Department of Oral and Maxillofacial Surgery, Istanbul Aydin University.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey.
J Craniofac Surg. 2020 Oct;31(7):1870-1874. doi: 10.1097/SCS.0000000000006545.
The aim of this study was to evaluate the effectiveness of intra-articular injection of liquid platelet-rich fibrin (I-PRF) versus hyaluronic acid (HA) following arthrocentesis in patients suffering from temporomandibular joint (TMJ) pain and dysfunction. A total of 69 patients with internal TMJ derangement were enrolled in this retrospective, matched cohort study. A total of 47 included patients (67 joints) were divided into 3 groups as follows: 16 participants in the arthrocentesis-only group; 14 patients in the arthrocentesis plus HA injection group (A+HA); and 17 participants in the arthrocentesis plus I-PRF injection group (A+I-PRF). The 2 outcome variables were TMJ pain and maximal mouth opening (MMO) which were evaluated up to 12 months postoperatively. The data were analyzed using the Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Wilcoxon sign test, Fisher exact test, and the χ test. Statistically significant decreases in pain scores and increases in MMO values were observed in all 3 groups during the 12 months of follow-up. The significant decrease in pain values was shown in the A+I-PRF group as compared with the A+HA group at 9 months postoperatively. MMO values in the A+I-PRF group were significantly higher than in the A+HA group at 9 and 12 months postoperatively. All conventional treatment procedures can provide pain reduction and improvement to MMO. However, intraarticular injections of I-PRF in combination with arthrocentesis showed superior performance in terms of the gradual improvement in pain alleviation and range of mouth opening.
本研究旨在评估关节内注射富含血小板的纤维蛋白(I-PRF)与透明质酸(HA)在关节腔穿刺后治疗颞下颌关节(TMJ)疼痛和功能障碍患者的疗效。共有 69 例 TMJ 内部紊乱患者参与了这项回顾性、匹配队列研究。共有 47 例纳入患者(67 个关节)分为 3 组:关节腔穿刺组(16 例);关节腔穿刺联合 HA 注射组(A+HA,14 例);关节腔穿刺联合 I-PRF 注射组(A+I-PRF,17 例)。2 个观察结果变量为 TMJ 疼痛和最大张口度(MMO),术后随访 12 个月时进行评估。采用 Shapiro-Wilk 检验、Kruskal-Wallis 检验、Mann-Whitney U 检验、Wilcoxon 符号秩检验、Fisher 确切检验和 χ 检验对数据进行分析。在 12 个月的随访中,所有 3 组的疼痛评分均显著降低,MMO 值均显著增加。与 A+HA 组相比,A+I-PRF 组术后 9 个月疼痛值显著降低。术后 9 个月和 12 个月,A+I-PRF 组的 MMO 值明显高于 A+HA 组。所有常规治疗程序均可减轻疼痛并改善 MMO。然而,与关节腔穿刺术联合使用 I-PRF 的关节内注射在缓解疼痛和张口度逐渐改善方面表现出更好的性能。