Evaluation the effectiveness of platelet rich fibrin and platelet rich plasma applied with arthrocentesis on pain and maximum mouth opening in temporomandibular joint disorders

Introduction: This retrospective study aims to evaluate the clinical effects of arthrocentesis only, arthrocentesis with injectable platelet-rich fibrin (i-PRF) and platelet-rich plasma (PRP) injection on postoperative pain and maximum mouth opening (MMO) in patients with temporomandibular joint disorders. Materials and Methods: The records of 116 patients who underwent arthrocentesis only, arthrocentesis with i-PRF and arthrocentesis with PRP between September 2018 and December 2022 at Necmettin Erbakan University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery were retrospectively analysed and the patients were divided into three groups. 35 patients underwent arthrocentesis (Group A), 47 patients underwent arthrocentesis with i-PRF (Group APRF) and 34 patients underwent arthrocentesis with PRP (Group APRP). Arthrocentesis was performed under local anaesthesia in all patients, and the articular cavity was irrigated with an average of 100 mL Salin solution. Patients in the APRF group were injected with 2 mL of i-PRF immediately after arthrocentesis and patients in the APRP group were injected with 2 mL of PRP immediately after arthrocentesis. Pre-procedure, 1 week, 1 month, 3 months and 6 months post-procedure pain and maximum mouth opening scores were statistically compared. Data were analysed using SPSS 26.0 software. Results: According to the results obtained, there was no statistically significant difference between the preoperative MMO and VAS measurements between the groups (p>0,05). In the 1st week MMO measurements, the highest value was found in Group A and the lowest value was found in Group APRF, and the differences between the groups were statistically significant (p<0,05). When the values of the 1st week VAS measurements were compared between the groups, it was observed that the values were close to each other and not statistically significant (p>0,05). Statistically significant differences were found between all groups (p<0,05) in the 1st month MMO measurements, the lowest MMO value was observed in the APRF group and the highest MMO value was observed in the APRP group. No statistically significant difference was found between the groups in terms of VAS scores at month 1 (p>0,05). At month 3 and 6 controls, statistically significant lower MMO scores were observed in the APRP group (p<0,05). No statistically significant difference was found in the 3rd and 6th month VAS measurements. Conclusion: No significant difference was found between the groups in terms of pain and quality of life measures. However, in terms of MMO, better results were obtained in the early postoperative period in the PRP group and in the late postoperative period in the i-PRF group. Keywords: Arthrocentesis, Temporomandibular Joint Disorders, Temporomandibular Joint Disc, Platelet Rich Fibrin, Platelet Rich Plasma