Sodium hyaluronic acid, platelet rich plasma and dextrose prolotherapy in management of Temporo-mandibular joint internal derangement. A Comparative study

Introduction: Internal derangement of temporomandibular joint (TMJ) is characterized by displacement of the intra-articular disc, results in clicking or popping sounds.
Aim of study: Is to compare the efficacy of arthrocentesis followed by hyaluronic acid, PRP versus dextrose prolotherapy in management of temporomandibular joint internal derangement.
Patients and methods: The present study included 45 adult patients suffering from internal derangement of Temporo-mandibular joint selected from those attending oral and maxillofacial surgery department, faculty of dentistry, October 6 University.Group I: Composed of 15 patients (10 females, 5 males) where arthrocentesis followed by hyaluronic acidwasinjected intra-articular. Group II: Composed of 15 patients (9 females , 6 males) where1ml of platelet rich plasma wasinjected intra-articular.Group III: Composed of 15 patients (9 females, 6 males) where dextrose prolotherapy was injected (3 times)at 0, 2 and 4 weeks.
Results:there was no statistically significant difference between Group I and Group III; both showed the statistically significantly highest mean MIO values. Group II showed the lowest mean MIO.Group I and Group III; both showed statistically significantly lower meanVAS scoresafter 12 months compared to pre-operative measurement.After 6 months, Group III showed the highest prevalence of deviation followed by Group I while Group II showed no deviation.
Conclusions :arthrocentesis followed by sodium hyaluronic acidand Prolotherapy is a successful technique to improve maximum inter-incisal opening as well as assisted interincisal opening and improved higher significant changes in pain intensity, however PRP was effective in improvement of deviation