COMPARATIVE EFFICACY OF HYALURONIC ACID, RINGER'S LACTATE, NORMAL SALINE, AND I-PRF AS IRRIGATING SOLUTIONS IN ARTHROCENTESIS FOR TEMPOROMANDIBULAR JOINT DISORDERS: A SYSTEMATIC REVIEW

Abstract

Arthrocentesis is a minimally invasive procedure widely used to treat temporomandibular joint (TMJ) disorders, but the comparative efficacy of different irrigating solutions remains unclear. This systematic review and meta-analysis evaluated randomized and prospective clinical studies examining Hyaluronic Acid (HA), Ringer’s Lactate (RL), Normal Saline (NS), and Injectable Platelet‑Rich Fibrin (I‑PRF) used during TMJ arthrocentesis. Electronic searches of major databases identified seven eligible studies reporting pain reduction and maximum mouth opening (MMO) outcomes. Arthrocentesis yielded better improvements with average pain reductions of 3–4 Visual Analog Scale points and MMO improvement of 8–13 mm. Bioactive irrigants, particularly HA and I‑PRF, tend to produce greater and more sustained improvements than purely mechanical solutions such as NS and RL. However, heterogeneity in diagnostic criteria, protocols, and follow‑up durations limits firm conclusions. Further rigorously designed trials are needed to inform evidence‑based selection of irrigating solutions for TMJ arthrocentesis.