Comparison of the Efficiacy of Intra-Articular Injection of Liquid Platelet-Rich Fibrin and Hyaluronic Acid After in Conjunction With Arthrocentesis for the Treatment of Internal Temporomandibular Joint Derangements

Abstract

The aim of this study was to evaluate the effectiveness of intra-articular injection of liquid platelet-rich fibrin (I-PRF) versus hyaluronic acid (HA) following arthrocentesis in patients suffering from temporomandibular joint (TMJ) pain and dysfunction. A total of 69 patients with internal TMJ derangement were enrolled in this retrospective, matched cohort study. A total of 47 included patients (67 joints) were divided into 3 groups as follows: 16 participants in the arthrocentesis-only group; 14 patients in the arthrocentesis plus HA injection group (A+HA); and 17 participants in the arthrocentesis plus I-PRF injection group (A+I-PRF). The 2 outcome variables were TMJ pain and maximal mouth opening (MMO) which were evaluated up to 12 months postoperatively. The data were analyzed using the Shapiro–Wilk test, Kruskal–Wallis test, Mann–Whitney U test, Wilcoxon sign test, Fisher exact test, and the χ 2 test. Statistically significant decreases in pain scores and increases in MMO values were observed in all 3 groups during the 12 months of follow-up. The significant decrease in pain values was shown in the A+I-PRF group as compared with the A+HA group at 9 months postoperatively. MMO values in the A+I-PRF group were significantly higher than in the A+HA group at 9 and 12 months postoperatively. All conventional treatment procedures can provide pain reduction and improvement to MMO. However, intraarticular injections of I-PRF in combination with arthrocentesis showed superior performance in terms of the gradual improvement in pain alleviation and range of mouth opening.

Treatment of temporomandibular joint disc displacement using arthrocentesis combined with injectable platelet rich fibrin versus arthrocentesis alone

“…In addition, there was statistically significant difference regarding all these studied parameters within the i-PRF group between baseline and 6 months follow up. Our results agreed with Yuce et al., 33 who compared the efficacy of arthrocentesis alone, arthrocentesis followed by HA injection, and arthrocentesis followed by i-PRF injection and revealed significant decrease in pain and increase in maximum inter-incisal opening in the study group. Similarly, Hancı et al.…”

“…Torul et al., 30 showed that injection of i-PRF appeared to have significant long-term promising effects in the management of TMJ internal derangement which can be related to its ability to selectively enrich leukocytes, platelets, growth factors and cytokines within its liquid matrices. 1 , 18 , 19 , 33 Our results disagreed with Albilia et al. 1 where no statistically significant decrease in pain score was obtained in the i-PRF group and the increase in maximum mouth opening was insignificant for all patients.…”

“… 1 who performed multiple injections with 2 weeks intervals until an acceptable improvement was observed and Yuce et al. 33 who applied three consecutive injections weekly. Our study was similar to Torul et al.…”

Evaluating the role of intra articular injection of platelet‐rich fibrin in the management of temporomandibular joint osteoarthritis: A STROBE compliant retrospective study

“…[20][21][22] Wilkes stages. 12 Yuce et al 23 in their study comparing arthrocentesis alone with addition of either HA or i-PRF showed significant benefits with addition of i-PRF compared with arthrocentesis alone in terms of VAS scores and MMO. Hydraulic adheolysis, elimination of negative pressure in the superior joint space, restoration of the synovial viscosity and growth factor release and circulation are the reason behind the effect of PRF.…”

Platelet-Therapeutics to Improve Tissue Regeneration and Wound Healing—Physiological Background and Methods of Preparation

“…In knee arthrosis, degenerative disc disease (intradiscal treatment), facet pathologies (intrafacial injection), and sacroiliitis, reduced pain scores and increased functionality were observed after platelet-rich plasma therapy [ 75 ]. Improvement can also be observed in severe temporomandibular joint disorders through platelet-rich fibrin injection after arthrocentesis into the upper join space or with adjuvant platelet-rich plasma insertion during arthroscopy procedures or arthrocentesis [ 76 , 77 ].…”