To Evaluate the Efficacy of Intra-articular Injectable Platelet Rich Fibrin with Arthrocentesis Versus Arthrocentesis Alone in the Management of Temporomandibular Joint Internal Derangement: A Prospective Study

Background Temporomandibular joint (TMJ) internal derangement commonly causes pain and functional limitation. Arthrocentesis is an established minimally invasive treatment, while injectable platelet-rich fibrin (i-PRF) has been proposed to improve clinical outcomes. Purpose To compare the efficacy of arthrocentesis combined with intra-articular i-PRF versus arthrocentesis alone in Wilkes Stage II–III TMJ internal derangement. Study Design, Setting, Sample This prospective comparative clinical study was conducted at a single tertiary care teaching hospital. Forty patients (18–55 years) with unilateral TMJ internal derangement refractory to conservative treatment were sequentially allocated to arthrocentesis alone ( n = 20) or arthrocentesis plus i-PRF ( n = 20). Independent Variable Treatment modality (arthrocentesis alone versus arthrocentesis with i-PRF). Main outcome Variables Pain (visual analogue scale and qualitative pain), maximum mouth opening, pain on lateral mandibular movement, and joint clicking. Covariates Age, sex, Wilkes stage, symptom duration, occlusal status, parafunctional habits, and psychological factors. Analyses Independent t test, repeated-measures ANOVA, Mann–Whitney U, Friedman, Chi-square, and Cochran Q tests were performed ( P <0.05). Results All 40 patients completed the study. Both groups showed significant improvement in pain, mandibular function, and joint clicking ( P <0.05). The i-PRF group demonstrated greater pain reduction and functional improvement during 1–3 months. At 6 months, pain outcomes were comparable, whereas maximum mouth opening remained significantly greater in the i-PRF group. Conclusion and Relevance Arthrocentesis effectively improved TMJ internal derangement. Adjunctive i-PRF accelerated early symptomatic and functional recovery but showed no clear long-term pain superiority. Larger randomized studies with MRI confirmation and longer follow-up are required.