INTRA ARTICULAR INJECTION OF HYALURONIC ACID ALONE IN COMPARISON WITH HYALURONIC ACID AND PRP IN THE TREATMENT OF INTERNAL DERANGEMENT OF TEMPOROMANDIBULAR JOINT

Objectives: This study aimed to compare the efficacy of intrarticular injection of HA alone versus HA and PRP in the treatment of internal derangement of the temporomandibular joint.
Patients and Methods: Twenty patients were involved in our study, divided into two equal groups, group (1), treated with intraarticular injection of HA alone and group (2) treated with intraarticular injection of HA and PRP. All patients were diagnosed with internal derangement of the TMJ. The patients were evaluated clinically and radiographically preoperatively and postoperatively: clinically for evaluation of pain intensity, maximal mouth opening and lateral movements. Radiographically by panoramic and MRI images for detection of the condyle disc relationship and detection of any pathological changes. Postoperatively the patient’s clinical data including pain intensity, maximal mouth opening and the lateral movements were evaluated at one week and 2, 3 weeks and one month and 2,3 and 6 months. Radigraphically using MRI images to determine any changes in the TMJ after injection at 6 months.
Results: Twenty patients, nineteen females and one male, their ages ranged from18-55 years with a mean of 29.5 years. The results of the clinical data including pain intensity, maximal mouth opening and lateral movements presented with significant improvements of all outcomes from preoperative to 6 months postoperatively for group (2) when compared with group (1). Radigraphically MRI after 6 months presented with no changes in the disc condyle relationship.
Conclusion: Intraarticular injection of HA and PRP considered to be strongly effective and optional treatment of internal derangement of TMJ when compared to HA alone by controlling pain, improving mouth opening and the lateral movements for up to 6 months.