Clinical and Radiological Comparison of Effects of Platelet-Rich Plasma, Hyaluronic Acid, and Corticosteroid Injections on Temporomandibular Joint Osteoarthritis

J Craniofac Surg. 2019 Jun;30(4):1144-1148. doi: 10.1097/SCS.0000000000005211.

Abstract

There are few studies in the literature that comparatively evaluate the use of intra-articular orticosteroids (CS), hyaluronic acid (HA), and platelet-rich plasma (PRP). In this study, the authors aimed to compare the clinical results of intra-articular CS, HA, and PRP injections in patients who presented to the authors' clinic with temporomandibular joint (TMJ) pain and clinically diagnosed with TMJ-osteoarthritis. Patients were evaluated in 2 groups as those patients who felt pain on lateral (n = 31), and posterior (n = 43) palpation. Patients who were evaluated in the study were randomly assigned to 3 different treatment groups as Group 1 (PRP), Group 2 (HA), and Group 3 (CS). Pain felt on the TMJ on lateral and posterior palpation was assessed before treatment and every month for 3 months using a 5-point pain scale. Presence of crepitation, loss of function, and loss of strength were assessed before treatment and every month for 3 months. Significant changes were observed in the PRP and HA groups when the patients were evaluated according to the VAS scores evaluated at different follow-up times for TMJ pain on lateral palpation. Significant changes were observed in the PRP, HA, and CS groups when VAS scores were evaluated according to the patients' follow-up times for TMJ pain on lateral palpation. In conclusion, the findings of this study have shown that intra-articular PRP injections decreased TMJ palpation pain more effectively compared with the HA and CS groups.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Hyaluronic Acid / therapeutic use*
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Osteoarthritis / physiopathology
  • Osteoarthritis / therapy*
  • Platelet-Rich Plasma*
  • Temporomandibular Joint Disorders / physiopathology
  • Temporomandibular Joint Disorders / therapy*
  • Triamcinolone Acetonide / therapeutic use
  • Viscosupplements / therapeutic use
  • Visual Analog Scale

Substances

  • Glucocorticoids
  • Viscosupplements
  • Hyaluronic Acid
  • Triamcinolone Acetonide