A COMPARATIVE EVALUATION OF OZONE AND PLATELET RICH FIBRIN INJECTION IN MANAGEMENT OF UNILATERAL ANTERIOR DISC DISPLACEMENT WITH REDUCTION IN TEMPOROMANDIBULAR JOINT: A RANDOMIZED CONTROL TRIAL

Abstract

Background: Temporomandibular disorders (TMDs), particularly anterior disc displacement with reduction (ADDwR), are common intra-articular disorders associated with pain, joint sounds, and functional limitation of the temporomandibular joint (TMJ). Conventional treatment modalities often provide variable outcomes, creating a need for minimally invasive regenerative approaches. Injectable platelet-rich fibrin (i-PRF) and ozone therapy have gained attention due to their anti-inflammatory, analgesic, and regenerative properties. Aim: To compare the efficacy of intra-articular injectable platelet-rich fibrin and ozone injections in the management of unilateral anterior disc displacement with reduction of the temporomandibular joint. Materials and Methods: This prospective randomized controlled clinical trial included 80 patients diagnosed with unilateral anterior disc displacement with reduction who were randomly divided into two groups of 40 patients each. Group I received a single intra-articular i-PRF injection, while Group II received intra-articular ozone injections (10 μg/mL) twice weekly for three weeks. All patients received occlusal splint therapy before intervention. Clinical parameters including pain intensity assessed using Visual Analog Scale (VAS), maximum inter-incisal opening, and lateral mandibular excursion were evaluated at baseline, 2 weeks, 3 months, and 6 months. Magnetic resonance imaging (MRI) was performed at baseline and after 12 months to evaluate regenerative changes. Results: Both treatment modalities demonstrated significant improvements in pain reduction and mandibular function during follow-up. Ozone therapy showed significantly greater pain reduction at 3 and 6 months and demonstrated superior regenerative changes on MRI evaluation compared with i-PRF. Improvement in maximum inter-incisal opening and lateral mandibular excursion was observed in both groups without statistically significant intergroup differences. Conclusion: Both i-PRF and ozone therapy were effective in managing unilateral ADDwR; however, ozone therapy demonstrated comparatively superior clinical and regenerative outcomes.