Effectiveness of Prolotherapy Injections (Ketoprofen + 5% Dextrose Solution/Aquadest) for Pain and Function in Temporomandibular Disorder: A Systematic Review

Background Temporomandibular disorder (TMD) often leads to pain and functional limitation of the temporomandibular joint (TMJ). Prolotherapy involves injection of a proliferative agent (such as dextrose) and/or anti-inflammatory (e.g., ketoprofen) into joint or periarticular tissues. Objective To evaluate the effectiveness of prolotherapy injections using ketoprofen + 5% dextrose solution (aquadest) compared with control interventions for pain relief and functional improvement in TMD. Methods Systematic search in PubMed (MEDLINE), Scopus, and ScienceDirect between January 2015 and December 2025. Inclusion: RCTs or controlled prospective studies on adults with TMD receiving prolotherapy injections. Primary outcome: pain (VAS/NRS). Secondary outcomes: maximal mouth opening (MIO/MMO), jaw function, joint noise/dislocations. Risk of bias assessed with RoB 2. Meta-analysis using standardized mean difference (SMD) or mean difference (MD). Results Provide diagram: e.g., “From 1,032 records, 820 after duplicates removed; 52 full texts assessed; 7 studies included (5 RCTs, 2 prospective controlled)”. List reasons for exclusion: wrong intervention, dextrose % ≠5%, no ketoprofen component, follow-up too short, non-comparator design. Conclusion Prolotherapy injections using ketoprofen + 5% dextrose show promising results for TMD pain and jaw function; however, evidence remains limited and standardized protocols are needed.