COMPARATIVE EVALUATION OF ULTRASOUND-GUIDED ARTHROCENTESIS ALONE VERSUS ARTHROCENTESIS WITH PROLOTHERAPY IN TMD MANAGEMENT – A COMPARATIVE STUDY

<p><strong><span>Abstract</span></strong></p> <p><strong><span>Background:</span></strong><span><span> </span></span><span>Intra-articular temporomandibular disorders (TMDs) often present with facial pain, restricted mouth opening, and joint dysfunction. Minimally invasive techniques such as arthrocentesis and dextrose prolotherapy have gained prominence for their efficacy in symptom relief and functional recovery. This study aimed to compare the clinical outcomes of ultrasound-guided single puncture arthrocentesis with combined single-session arthrocentesis plus dextrose prolotherapy in patients with TMD. </span><strong><span>Materials and Methods:</span></strong><span><span> </span></span><span>A total of 40 patients (28 females, 12 males; mean age 33.4 ± 9.2 years) diagnosed with intra-articular TMD unresponsive to conservative therapy were randomly allocated into two groups of 20 each. Group I received ultrasound-guided single puncture arthrocentesis, while Group II underwent combined single-session arthrocentesis with 25% dextrose prolotherapy. Clinical parameters including pain intensity (VAS), maximum mouth opening (MMO), and joint clicking were evaluated at baseline and at 2, 4, and 12 weeks postoperatively. Statistical analysis was performed using repeated measures ANOVA and Chi-square tests, with p < 0.05 considered significant. </span><strong><span>Results:</span></strong><span><span> </span></span><span>Both groups demonstrated significant improvements in pain and MMO over time (p < 0.001). Mean VAS scores reduced from 7.1 ± 0.9 to 2.1 ± 0.6 in Group I and from 7.3 ± 1.0 to 0.8 ± 0.5 in Group II. Correspondingly, mean MMO increased from 29.5 ± 3.1 mm to 41.1 ± 2.7 mm in Group I and from 29.9 ± 3.3 mm to 44.5 ± 2.4 mm in Group II. Reduction in joint clicking was more significant in Group II (p = 0.03). No postoperative complications were observed. </span><strong><span>Conclusion:</span></strong><span><span> </span></span><span>Both ultrasound-guided arthrocentesis and combined arthrocentesis with dextrose prolotherapy are effective in managing intra-articular TMDs. However, the addition of dextrose prolotherapy provides superior long-term improvement in pain reduction, mouth opening, and joint function without adverse effects.</span></p>