Comparison of Intra-articular Injection of PRGF and Corticosteroid When Used as an Adjunct to Temporomandibular Joint Arthrocentesis: A Blinded Randomized Control Trial

Abstract

Background: Intraarticular pain in dysfunction (IPD) is a notably prevalent condition affecting the temporomandibular joint. Both marcotrauma and microtrauma, from bruxism and parafunctional habits, can lead to internal derangement of the temporomandibular joint disc causing chronic inflammation and pain. Arthrocentesis is a surgical procedure used to reduce this inflammation and return the patient to painless function. Several drugs have been used as an adjunct to arthrocentesis. Research has suggested platelet concentrates may serve as a superior alternative supplement when used in combination with arthrocentesis from the treatment of IPD. Objectives: To compare the clinical outcomes of platelet-rich in growth factor (PRGF) versus corticosteroid (CS) injections as adjuncts to temporomandibular joint (TMJ) arthrocentesis in patients with predominantly Wilkes stage II–III internal derangement. Materials and Methods: This single-blinded randomized controlled trial included sixteen participants who underwent standardized unilateral TMJ arthrocentesis. Subjects were randomized to receive either intra-articular triamcinolone (40 mg) or PRGF (2 mL). Clinical outcomes—including maximum interincisal opening (MIO), average daily pain, maximum pain intensity, joint sounds, and muscle tenderness—were recorded preoperatively and at 7, 30, 90, and 180 days postoperatively. Results: At 6 months, the CS group demonstrated a greater mean improvement in MIO (+7.0 mm) compared with PRGF (–8.6 mm). PRGF resulted in a significant reduction in average daily pain in the early follow-up period, however steroid provided similar early pain reduction, and improved long term pain reduction. Joint sounds and muscle tenderness declined slightly in both groups, with no significant differences between treatments. Conclusion: Given the small sample size, higher attrition in the PRGF group, and lack of quality-of-life measures, findings should be interpreted with caution. Within these limitations, PRGF did not demonstrate superiority over corticosteroids as an adjunct to TMJ arthrocentesis.