Computed Guided Prolotherapy Versus Conventional Prolotherapy in The Treatment of TMJ Internal Derangement

Abstract

Aim: This study was conducted to compare Computed guided arthrocentesis with conventional arthrocentesis followed by I-PRF prolotherapy in the treatment of TMJ internal derangement. Subjects and methods: the study was carried out on 20 patients divided into two groups: Group I, patients underwent arthrocentesis followed by I-PRF injection using conventional TMJ injection technique with the aid of facial anatomical landmarks. Group II, patients underwent arthrocentesis followed by I-PRF injection using a CT-guided 3D printed surgical guide. Pain scores measured and MIO, preoperatively, immediately after the procedures, 1 week, 1 month, and 3 months. MRI was made 1 week and 3 months after the procedures. The number of attempts of needle insertions of 1st & 2nd needle (Right -Left) were assessed and the Time of operation and pain during the operation were assessed. Results: a significant decrease in pain during procedures, immediately post-operative, 1 week and 1 month post-operative, number of insertions and relocation of the needles in each joint, and time of the procedures in the guided arthrocentesis group compared to the conventional arthrocentesis group. On the other hand, there was no significant difference between both groups in MIO, preoperative pain after 3 months. Conclusion: Digital arthrocentesis and prolotherapy of TMJ showed superiority and could replace the current conventional and prolotherapy types. Intra-articular PRF injection after arthrocentesis is an effective treatment method for the pain relief of TMJ internal derangements