Randomised controlled trial of arthrocentesis with or without PRF for internal derangement of the TMJ

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

“… 21 who showed significant increase in mouth opening at 6 months with arthrocentesis and stated that arthrocentesis was effective in the late term results due to removal of the articular adhesions and expanding the articular space which in turn causes muscles relaxation and tissue contraction. 26 Besides, many studies have reported the effectiveness of arthrocentesis to be up to 91%, including displacement without reduction. 13 , 26 …”

“… 26 Besides, many studies have reported the effectiveness of arthrocentesis to be up to 91%, including displacement without reduction. 13 , 26 …”

“…Many studies evaluated the efficacy of some drugs or autologous products after TMJ arthrocentesis procedure to relieve symptomatic internal derangements and improve the quality of life of the patients. 26 Hyaluronic acid, 7 , 10 steroids 27 NSAIDs 28 and morphine were injected into the joint either alone or in combination. 11 , 29 and proved neither reversal nor permanent cessation of the deterioration cycle of the derangement.…”

“…Considering the complications such as allergic reactions and infection 26 on addition to understanding the deterioration mechanism that occurs in the TMJ, bio-supplementation approaches with ortho-biological agents like platelet-rich biomaterials have become popular in the management of ID. 9 , 22 Many researches have managed TMJ internal derangement by PRP injection, since it can stimulate release of endogenous HA, growth factors as well as joint angiogenesis.…”

“… 30 and Karadayi et al. 26 who used single injection of i-PRF in addition to arthrocentesis and observed promising results regarding postoperative pain, clicking and mouth opening. This may be due to the sustained growth factors release from its matrices which eliminates the need for subsequent injections.…”