Abstract

Purpose: This study aimed to evaluate the clinical effectiveness and safety of dextrose prolotherapy targeting the retrodiscal tissue in patients with refractory temporomandibular disorders (TMD) who did not respond to conven-tional conservative therapies.Materials and Methods: Thirty patients with persistent temporomandibular joint (TMJ) pain despite undergoing three sessions of arthrocentesis were enrolled. All patients received 12.5% dextrose prolotherapy injections into the retrodiscal tissue, administered three times at two-week intervals. Clinical outcomes included pain intensity assessed by visual analogue scale (VAS), patient-reported joint noise (VAS), and maximum comfortable mouth opening (MCO; mm). Evaluations were performed at baseline and after each treatment session.Results: Pain scores demonstrated a significant reduction, from 3.2 ± 2.1 at baseline to 1.5 ± 1.5 after the third injection, representing a 53% decrease (p < 0.05). MCO improved from 40.0 ± 6.3 mm to 42.7 ± 5.9 mm after the final session (p < 0.05). Joint noise scores showed a 13% reduction trend, decreasing from 1.5 ± 1.7 to 1.3 ± 1.3, although this change was not statistically significant (p > 0.05). No major complications were reported, apart from transient post-injection discomfort in a few patients that resolved spontaneously with analgesics.Conclusion: Dextrose prolotherapy targeting the retrodiscal tissue appears to be a safe and effective adjunctive therapy for reducing pain and improving mandibular function in patients with refractory TMD. Although im-provements in joint noise were not statistically significant, the overall outcomes support prolotherapy as a viable therapeutic option warranting further controlled trials. (J Korean Dent Assoc 2025; 63(10): 316-321)