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

Abstract

Background/purpose Temporomandibular joint disc displacement is the most frequently reported temporomandibular disorder that may severely impair quality of life and can be challenging to treat. This study aimed to evaluate and compare the efficiency of intra-articular injection of injectable platelet rich fibrin (i-PRF) following arthrocentesis or arthrocentesis alone in treatment of patients with TMJ disc displacement with reduction. Materials and methods Forty patients for a total of forty joints with reducible anterior disc displacement, as confirmed by Magnetic Resonance Imaging (MRI) were selected and divided into 2 equal groups. In group I (control group), arthrocentesis alone was performed with Ringer solution. In group II (study group), a combination of arthrocentesis and intra-articular injection with 1.5 ml i-PRF was performed. The outcome variables included pain intensity evaluated with a visual analogue scale, inter-incisal opening, lateral movement evaluated in millimeters, and clicking. Assessments were done pre-operatively, and 1 week, 3 months, and 6 months postoperatively. Results There was statistically significant reduction in pain intensity and clicking sound and increase in mouth opening and lateral movement in i-PRF group when compared to arthrocentesis group. In addition, the differences between preoperative and postoperative status in all the measured parameters were statistically significant within the study and the control group throughout the postoperative period. Conclusion The combination of i-PRF with arthrocentesis is a safe and effective method in the treatment of TMJ disc displacement with reduction.

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

“…However, it is known that major growth factors and growth factor families from PRP, such as tissue growth factor-β (TGF-β), insulin-like growth factor 1 (IGF- 1), bone morphogenetic proteins (BMP), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), and hepatocyte growth factor (HGF), take part in the process of OA healing [ 42 , 43 , 44 ]. The detailed composition of blood products results not only from the properties of the patient’s blood but also from the method of preparation; hence, apart from PRP used for injection into TMJs cavities, there are also other substances including I-PRF (injectable platelet-rich fibrin) and PRGF (plasma-rich in growth factors) [ 45 , 46 , 47 ]. Various growth factors play a role in the proliferation and differentiation of chondrocytes, chondrocyte mitosis and extracellular matrix synthesis, and vascular structure formation and regeneration, which are the basis for cartilage regeneration [ 43 ].…”

Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

“…Publication Year First Author Diagnosis Intervention Substance Comparison Group Ghoneim [38] DDwR R+A I-PRF R * Sembronio [39] ID, OA R+A Adipose tissue R+HA * Sembronio [39] ID, OA R+A HA R+Adipose tissue * Karadayi [40] ID R+A I-PRF R * Jacob [41] DDwR, DDwoR R+A PRP R * Jacob [41] DDwR, DDwoR R+A HA R * Singh [42] ID R+A PRP R * Dolwick [43] P R+A CS R+Placebo * Zarate [44] P A Dextrose+Lidocaine Lidocaine * De Riu [45] DD R+A HA R+Bone marrow * De Riu [45] DD R+A Bone marrow R+HA * Yilmaz [46] ID A HA R+HA * Yilmaz [46] ID R+A HA HA * Bergstrand [47] OA R+A HA R * Isacsson [48] P A CS Placebo * Louw [49] P A Dextrose+Lidocaine Lidocaine * Gokçe Kutuk [50] P A HA CS * Gokçe Kutuk [50] P A CS HA * Gokçe Kutuk [50] P A PRP CS * Diaz [51] P R+A CS R+Placebo * Yapici-Yavuz [52] DDwoR R+A CS R * Yapici-Yavuz [52] DDwoR R+A HA R * Yapici-Yavuz [52] DDwoR R+A Tenoxicam R * Ozdamar [53] ID R+A HA R * Gorrela [54] DDwR, DDwoR R+A HA R * Gurung [55] OA R+A HA R * Cömert Kiliç [56] OA R+A CS R * Patel [57] ID R+A HA R * Bouloux [58,59] P R+A CS R * Bouloux [58,59] P R+A HA R * Cömert Kiliç [60] OA R+A PRP R+HA * Korkmaz [61] DDwR A HA Splint therapy * Lam [62] P A Dextrose+Lidocaine Lidocaine * Cömert Kiliç [63] OA R+A PRP R * Hegab [64] OA A HA PRP * Hegab [64] OA A PRP HA * In line with the assumptions ...…”

“…PRP administration as the only procedure was effective in terms of increasing mandibular abduction amplitude in the diagnoses of disk displacement with reduction and not specified joint pain. I-PRF was used only after arthrocentesis, and PRGF was used without rinsing the joint [38,40,79]. Data on the use of the latter substance are derived from only one report, describing a study without a control group [79].…”

Temporomandibular Joint Disk Displacement: Etiology, Diagnosis, Imaging, and Therapeutic Approaches

“…Arthrocentsis, arthroscopy, arthroplasty are aggressive procedures performed with anesthesia with several adverse reactions 11,43,45,48,73–76…”

“…Finally, arthroplasty is an open joint procedure,11,73–75 it may involve disk repositioning, articular surface recontouring, disk removal or a combination thereof 11…”