Does concentrated growth factor provide better outcomes than platelet-rich fibrin or arthrocentesis in the management of temporomandibular disorders?

The purpose of this study was to compare and evaluate the efficacy of intra-articular injection of liquid platelet-rich fibrin (liquid-PRF) or liquid phase concentrated growth factors (LPCGF) with arthrocentesis for temporomandibular disorders. This randomized controlled trial included 60 patients with internal disc derangement who were randomly assigned to three groups: liquid-PRF injection, LPCGF injection, and arthrocentesis. The clinical parameters evaluated were pain on function, tenderness on palpation, temporomandibular joint sounds, jaw deviation, maximum mouth opening (MMO), and maximum protrusive and laterotrusive (ipsilateral and contralateral) jaw movements. Radiographic parameters included vertical joint space height (measured on panoramic radiographs) and articular disc position, disc shape, and total joint space (assessed on magnetic resonance imaging). Treatment outcomes were compared between the groups using ANOVA for continuous variables and the χ2 test for categorical variables. LPCGF patients reported significantly lower mean ± standard deviation pain scores at 6 months than the liquid-PRF and arthrocentesis patients (LPCGF 1.80 ± 0.83, liquid-PRF 2.60 ± 0.94, arthrocentesis 3.30 ± 0.65; P < 0.001). Furthermore, the LPCGF patients had significantly higher MMO (LPCGF 37.60 ± 3.20 mm, liquid-PRF 32.65 ± 1.81 mm, arthrocentesis 31.05 ± 1.31 mm; P < 0.001), as well as mean protrusive and contralateral movements (all P < 0.001), than the liquid-PRF and arthrocentesis patients. Overall, LPCGF demonstrated superior performance for the clinical outcomes analysed when compared with liquid-PRF and arthrocentesis; however, radiographic outcomes did not differ significantly.