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Temporomandibular Joint DisordersPhase 4NCT05817162

Temporomandibular Joint Arthrocentesis With Infiltration of PRP + Ropivacaine Versus PRP

A Phase 4 study testing Ropivacaine injection, temporomandibular joint arthrocentesis and PRP injection in people with Temporomandibular Joint Disorders, run by Instituto Portugues da Face at 1 site in Portugal.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The infiltration of Platelet Rich Plasma (PRP) at the end of Temporomandibular Joint (TMJ) arthrocentesis is already an established procedure in the treatment of Temporomandibular Disorders (TMD). Read more about this study

Who is it for?
Ages 18 to 99 years
Conditions the study is for
Temporomandibular Joint Disorders
What is being tested?
Ropivacaine injection, temporomandibular joint arthrocentesis and PRP injection
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 sitePortugal
Study dates
1 Apr 2023to 1 Jul 2024
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and female subjects between the ages of 18-99 years;
  • For women of reproductive potential: use of highly effective contraception for at least 1 month prior to the first visit and agreement to use such a method during participation in the study;
  • In the opinion of the investigator, the subject is capable of understanding and comprehending the study in question;
  • The subject signs the written informed consent form and provides the necessary privacy clearance prior to the start of any study procedures;
  • Patients with TMD with an indication for TMJ arthrocentesis: clinical and imaging diagnosis of unilateral or bilateral intra-articular disorder;
  • Magnetic resonance imaging (MRI) assessing the intra-articular derangement;
  • Radiological findings that most components of the joint were salvageable;
  • Dimitroulis classification between 2 and 3.

Who cannot join

  • Subject has had other previous minimally invasive or invasive treatment for TMD;
  • Subject has any contraindication to the use of ropivacaine according to the Ropivacaine (Fresenius Kabi) bulletin;
  • Subject has a history of allergy to any drug in the study;
  • Subject taking analgesic medication prior to treatment for other conditions;
  • The subject has an inability to interpret pain scales or to read and interpret the study's target questionnaire;
  • Women who are pregnant or breastfeeding. For women of reproductive potential, use of highly effective contraception for at least 1 month prior to the first visit is required (Combined oral contraceptive pill, vaginal ring, male and female condom, intrauterine device, diaphragm, injectable hormonal contraceptive) and agreement to use such a method during study participation.
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  • Subjects under 18 and over 99 years old;
  • Subjects diagnosed with the following conditions cannot participate in the study: cardiovascular disorders, peripheral vascular disease, arrhythmias, auriculoventricular conduction disorders, heart failure; hypotension, epileptic patients, patients with liver and kidney disease, patients with porphyria, patients with acidosis.
  • Subjects with severe medical problems and mental illness.

Trial locations and contacts

1 site in 1 country.

Portugal1 site
  • Instituto Português da Face

    Lisbon, 1050-227

Other trials in Portugal

About this study

Official title: Comparison of Temporomandibular Joint Arthrocentesis With Infiltration of PRP + Ropivacaine Versus PRP: Does It Reduce Postoperative Pain?

The infiltration of Platelet Rich Plasma (PRP) at the end of Temporomandibular Joint (TMJ) arthrocentesis is already an established procedure in the treatment of Temporomandibular Disorders (TMD). Arthrocentesis is a minimally invasive surgical procedure, which aims to eliminate the inflammatory mediators from the inside of the TMJ. PRP is an autologous concentrate of platelets and growth factors, derived from centrifugated blood. Several studies have described the benefits of PRP: it enhances wound healing because of the presence of cytokines and growth factors, and is also stimulates chondrocytes to biosynthesis of collagen. Ropivacaine is a local anesthetic that has been synthesized for use in infiltration anesthesia and to produce both peripheral and central block. Unlike one of its analogues, Bupivacaine, Ropivacaine anesthetize the sensory fibers without affecting the motor ones. The main goal of this investigation is to test the benefits of adding Ropivacaine to the infiltration of PRP in patients submitted to TMJ arthrocentesis.

Read the detailed description

To investigate the potential reduction of pain in the postoperative week in patients submitted to temporomandibular joint double portal arthrocentesis with lavage and Platelet Rich Plasma (PRP) the authors designed a double-blind randomized clinical trial, comparing a treatment group with additional ropivacaine and a control group without ropivacaine.

Being tested
Ropivacaine injection, temporomandibular joint arthrocentesis, PRP injection, Ringer's Lactate solution
Keywords
temporomandibular disorders, temporomandibular joint arthrocentesis, ropivacaine, randomized clinical trial
Medical subject headings
Temporomandibular Joint Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ropivacaine injectionDrug

    Ropivacaine is a local anesthetic that has been synthesized for use in infiltration anesthesia and to produce both peripheral and central block. Unlike one of its analogues, Bupivacaine, Ropivacaine anesthetize the sensory fibers without affecting the without affecting the motor ones. Ropivacaine comes as solution for injection.

  • temporomandibular joint arthrocentesisProcedure or surgery

    Temporomandibular arthrocentesis is a minimally invasive surgical procedure, which aims to eliminate the inflammatory mediators from the inside of the TMJ.

  • PRP injectionDrug

    Platelet-Rich Plasma (PRP) is an orthobiological adjuvant treatment. PRP has properties to restore intra-articular hyaluronic acid, increases glycosaminoglycan chondrocyte synthesis and balances joint angiogenesis. It is often used as a viscosupplement in TMJ arthrocentesis

  • Ringer's Lactate solutionDrug

    Ringers lactate solution is used during arthrocentesis to wash out the joint inflammatory cells and to release the stuck disc phenomenon.

Study groups in NCT05817162
Study groupRoleWhat they receive
Placebo Group: PRPPlacebo comparatorTemporomandibular joint arthrocentesis, Ringer lactate for washing, and 1ml PRP infiltration in each temporomandibular joint
Receives: Procedure: temporomandibular joint arthrocentesis; Drug: PRP injection; Drug: Ringer's Lactate solution
PRP + RopivacaineActive comparatorTemporomandibular joint arthrocentesis, Ringer lactate for washing, and 1ml PRP + ropivacaine infiltration in each temporomandibular joint
Receives: Drug: Ropivacaine injection; Procedure: temporomandibular joint arthrocentesis; Drug: PRP injection; Drug: Ringer's Lactate solution

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. TMJ Pain

    Change in TMJ pain in a 0-10 scale (where 0 is no pain and 10 is the maximum possible pain) assessed by the surgeon

    Measured: In the first week at a consultation after injection and TMJ arthrocentesis

Secondary outcomes (16)
  1. Postoperative pain

    Change in TMJ pain / TMJ muscles pain: measured by the patient using a Visual Analogue scale (VAS), with a range from 0 to 10, with 0 being no pain and 10 having maximum unbearable pain. VAS score will be measured every day before TMJ arthrocentesis in the week after surgery.

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  2. General state pre vs post

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week. (0-much better, 1-litte better, 2-no changes, 3-litter worse, 4-much worse)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  3. Functional limitation chewing foods

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  4. Difficulty closing and mouth opening

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  5. TMJ pain, muscular pain, ear pain

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  6. Interrupt meals

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  7. Sleep been interrupted

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  8. Difficult doing usual jobs

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  9. Unable to work full capacity

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  10. Difficult to relax

    Daily questionnaire based (OHIP 10) furnished by surgeon to fill at home: the patient has to fill it every day for 1 week (0-never, 1-hardly never, 2-occasionally, 3-fairy often, 4-very often)

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  11. Need of medication after intervention

    Indication of the number of SOS analgesic pills taken each day

    Measured: Daily 1 week after TMJ arthrocentesis and infiltration

  12. TMJ pain assessed by the physiotherapist

    Pain in left and right TMJ evaluated by the physiotherapist in a 0-10 scale (where 0 is no pain and 10 is the maximum possible pain)

    Measured: 1 week after injection and TMJ arthrocentesis in a physiotherapy consultation

  13. TMJ pain during lateral deviation assessed by the physiotherapist

    Pain in left and right TMJ during lateral deviation evaluated by the physiotherapist in a 0-10 scale (where 0 is no pain and 10 is the maximum possible pain)

    Measured: 1 week after injection and TMJ arthrocentesis in a physiotherapy consultation

  14. TMJ pain during protrusion assessed by the physiotherapist

    TMJ pain during protrusion evaluated by the physiotherapist in a 0-10 scale (where 0 is no pain and 10 is the maximum possible pain)

    Measured: 1 week after injection and TMJ arthrocentesis in a physiotherapy consultation

  15. Myalgia degree assessed by the physiotherapist

    Myalgia degree in right and left masseter and temporalis muscles evaluated by the physiotherapist in a 0-3 scale

    Measured: 1 week after injection and TMJ arthrocentesis in a physiotherapy consultation

  16. Physiotherapist's perception of comfort during the consultation

    For the therapist: in a 0 to 10 scale evaluate your perception of patients comfort during the physical therapy question

    Measured: 1 week after injection and TMJ arthrocentesis in a physiotherapy consultation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Apr 2023
  2. Study start1 Apr 2023
  3. Primary completion1 Apr 2024 (estimated)
  4. Study completion1 Jul 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
For this randomized clinical trial an appropriate number of sealed envelopes will be prepared: 15 for PRP and 15 for PRP + Ropivacaine. Patients with inclusion criteria will be seen in an orofacial pain session and assessed for pain using the VAS scale, by scoring the degree of pain between 0 (absence of pain) and 10 (maximum pain). Then the patients are proposed for TMJ arthrocentesis.
Masking
Single blind
Who is masked
Investigator
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05817162
Sponsor's protocol ID
ROPIVACAINE_TMJ
Status last verified
Mar 2023
First submitted
4 Apr 2023
Last updated
20 Apr 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Due to data protection policy it is not possible to share this data with other researchers.

Publications

  • Derwich M, Mitus-Kenig M, Pawlowska E. Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis-A Systematic Review. Int J Mol Sci. 2021 Jul 9;22(14):7405. doi: 10.3390/ijms22147405.

    PubMed 34299024
  • Keyser C, Bhashyam A, Abdurrob A, Smith JT, Bluman E, Chiodo C. Excess Opioid Disposal Following Orthopaedic Surgery: A Randomized Clinical Trial. Foot Ankle Spec. 2022 Dec;15(6):545-550. doi: 10.1177/1938640020980921. Epub 2020 Dec 27.

    PubMed 33356547
  • Rao TN, Goswami D, Roychoudhury A, Bhutia O, Baidya DK, Trikha A. Efficacy of Local Anesthetic Wound Infiltration in Temporomandibular Joint Ankylosis Surgery for Control of Postoperative Pain: A Prospective, Randomized Controlled, and Double-Blinded Trial. J Oral Maxillofac Surg. 2021 Mar;79(3):559.e1-559.e11. doi: 10.1016/j.joms.2020.10.034. Epub 2020 Oct 29.

    PubMed 33232658

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ropivacaine injection, temporomandibular joint arthrocentesis and PRP injection in people with Temporomandibular Joint Disorders, run by Instituto Portugues da Face at 1 site in Portugal.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 20 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Portugal. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

TMJ Pain (time frame: In the first week at a consultation after injection and TMJ arthrocentesis). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05817162, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Apr 2023.

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