Platelet lysate versus hyaluronic acid after arthrocentesis in the treatment of temporomandibular joint anterior disc displacement with reduction: a randomized clinical trial.

Abstract

The aim of the study was to compare the clinical efficacy of Platelet Lysate (PL) versus Hyaluronic Acid (HA) after arthrocentesis in the management of patients with anterior disc displacement with reduction. This randomized clinical trial was conducted on 60 patients (17 males and 43 females) with anterior disc displacement with reduction confirmed with magnetic resonance imaging (MRI). The patients were split into two equal groups at random based on the type of treatment that was used. Group 1: arthrocentesis plus PL, Group 2 arthrocentesis plus HA. The pain intensity, clicking sound, maximum inter-incisal opening (MIO) and range of lateral mandibular excursions were measured. All the measured parameters were statistically analyzed. After 6 months, both groups demonstrated a significant improvement in all the parameters that were measured. The PL Group showed a statistically better resolution of clicking compared to HA Group with an Absolute Risk Difference of 33.3% (P < 0.05). The MIO between-group difference was 4.867 mm (P < 0.001), so exceeding the Minimum Clinically Important Difference (MCID). On the other hand, although the PL Group demonstrated statistical superiority in pain scores and range of lateral mandibular excursions (P < 0.05), the clinical magnitude of the between-group difference was modest. PL appears to be a safe and effective adjunctive intra-articular therapy after arthrocentesis for the management of patients with anterior disc displacement with reduction. It provides a clinical advantage over HA in resolving joint clicking and improving MIO. For pain reduction and range of lateral mandibular excursions, the therapeutic benefits of PL and HA are clinically comparable. Trial registration: On 4/12/2024, it was registered in Clinical-Trials.gov PRS ( https://register.clinicaltrials.gov ) with identification number NCT06441279.