The efficacy of intra-articular injectable platelet-rich fibrin application in the management of Wilkes stage III temporomandibular joint internal derangement |
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| Institution: | 1. Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;2. Eyesthetica, Oculofacial and Cosmetic Surgery Associates, Los Angeles, CA, USA;1. Resident, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China;2. Attending Doctor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China;3. Attending Doctor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China;4. Professor, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, PR China |
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| Abstract: | The aim of this retrospective study was to compare the effectiveness of hyaluronic acid (HA) and injectable platelet-rich fibrin (i-PRF) in the management of Wilkes stage III internal derangement, and to evaluate the biosupplementation capacity of i-PRF. The records of all 54 relevant patients with Wilkes stage III internal derangement confirmed by magnetic resonance imaging and treated with arthrocentesis alone or in combination with HA or i-PRF were selected. The outcome variables were pain intensity at rest (VASr) and in function (VASf), evaluated with a visual analogue scale, and maximum mouth opening (MMO), evaluated in millimetres; assessments were made preoperatively, immediately after the procedure, and at 1 week, 1 month, and 3 months postoperatively. When compared to the HA and arthrocentesis groups, the i-PRF group showed significantly better improvements in MMO at 1 and 3 months (P = 0.024 and P = 0.006, respectively), VASr at 1 and 3 months (both P < 0.001), and VASf at 1 week (P = 0.019) and 1 and 3 months (both P < 0.001) postoperatively. In all groups, better MMO, VASr, and VASf values were observed compared to the preoperative status. The application of i-PRF after arthrocentesis is more effective than arthrocentesis alone or with HA in the short term. HA was found not to provide significant additional benefits over arthrocentesis alone. |
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| Keywords: | arthrocentesis temporomandibular joint disorders temporomandibular joint degenerative platelet-rich fibrin |
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