Evaluation of injectable platelet-rich fibrin (I-PRF) as a treatment in internal derangement of temporomandibular joint.

Introduction: The study aimed to evaluate the role of I-PRF in treating temporomandibular joint (TMJ) internal derangements with the primary objective being improvement in maximum interincisal opening and Helkimo clinical dysfunction score (HCDS), and secondary objective as identifying any side effects.

Material and methods: The study involved 34 patients with MRI confirmed TMJ internal derangements (Wilkes 3-5). Injectable platelet-rich fibrin injected into TMJ (maximum 2 ml), one injection every week for 3 weeks. Total 3 injections were given to each affected TMJ. After total 3 injections, the patients were assessed for maximum interincisal opening, Helkimo Clinical Dysfunction Score (Range of movement, TMJ function, muscle pain, TMJ pain, pain on movement of mandible), and complications on 10^th day, 1 month, and 3 months postoperatively as the dependant variable. The results obtained were tabulated and compared with the inferential analysis.

Results: Statistically significant differences were observed with respect to maximum interincisal opening and Helkimo Clinical Dysfunction Score at the end of 10^th day, 1 month, and 3 months postoperatively. No major complications were reported during the study; 11 patients had transient edema immediately following I-PRF injections which resolved itself, 1 patient had an episode of syncope during the 2^nd injection and 4 patients had transient facial nerve palsy during auriculotemporal nerve block which again resolved on itself.

Conclusion: Our study also agreed with the previous literature and concluded that injectable platelet-rich fibrin has significant clinical efficacy in improving Helkimo clinical dysfunction score and maximum interincisal opening in patients suffering from internal derangements. Hence, it can be a potent treatment modality for patients with internal disk derangements.