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Different Treatments in Patients with Temporomandibular Joint Disorders: A Comparative Randomized Study

1
Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Polo I-Edifício Central Rua Larga, 3004-504 Coimbra, Portugal
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Department of Surgery. University of Salamanca, Salamanca, Spain. Instituto de Investigación Biomédica de Salamanca (IBSAL), Avda. Alfonso X El Sabio S/N. 37007, Salamanca, Spain
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Laboratory of Biostatistics and Medical Informatics, Coimbra. Institute for Clinical and Biomedical Research (iCBR), School of Medicine, University of Coimbra, Polo 3, Azinhaga de Santa Comba, Celas 3000-548 Coimbra, Portugal
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(3), 113; https://doi.org/10.3390/medicina56030113
Received: 28 January 2020 / Revised: 27 February 2020 / Accepted: 28 February 2020 / Published: 5 March 2020
(This article belongs to the Section Dentistry)
Background and Objectives: Temporomandibular joint disorders (TMJDs) are associated with pain and reduced jaw mobility. The aim of this study was to compare the outcome of patients with TMJ arthralgia when submitted to four different treatment modalities, in some cases using intra-articular injections of substances with anti-inflammatory properties and in others, a more conservative approach consisting only of a bite splint. Materials and Methods: The sample was made up of 80 patients, randomly distributed into 4 groups of 20 patients each. Each patient was given a nocturnal bite splint. One of the groups was treated with the bite splint only, while each patient in the other 3 was injected with betamethasone, sodium hyaluronate, or platelet-rich plasma in addition to using the bite splint. Two variables were assessed, namely pain intensity between 0 to 10 according to the visual analogue scale and maximum pain-free mouth opening in mm. The patients were evaluated at four different points: at the beginning of the treatment, as well as one week, one month and six months after initiation. Results: The results showed that maximum pain-free mouth opening improved in all the groups that made up the sample, with either a reduction in pain severity or with no pain. However, the group injected with platelet-rich plasma yielded the best results after six months, while patients treated with sodium hyaluronate or betamethasone obtained the best results at the end of the first week. Conclusions: We concluded that all the treatments used caused a reduction in pain and increased pain-free mouth opening. The splint combined with the platelet-rich plasma injection achieved long-term success. View Full-Text
Keywords: temporomandibular disorders; arthralgia; bite splint; sodium hyaluronate; betamethasone; platelet-rich plasma temporomandibular disorders; arthralgia; bite splint; sodium hyaluronate; betamethasone; platelet-rich plasma
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Macedo De Sousa, B.; López-Valverde, N.; López-Valverde, A.; Caramelo, F.; Flores Fraile, J.; Herrero Payo, J.; Rodrigues, M.J. Different Treatments in Patients with Temporomandibular Joint Disorders: A Comparative Randomized Study. Medicina 2020, 56, 113.

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