Viscosupplementation compared to arthrocentesis in the management of disc displacement without reduction.

The aim of this study was to compare the efficacy of viscosupplementation and arthrocentesis in the management of patients with disc displacement without reduction (DDwR). This review critically analysed randomized clinical trials, following PRISMA guidelines and with a protocol registered in PROSPERO (CRD42025650126). A compre-hensive search was carried out in PubMed, Scopus, Web of Science, Cochrane, Embase, and Google Scholar. The PICOS framework guided the inclusion criteria, considering Population, Intervention, Comparator, Outcome, and Study design. Keywords such as “Temporomandibular Joint Dysfunction Syndrome”, “Temporomandibular Joint”, “Temporomandibular Joint Disc”, “Arthrocentesis”, and “Viscosupplementation” were used, individually and in combination. After screening and applying eligibility criteria, five study articles were included and assessed for risk of bias, level of evidence, and reported clinical outcomes. Both techniques were efficacious in controlling pain and improving the range of jaw opening. Arthrocentesis alone showed satisfactory results, but its association with viscosupplementation, especially with the use of Hyaluronic Acid (HA) or Injectable Platelet Rich Plasma (I-PRF), enhanced clinical effects. The choice of material for viscosupplementation appeared to have a direct impact on clinical outcomes. However, most of the study articles evaluated presented a high risk of bias, demonstrating the need for further research with greater methodological rigor for the scientific consolidation of these protocols. Although arthrocentesis remains a well-established management approach, viscosupplementation has emerged as a promising alternative, especially when combined with biomaterials, offering potential for improving patient outcomes in clinical practice.