Effect of Plasma Rich in Growth Factors Intra Articular Injection in Management of Patients with Internal Derangement of TMJ Using CT Guided Puncture versus Conventional Technique

Purpose: To evaluate effect of PRGF intra articular injection in patients with internal derangement of TMJ using CT guided versus conventional puncture technique. Materials and methods: Twenty patients with internal derangement without improvement by conservative treatment were divided into two groups: Group I: ten patients underwent arthrocentesis followed by PRGF injection using conventional puncture by anatomical landmarks. Group II: ten patients underwent arthrocentesis followed by PRGF injection using landmark and confirmed by CT. All patients were assessed preoperatively and postoperatively at 1week, 3 and 6 months for pain level, maximum interincisal opening, lateral, protrusive movements, joint tenderness and disk position with MRI after 6 months. Results: In both groups, all clinical variables showed statistical significant discrepancy postoperatively, the discrepancy between both groups was not statistically significant and MRI showed no statistical significant change in disc position. Conclusion: CT confirmed accurate position and depth within TMJ upper compartment in different views, allowed correction with less puncture trials and decreased learning curve of TMJ puncture but it is expensive, time consuming and not available in clinics. Anatomical landmarks is easy and representable method for TMJ puncture but blind technique and needs skill. Single injection of PRGF found efficient in the treatment of internal derangement of TMJ.