Intra-Articular Injections of Amniotic Fluid for Temporomandibular Joint Disorder

Objectives: Currently, there is no injectable that has proven to be effective in relieving clinical symptoms associated with temporomandibular disorder (TMD). Amniotic fluid has the potential as a novel anti-inflammatory, pain reducing intra-articular injectable. The goal of this study was to assess the effectiveness of amniotic fluid in the reduction of pain and clinical symptoms experienced by patients who suffer from TMD.

Methods: Cryopreserved human amniotic fluid has shown promising results in the treatment of symptomatic knee osteoarthritis (Vines et al.). Eleven patients were enrolled. A clinical examination obtained a baseline pain score, assessment of joint noise, and measurement of maximal incisal opening (MIO). Patients were injected with 1cc of amniotic fluid into the TMJ space. Follow up calls were made every week to note level of pain via visual analog system (VAS) following the injections.
Results: Amniotic fluid injections had a significant effect on TMD measures. Injections resulted in a decreased pain score and increased MIO in fourteen out of fifteen patients. In the responders, pre and post pain score results showed a significant decrease in pain (paired t test, p<5.67E-08), as well as a significant increase in MIO (paired t test, p<0.0058). For example, one patient has experienced pain relief that pre-injection was an 8/10 which decreased to a 1/10 for 10 months and counting. Other patients have experienced similar results, however there have been a small proportion that have been non-responsive.

Conclusions: The results of the study support the hypothesis that amniotic fluid is an effective treatment in the reduction in pain and clinical symptoms experienced by patients who suffer from TMD. Because of this, it has the potential to decrease opioid medication use, decrease the need for invasive surgery, and result in a higher quality of life.