Ass. Lecturer of Oral and Maxillofacial Surgery, Faculty of Dental Medicine Al-Azhar University. Assuit City, Assuit, Egypt.
Ass. Lecturer of Oral and Maxillofacial Surgery, Faculty of Dental Medicine Al-Azhar University. Assuit City, Assuit, Egypt; Ass. Prof of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University. Assuit City, Assuit, Egypt.
Br J Oral Maxillofac Surg. 2024 Oct;62(8):710-715. doi: 10.1016/j.bjoms.2024.05.002. Epub 2024 May 20.
The current research paper was designed to assess the impact of an intra-articular injection of injectable platelet-rich fibrin (I-PRF) following arthrocentesis and the use of an anterior repositioning splint (ARS) as a proposed treatment approach for addressing symptomatic internal derangement of the temporomandibular joint (TMJ). This study comprised thirty patients who presented with bilateral disc displacement without reduction. The patients were evenly distributed into two groups: Group I underwent treatment involving ARS and arthrocentesis alone, while Group II underwent treatment with ARS, arthrocentesis, and the injection of I-PRF. Clinical assessment of all patients was done postoperatively in the following intervals; first week, first month, third month, and six months for maximum mouth opening (MMO), right and left lateral excursion, and pain score. Magnetic resonance imaging (MRI) assessment for all joints was done at the sixth month postoperatively. Both groups demonstrated improvement in MMO, lateral excursion, and pain. Significant statistical differences were observed in the mean values of MMO and Visual Analogue Scale (VAS), favouring the I-PRF group. MRI postoperatively showed no significant changes in disk position or morphology at the end of the sixth month. Administering an intra-articular I-PRF injection subsequent to arthrocentesis demonstrates effectiveness as a treatment approach for alleviating the signs and symptoms associated with internal derangement of the TMJ.
本研究旨在评估关节内注射富含血小板纤维蛋白(I-PRF)联合关节腔穿刺抽吸术,以及使用前移位夹板(ARS)作为治疗伴有关节盘不可复性前移位的颞下颌关节(TMJ)紊乱的一种方法。本研究共纳入 30 例双侧不可复性关节盘前移位的患者,将患者平均分为两组:I 组单纯采用 ARS 和关节腔穿刺抽吸术治疗,II 组采用 ARS、关节腔穿刺抽吸术联合 I-PRF 注射治疗。所有患者术后分别于第 1 周、第 1 个月、第 3 个月和第 6 个月进行临床评估,评估项目包括最大张口度(MMO)、左右侧方运动距离和疼痛评分。术后第 6 个月对所有关节进行磁共振成像(MRI)评估。两组患者的 MMO、侧方运动距离和疼痛均有改善。I-PRF 组的 MMO 和视觉模拟评分(VAS)的均值有显著统计学差异。术后 6 个月的 MRI 显示,两组患者的关节盘位置或形态均无明显变化。关节内注射 I-PRF 联合关节腔穿刺抽吸术可有效缓解 TMJ 紊乱相关的症状和体征。