Assessment of Injectable PRF Versus Dextrose Injection in Temporomandibular Joint in Anterior Disc Displacement With Reduction

Anterior disc displacement with reduction is a common intra-articular disorder of the temporomandibular joint and may be associated with clicking sounds, pain, and impaired mandibular function. This randomized clinical trial will compare injectable platelet-rich fibrin (I-PRF) with 25% dextrose injection in retrocondylar tissues in patients with anterior disc displacement with reduction.

Participants will be randomly allocated into two parallel groups with an allocation ratio of 1:1. The intervention group will receive 1.5 cc of I-PRF injected into the retrocondylar tissues at 0, 2, and 4 weeks. The control group will receive 1.5 mL of 25% dextrose solution injected into the retrocondylar tissues at 0, 2, and 4 weeks.

Clinical outcomes will include pain intensity assessed using a Visual Analogue Scale, maximum mouth opening measured using a digital caliper, and the presence or absence of clicking sounds. Magnetic resonance imaging will be performed before treatment and at 6 months after treatment to evaluate the position of the articular disc in open- and closed-mouth positions.

Clinical assessments will be performed preoperatively and at 15 days after the first injection, 15 days after the second injection, 15 days after the third injection, 30 days after the third injection, 3 months after the third injection, and 6 months after the third injection.

Inclusion criteria

• Participants must meet all of the following criteria:

Age ≥18 years. Female patients. Patients with anterior disc displacement with reduction. Anterior disc displacement with reduction assessed using preoperative MRI in open- and closed-mouth positions.

Patients who are willing and fully capable of complying with the study protocol.

Exclusion criteria

• Participants will be excluded if they have:

Bleeding disorders or are receiving anticoagulant medications. Pregnancy. Bony pathology of the temporomandibular joint. Temporomandibular disorder patients or patients with anterior disc displacement without reduction.

Any temporomandibular joint infection. Mental instabilities or psychiatric conditions. Previous invasive or surgical procedures of the temporomandibular joint. Inability to attend follow-up during the entire follow-up period. Refusal to sign the written informed consent. Dystonia.