EFFICACY OF INTRA-ARTICULAR PLATELET RICH PLASMA VERSUS HYALURONIC ACID AFTER ARTHROCENTESIS FOR THE TREATMENT OF INTERNAL DERANGEMENTS OF THE TEMPOROMANDIBULAR JOINT – A RANDOMIZED CONTROLLED TRIAL

Temporomandibular joint disorder (TMD) is a common source of orofacial pain and is characterized by pain, joint noise, limited range of motion, impaired jaw function, deviation or deflection upon mouth opening, malocclusion and closed or open locking. The term temporomandibular joint (TMJ) internal derangement is used synonymously to describe displacement of the articular disc. Though there are many conservative as well as surgical modalities available for management of TMD, only a few have been proved foolproof. The primary goals of the treatment for TMD are pain relief and increasing the range of mandibular motion. The milestone in the treatment of TMJ internal derangement was with the introduction of TMJ arthroscopy and methods for lysis and lavage of the upper joint space by arthrocentesis.

The lavage and lysis of the upper joint compartment under local anesthesia enables the disc to slide to its normal anatomic position, thus re-establishing the normal range of mandibular functions. Intra-articular administration of medications is an established method of treatment, particularly for rheumatic disorders that are associated with pain, effusion, inflammation of cartilage, bone and joint capsules as well as fibrous adhesions.

The aim of this prospective study is to compare the efficacy of arthrocentesis followed by intra-articular administration of PRP vs arthrocentesis followed by intra-articular administration of hyaluronic acid in patients with anterior disc displacement of the TMJ with or without reduction in order to minimize the symptoms which were unresponsive to conservative treatment modalities.