Clinical Application Of Injectable Platelet-rich Fibrin In Treatmenting Of Temporomandibular Joint Osteoarthritis

Objective:To explore the methods and clinical pathways of intra-articular injection with injectable platelet-rich fibrin(i-PRF)in treatmenting of temporomandibular joint osteoarthritis(TMJOA).To provide a new idea for the clinical treatment of temporomandibular joint osteoarthritis.Methods:According to the inclusion and exclusion criteria,16 adult female patients with osteoarthritis diagnosed were selected from the TMJ specialty outpatient department of the Stomatological Hospital Affiliated to Kunming Medical University between September 2019 to January 2020.The diagnostic criteria is based on domestic TMD classification.The oldest is 55 and the youngest is 23.Venous blood was collected beside the dental chair and low-speed centrifuged to prepare i-PRF.Using injectable rich platelet fibrin to perform articular cavity injection treatment for one period of treatment and all patients will be conducted to do TMD specification inspection in the preoperative and postoperative 6 and 12 months.Researchers record each patient’s MMO,VAS scores,Fricton index and CBCT images before and after the treatment,using the paired t test and signed rank sum test for statistical analysis.Results:The mean opening degree of the patients before surgery was 38±7.23mm,6 months after surgery was 41.33±6.74mm,12 months after surgery was 42.33±10.54mm,the opening degree increased 6 months after surgery(P<0.05),which was statistically significant.Compared with the degree of opening 6 months after surgery,the degree of opening 12 months after surgery had no significant change from that 6 months after surgery(P>0.05),which was not statistically significant.The median VAS value before surgery(interquartile interval)was 5.50(1.50),the median VAS value 6 months after surgery(interquartile interval)was 0.00(1.75),and the median VAS value 12 months after surgery was 0.00(0.50).The VAS value 6 months after surgery was smaller than the initial VAS value(P<0.05).It was statistically significant.The VAS value at 12 months after surgery had no significant change from that at 6 months after surgery(P>0.05),which was not statistically significant.Preoperative median DI(interquartile interval)was 0.37(0.08),PI(interquartile interval)was 0.055(0.09),CMI(interquartile interval)was 0.21(0.06),and 6 months after surgery,median DI(interquartile interval)was 0.08(0.06).Median PI value(interquartile interval)0.00(0.05),median CMI value(interquartile interval)0.045(0.05),median DI value(interquartile interval)0.00(0.05),median PI value(interquartile interval)0.00(0.01),The median CMI value(interquad interval)was 0.00(0.04).Compared with the initial DI value and CMI value,DI value and CMI value decreased 6 months after surgery(P<0.05),which was statistically significant.Compared with the initial PI value,there was no significant change in PI value 6 months after operation(P>0.05),which was not statistically significant.Compared with DI and CMI values 6 months after surgery,DI and CMI values had no significant changes 12 months after surgery(P<0.05),which was statistically significant.Compared with the PI value 6 months after surgery,there was no significant change in PI value 12 months after surgery(P>0.05),which was not statistically significant.At 6 and 12 months postoperatively,CBCT showed significant repair of the bone defect in the condyle.Conclusions:The intra-articular injection of platelet-rich fibrin(i-PRF)can effectively relieve the pain in patients with TMJOA.After 6 months of treatment,the maximum mouth opening improved most obviously.CBCT imaging results showed that i-PRF could continue to repair the condylar defect within 12 months and alleviate the symptoms of TMJOA.I-PRF can be considered as a new method for clinical treatment of patients with TMJOA,which has important clinical guiding significance in exploring and regulating its clinical pathway.