results: Two authors assessed the 49 articles identified from electronic search based on inclusion criteria and research question. 2 were excluded after removing duplicates and 42 were excluded after reading titles. 5 studies were evaluated in detail after reading the abstract and full text. 2 studies were included based on the inclusion criteria and research question. Conclusion: On the basis of current literature there is evidence that the concomitant use of prolotherapy with arthrocentesis may be superior in the management of TMJ hypermobility as compared to their individual use. The authors suggest formulation of well-designed randomised controlled trials to formulate a step ladder like treatment protocol for the management of TMJ hypermobility. This will help to achieve optimum amelioration of the quality of life of the individual.