Evaluation of the efficacy of injectable platelet-rich fibrin and concentrated platelet-rich fibrin injections combined with arthrocentesis in the treatment of temporomandibular joint internal disorders

Aim: The aim of this study is to investigate the effectiveness of injectable platelet-rich fibrin (I-PRF) and concentrated platelet-rich fibrin (C-PRF) injections applied after arthrocentesis in patients with temporomandibular joint internal derangements. Material and Method: This prospective, randomized, controlled clinical study was conducted with patients who presented with joint complaints and met the inclusion criteria. The patients were randomly divided into three groups in which arthrocentesis alone or arthrocentesis and I-PRF or C-PRF injections were applied. Pain level, maximum mouth opening (MMO), lateral and protrusive movements and joint sounds preoperatively, postoperatively, 1st week, 1st month and 3rd month; Oral health-related quality of life (OHRQoL) and mandibular dysfunction were evaluated preoperatively and at 3 months. Visual analogue scale (VAS) was used to evaluate pain, oral health impact profile-14 (OHIP-14) was used to evaluate OHRQoL, and mandibular functional impairment questionnaire (MFIQ) was used to evaluate mandibular dysfunction. Results: 30 patients (mean age 41±12.19), 2 male and 28 female, were included in the study. Although generally more successful results were obtained in the I-PRF and C-PRF groups in terms of pain level, MMO, lateral and protrusive movements, no statistically significant differences were observed between the groups except for the significant differences at postoperative-1st week (p=0.023) for MMO and preoperative-1st month (p=0.043), preoperative-3rd month (p=0.005) and 1st week-3rd month (p=0.007) for left lateral movement. No statistically significant differences were observed between the groups in terms of OHIP-14 and MFIQ scores (p>0.05). Conclusion: It has been observed that intra-articular I-PRF and C-PRF injections applied following arthrocentesis are more successful in terms of the effectiveness on clinical parameters than arthrocentesis alone, although it is limited to the early period for C-PRF.