Concentrated growth factor as treatment for temporomandibular joint osteoarthritis: A randomized controlled clinical trial

This study sought to assess and compare the clinical efficacy of concentrated growth factor (CGF) and sodium hyaluronate (SH) injections in the management of temporomandibular joint osteoarthritis (TMJOA). Furthermore, it examined alterations in the expression levels of inflammatory cytokines within the synovial fluid throughout the treatment process. In this randomized controlled trial, 40 patients with TMJOA were randomly assigned to either the CGF group or the SH group. Clinical outcomes were evaluated and compared at the preoperative baseline, and at 1-month, 3-month, and 6-month follow-ups. The assessments included therapeutic efficacy evaluation, the Fricton temporomandibular disorder index, visual analog scale (VAS) scores, maximum pain-free mouth opening (MPO), cone-beam computed tomography (CBCT) evaluation, and changes in the expression levels of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) in synovial fluid. Throughout the 6-month follow-up period, statistically significant differences were observed between the two groups in both the Fricton temporomandibular disorder index and VAS scores. The CGF group exhibited superior clinical efficacy from months 3 to 6 post-treatment, along with significantly greater MPO. By the 6-month evaluation, CBCT imaging indicated enhanced condylar bone remodeling in the CGF group. In terms of synovial inflammatory markers, the CGF group demonstrated a more rapid reduction in IL-1 and IL-6 levels throughout the entire follow-up period, while TNF-α levels decreased more significantly between months 1 and 3. Within the limitations of the current study, CGF injection therapy emerges as a clinically relevant option, worthy of consideration in the management of TMJOA.