Comparison of the efficacy of hyaluronic acid and platelet rich plasma with and without arthrocentesis in the treatment of temporomandibular joint internal disorders

Temporomandibular disorders are complex diseases which reduce life quality by causing pain and dysfunction and affect daily activities in negative manner, have frequent occurrence in population. Various procedures are developed in order to reduce pain and functional complaints of patients with TMJ dysfunction. Arthrocentesis is a simple, minimally invasive and (depending on long term results and low complication rate) efficient treatment method. Thus, arthrocentesis can be performed in acute and chronic closed lock of TMJ as a first step procedure. Sodium hyaluronate, one of the major components of the synovial fluid, is responsible for the viscosity of the synovial fluid and It is important to maintain the lubricity of the joint surfaces. It prevents intra-articular adhesions and has analgesic and anti-inflammatory properties. Platelet rich plasma is a cellular plasma component that is obtained by whole blood centrifugation and contains a higher platelet concentration and hyperphysiological proportional growth factor than whole blood, which accelerates the healing process in tendon, ligament, cartilage and muscle injuries with this properties. A single-blind, randomized, prospective clinical study was designed. 60 healthy patients with disk displacement and degenerative changes, maximum inerincisal opening (MIO) less than 35 mm and, pain at palpation of temporomandibular joint were included. Patients' MIO and pain scores at palpation (NS) were recorded. Patients will into four groups randomly. 1.group arthrocentesis + hyaluronic acid injection, 2.group only hyaluronic acid injection , 3.group arthrocentesis+ platelet rich plasma injection,4.group only platelet rich plasma injection. At the end of six months clinically findings will record. Key words: TMJ, Arthrocentesis, Hyaluronic acid, PRP