Effects of Platelet-rich Plasma Prolotherapy of Temporomandibular Joint Subluxation

NCT ID: NCT03655275

Last Updated: 2018-09-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

EARLY_PHASE1

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-24

Study Completion Date

2019-05-30

Brief Summary

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The aim of this study is to clinically assess the efficacy of PRP prolotherapy for treatment of TMJ subluxation

Detailed Description

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The effect of platelet-rich plasma prolotherapy on the pain score and frequency of luxation in temporomandibular joint subluxation. A prospective randomized placebo controlled trial

* After detailed clinical evaluation, every patient will undergo routine preoperative laboratory tests (complete blood cell count, HCV , HBV , Tomogram of TMJ examination). In cases in which special diagnostic procedures will be needed for more detailed evaluation of the patients, they will also be performed.
* All cases will undergo to withdraw 40 ml of blood from the patient's upper limb cubital vein using an 18G needle, subsequently 5 ml of citrate sodium solution is added to the sample as an anticoagulant. One milliliter of the blood sample will be sent for complete blood count.
* To prepare of high concentration PRP the blood sample will be then centrifuged for 15 minutes at 1600 rpm resulting in three layers: the lower layer made up of red blood cells, the intermediate layer is composed of white blood cells, and the upper layer is composed of plasma. The Buffy coat layer and the plasma layer will be later collected and centrifuged for another 7 minutes at 2800 rpm in order to concentrate platelets. The final product will be about 4-6 mL of PRP containing leukocytes.
* the skin surface of the preauricular area will be disinfected with Betadine surgical scrub solution. The anatomic landmarks will be located by asking the patient to open widely to allow drawing of the articular fossa and then to close lightly on the posterior teeth to draw the condyle within the glenoid fossa.
* Typically, each joint had 3 injection sites:
* The needle will be inserted at lateral margin of the glenoid fossa and 0.5 ml of the PRP will be slowly injected at the superior capsular attachment .Then needle will be directed immediately under the lateral margin of the glenoid fossa superiorly and medially toward the apex of the fossa.1ml of the PRP will be then slowly injected into the superior joint space
* The needle will be inserted at the condylar neck and 0.5 ml of the PRP will be injected at the inferior capsular attachment. Then needle will be directed superficial to the TMJ capsule, 0.5 ml of the PRP will be deposited as needle will be withdrawn.
* patients in the placebo group received injections of placebo (saline) using the same volume on the same schedule.
* Post operative care and instructions:
* Bleeding from the injection sites will be generally minimal and could be controlled with direct pressure on the injection site for a few seconds.
* All patients will be advised to take "paracetamol", one tablet when needed and to stop the use of other pain and anti-inflammatory drugs during the treatment phase.
* Each patient will be instructed to receive soft diet only for two weeks in order to decrease the effort upon TMJ .

Conditions

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Temporomandibular Joint Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study is randomized, placebo controlled trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

This study is randomized, placebo controlled trial.

Study Groups

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Group(A): PRP

PRP prolotherapy injections with 2.5ml of PRP at an interval of 2 weeks. Intraticular and pericapsular

Group Type ACTIVE_COMPARATOR

PRP prolotherapy

Intervention Type BIOLOGICAL

PRP prolotherapy By injection 2.5ml of PRP at an interval of 2 weeks.

Group (B): saline

Saline prolotherapy injections with 2.5ml of saline at an interval of 2 weeks.intrarticular and pericapsular

Group Type ACTIVE_COMPARATOR

Saline prolotherapy

Intervention Type BIOLOGICAL

Saline prolotherapy Injection 2.5 ml of saline at an interval of 2 weeks.

Interventions

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PRP prolotherapy

PRP prolotherapy By injection 2.5ml of PRP at an interval of 2 weeks.

Intervention Type BIOLOGICAL

Saline prolotherapy

Saline prolotherapy Injection 2.5 ml of saline at an interval of 2 weeks.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

1. Patients who had TMJ subluxation for at least six months.
2. Age ≥ 18 years
3. Willingness of the patient to receive relative painful injections and to follow instructions.

Exclusion Criteria

* 1\. Patients with dystonia 2. Drug induced TMJ hypermobility 3. Medical conditions that could significantly interfere with treatment
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cairo University

OTHER

Sponsor Role collaborator

Abdelrahman Soliman Alateyh

OTHER

Sponsor Role lead

Responsible Party

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Abdelrahman Soliman Alateyh

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Hamida R Hassanien, phd

Role: STUDY_DIRECTOR

Cairo University

Locations

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Faculty of Oral and Dental Medicine

Cairo, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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abdelrahman alatyeh, B.D.S

Role: CONTACT

00201099179039

Facility Contacts

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Abdelrahman S Alatyeh, B.D.S

Role: primary

mohammed Alatyeh

Role: backup

00201097114252

References

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Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J. 2012;32:150-63.

Reference Type BACKGROUND
PMID: 23576936 (View on PubMed)

Pihut M, Szuta M, Ferendiuk E, Zenczak-Wieckiewicz D. Evaluation of pain regression in patients with temporomandibular dysfunction treated by intra-articular platelet-rich plasma injections: a preliminary report. Biomed Res Int. 2014;2014:132369. doi: 10.1155/2014/132369. Epub 2014 Aug 3.

Reference Type BACKGROUND
PMID: 25157351 (View on PubMed)

Jureidini J. Is there a role for placebo analgesia? N Z Med J. 2003 Aug 8;116(1179):U541. No abstract available.

Reference Type BACKGROUND
PMID: 14513087 (View on PubMed)

Yelland MJ, Glasziou PP, Bogduk N, Schluter PJ, McKernon M. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial. Spine (Phila Pa 1976). 2004 Jan 1;29(1):9-16; discussion 16. doi: 10.1097/01.BRS.0000105529.07222.5B.

Reference Type BACKGROUND
PMID: 14699269 (View on PubMed)

Other Identifiers

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TMJ prolotherapy

Identifier Type: -

Identifier Source: org_study_id

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