Efficacy of prolotherapy in temporomandibular joint disorders with hypertonic dextrose and Polydeoxyribonucleotide (PDRN)

This study evaluated the clinical efficacy of prolotherapy using hypertonic dextrose and polydeoxyribonucleotide (PDRN) in patients with temporomandibular joint disorders (TMDs) who did not respond to conventional treatments. A retrospective chart review of 66 patients diagnosed with TMD was conducted. Patients underwent prolotherapy between March and December 2024 and were classified into soft-tissue-related and bone-related TMD groups. Treatment involved injections of hypertonic dextrose or PDRN targeting anatomical structures within the temporomandibular joint (TMJ). Pain and function were assessed using the visual analog scale (VAS) and maximum mouth opening (MMO). Additional parameters, including joint sounds and jaw displacement (S deviation or L deflection), were analyzed. Outcomes were measured at baseline, after each prolotherapy session, and during the final follow-up. Statistical analyses included paired t-tests, McNemar's tests, Analysis of Variance (ANOVA), and regression modeling. Prolotherapy was administered an average of 2.3 times per patient. The baseline VAS score decreased from 4.34 ± 2.12 to 1.00 ± 1.58 (p < 0.001), and MMO improved from 31.0 ± 8.7 mm to 40.8 ± 4.55 mm (p < 0.001). Joint sounds, jaw displacement, and deflection also showed significant reductions. Comparative analysis of prolotherapy agents revealed no statistically significant differences between the PDRN and dextrose groups, although both demonstrated significant improvements in MMO and VAS scores. Among patients with baseline joint sounds, 23 individuals experienced complete resolution of sounds, along with significant reductions in jaw displacement (69.6% to 13.0%, p < 0.001) and deflection (52.2% to 8.7%, p < 0.001). Prolotherapy is an effective intervention for improving pain and jaw function in TMD patients. Both hypertonic dextrose and PDRN demonstrated significant clinical improvements on TMD prolotherapy.