Efficacy of computer assisted double-needle arthrocentesis with intra articular injection of sodium hyaluronate versus platelet rich plasma for treatment of TMJ internal derangement (a clinical study)

Document Type : Original Article

Authors

1 Maxillofacial Surgery Department, Faculty of Dental Medicine, Al-Azhar University, Cairo, Boys

2 Oral and Maxillofacial Surgery, Faculty of Dentistry, Al-Azhar University, Cairo, Egypt

3 Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University, Cairo, Boys

Abstract

Objective of the present study evaluated the efficacy of computer-assisted arthrocentesis with intra articular injection of sodium hyaluronate versus autologous platelet rich plasma for treatment of internal derangement of TMJ. Subjects and methods: Randomized controlled trial conducted on fourteen patients diagnosed with bilateral TMJ-ID divided into two equal groups were randomly selected from the patients. Group I (SH) treated with TMJ arthrocentesis using customized 3D printed computer assisted guide followed by intra articular injection of SH. Group II (PRP) received a similar surgical protocol but injection with PRP. All patients were clinically and radiographically evaluated for the pain intensity through visual analog scale (VAS), maximum inter incisal opening (MIO). Results: Regarding the change in pain score increased immediately after arthrocentesis for about two days then the pain level decreases dramatically for fourteen days to reach mild level lower than preoperative scores after six months postoperatively, there was a statistically insignificant difference between both groups in all observation intervals. But, within each group there was significant improvement. Regarding the change in MIO opening decreased significantly immediately postoperative and improved gradually and gained a noticeable increase after six months postoperatively, there was a statistically insignificant difference between both groups in all observation intervals. but within each group there was significant improvement. Conclusion: Either intra-articular injections of SH or autologous PRP have shown promising results in managing TMD with ID. The study did not reveal any significant preference for one material over the other in terms of clinical efficacy.

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Al-Azhar Journal of Dental Science
Volume 28, Issue 3 - Serial Number 3
July - Oral Medicine & Surgical Sciences Issue (Oral Medicine, Oral & Maxillofacial Surgery, Oral Pathology, Oral Biology)
July 2025
Pages 467-476

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