Clinical Research Directory

Joint arthrocentesis was done to wash out any inflammatory exudate that were detected clinically as joint swelling or as white dots in T2 MRI images. The two needle arthrocentesis technique was used under local anesthesia. Two points were marked along the canthotragal line; the first /posterior point was marked 10mm along the line and 2mm below it ( representative of the glenoid fossa) whereas the second/ anterior point was marked 20mm along the line and 10mm below it( representative of the articular eminence). The first needle was inserted first and about 20ml of ringer's solution was injected to distend the joint capsule then the second needle was inserted and about 100ml of ringer's solution was injected. Throughout the whole procedure, the patients were asked to open, close and protrude their jaw and move their jaw laterally to help the fluid diffuse through the joint and release any adhesions.

Single intraarticular administration of 2ml of injectable PRF immediately after TMJ arthrocentesis. Injectable PRF was prepared immediately before arthrocentesis from centrifuging (TD4 centrifuge, Hunan Lab we scientific instruments, China) of blood taking from the ulnar vein in a plain glass coated tube without anticoagulants at 700 rpm for 3 minutes , after centrifuging it was separated from the blood hemocytes as I-PRF was collected on the top of the tube while the blood hemocytes was precipitated in the bottom of the tube , 2ml of I-PRF was collected then injected directly into the joint after arthrocentesis with ringers solution through the first needle.

A single intraarticular administration of 2ml of low molecular weight Hyaluronic acid gel ( Hyalgan, hyaluronic acid sodium salt, Fidia pharmaceuticals, Italy) immediately after joint arthrocentesis.