Platelet-rich plasma versus hyaluronic acid injection following arthrocentesis for temporomandibular joint disorders under sedation: a comparative clinical study.

OBJECTIVE

Temporomandibular joint disorders (TMDs) are a common source of orofacial pain and dysfunction. Arthrocentesis of the temporomandibular joint (TMJ) is a minimally invasive treatment that can be augmented with intra-articular injections. This study aimed to compare the clinical efficacy of platelet-rich plasma (PRP) versus hyaluronic acid (HA) injections following TMJ arthrocentesis in patients with TMDs unresponsive to conservative therapy.

METHODS

Sixty patients (72 joints) were randomized into three equal groups. Group A underwent arthrocentesis with Ringer's lactate (RL) alone (control), Group B received PRP injection post-arthrocentesis, and Group C received HA injection post-arthrocentesis. Pain intensity (VAS), maximum mouth opening (MMO), and TMJ sounds were evaluated at baseline, 1 week, 12 weeks, and 24 weeks. Repeated-measures ANOVA and chi-square tests were used for analysis (p < 0.05).

RESULTS

All groups showed significant improvements in pain and MMO over time. Mean VAS pain scores decreased from ~ 4.8 to < 1.0 at 24 weeks (p < 0.001), while MMO increased from ~ 32 mm to ~ 40 mm (p < 0.001). No significant differences were found between the PRP and HA groups in pain or function at any follow-up point, nor between either treatment group and the control group. TMJ clicking resolved or improved in > 95% of joints across all groups. No adverse events were recorded.

CONCLUSION

TMJ arthrocentesis alone provides substantial pain relief and functional gains. PRP and HA did not confer additional benefit over lavage alone within the 6-month timeframe. Further studies are required to assess any potential long-term differences.