Background: The temporomandibular joint (TMJ) is a highly intricate and complex synovial joint found in the human body. When TMJ dysfunction occurs, it causes pain and difficulties in opening the mouth, significantly impacting the patient's quality of life. Internal derangements, characterized by the gradual displacement of the articular disc, stand out as the most prevalent intra-articular temporomandibular disorders. Temporomandibular joint arthrocentesis, a procedure utilizing different irrigating solutions, is acknowledged as an efficient therapy for managing internal derangements of the TMJ. Recently, ozone therapy and orthobiologics like Platelet rich plasma (PRP) have been attracting increasing attention worldwide due to their promising medical applications and diverse therapeutic benefits in management of joint dysfunctions. Aim of this study: The aim of the study is to compare the effectiveness of temporomandibular joint arthrocentesis using ozonated water combined with platelet-rich plasma (PRP) injection versus ozonated water alone for treating Wilkes stages III and IV of anterior disc displacement in terms of pain score, maximum mouth opening, and range of motion. Additionally, the study aims to compare the impact of both treatments on the concentration of the proinflammatory cytokine interleukin-6 (IL-6) in the joint space.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
patients will undergo arthrocentesis using ozonated water alongside PRP injection
patients will undergo arthrocentesis using ozonated water alone.
Outpatient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Egypt
Alexandria, Azarita, Egypt
Change in maximum mouth opening
mouth opening will be measured as the maximal distance between the cutting edge of the maxillary and mandibular central incisors using a millimeter ruler in the superioinferior direction.
Time frame: up to 6 months
change in level of IL-6
synovial fluid samples will be collected to detect the level of IL-6
Time frame: up to 6 months
change in lateral mandibular movement
The range of lateral mandibular movement will be measured after moving the mandible as far as possible to the right, and then to the left, starting from the mandibular rest position. Then, the distance between the lower and upper central incisor lines will be measured in the mediolateral direction
Time frame: up to 6 months
change in protrusive movement
The range of protrusive movement will be measured after protruding the mandible as far as possible from the rest position. Then, the distance between the labial surface of the upper and lower incisors in the anteroposterior direction will be measured.
Time frame: up to 6 months
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