title: Is Arthrocentesis Plus Platelet-Rich Plasma Superior to Arthrocentesis Alone in the Treatment of Temporomandibular Joint Osteoarthritis? A Randomized Clinical Trial.
abstract: OBJECTIVE
  To compare the long-term clinical and radiologic outcomes of temporomandibular joint osteoarthritis (TMJ-OA) treated with arthrocentesis plus platelet-rich plasma (PRP) versus arthrocentesis alone.
  
  
  METHODS
  A randomized clinical trial in adult patients with TMJ-OA referred to the authors' clinic from May 2012 through July 2013 was implemented. The sample was composed of 30 consecutive patients with TMJ-OA treated randomly with arthrocentesis alone (control group) or initial arthrocentesis plus PRP injection and then 4 consecutive PRP injections (study group). The predictor variable was treatment technique. The outcome variables were visual analog scale evaluations (masticatory efficiency, joint sounds, and pain complaints), maximal interincisal opening, and cone-beam computed tomographic (CBCT) findings. Outcome variables were recorded preoperatively and 12 months postoperatively. Descriptive and bivariate statistics were computed, and significance was set at a P value less than .05. The paired t and Student t tests were used for intragroup and intergroup comparisons, respectively.
  
  
  RESULTS
  The sample was composed of 47 joints of 30 patients with OA (control group: 15 joints of 12 patients; mean age, 35.08 ± 14.84 yr; study group: 32 joints of 18 patients; mean age, 32.22 ± 14.32 yr). Joint sounds and general pain complaints decreased statistically in the 2 groups, whereas masticatory efficiency, painless interincisal opening, and lateral motion increased statistically only in the study group. However, only masticatory efficiency showed statistically greater improvement in the study group compared with the control group. CBCT evaluations showed that reparative remodeling of the osseous abnormalities occurred at rates of 87.5 and 46.6% in the study and control groups, respectively.
  
  
  CONCLUSIONS
  These findings suggested that arthrocentesis and PRP injections constitute a safe and promising method for the treatment of TMJ-OA that is superior to arthrocentesis alone.
authors.affiliation: Specialist, Ministry of Health, Department of Oral and Maxillofacial Surgery, Center for Oral and Dental Health, Erzurum, Turkey. Electronic address: drsckilic@yahoo.com.tr.
authors.forename: Songül
authors.initials: S
authors.lastname: Cömert Kiliç
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Güngörmüş
authors.affiliation: Associate Professor, Department of Maxillofacial Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
authors.forename: Muhammed Akif
authors.initials: MA
authors.lastname: Sümbüllü
mesh_terms: D000328:Adult; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000628:therapy*; D019152:Paracentesis / Q000379:methods*; D053657:Platelet-Rich Plasma; D013705:Temporomandibular Joint Disorders / Q000628:therapy*