{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T09:33:37Z","timestamp":1776332017156,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Portuguese Society of Rheumatology and the Rheumatic Diseases Portuguese Registry (Reuma.pt)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Intra-articular injections of hyaluronic acid (HA) or platelet-rich plasma (PRP) have been used in the treatment of temporomandibular joint (TMJ) arthrocentesis to improve lubricative properties and influence regenerative processes. This study aimed to evaluate the potential clinical benefits of complementary bioviscosupplementation with hyaluronic acid (HA) and platelet-rich plasma (PRP) in patients undergoing double-portal TMJ arthrocentesis. Methods: A total of forty-six patients (33 females, 13 males; mean age of 45.83 \u00b1 20.62 years) with arthrogenous temporomandibular disorders, identified through clinical and imaging examinations, were randomized into HA+PRP (23 patients) or HA-alone (23 patients) groups. The primary outcome variable was TMJ arthralgia; the secondary outcome was maximum mouth opening (MMO). All the outcome variables were assessed preoperatively (T0) and at several follow-ups (T1\u20141 month, T2\u20143 months, T3\u20146 months, T4\u201412 months follow-up). Results: The HA+PRP group presents lower TMJ arthralgia levels than the HA group at every follow-up moment (p &lt; 0.05, r \u2248 0.3). At T3 and T4, the HA+PRP group presented a higher MMO average than the HA group (p = 0.03 and p = 0.02; r \u2248 0.3). At T4, the HA group\u2019s success rate was lower than the HA+PRP group (65% vs. 96%), and a higher number of postoperative reinterventions were observed (35% vs. 4%). Conclusions: In this study, complementary intra-articular bioviscosupplementation (HA+PRP) following double-portal TMJ arthrocentesis was associated with better clinical outcomes regarding TMJ arthralgia reduction, MMO improvement, and reduced risk of future TMJ reintervention.<\/jats:p>","DOI":"10.3390\/jcm14113750","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T09:29:36Z","timestamp":1748338176000},"page":"3750","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Double-Puncture Arthrocentesis in Arthrogenous TMJ Disorders: Bioviscosupplementation vs. Viscosupplementation a Randomized Controlled Trial"],"prefix":"10.3390","volume":"14","author":[{"given":"David Faustino","family":"\u00c2ngelo","sequence":"first","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"},{"name":"Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, 2430-028 Marinha Grande, Portugal"},{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisboa, Portugal"},{"name":"Servi\u00e7o de Estomatologia, Hospital Egas Moniz\u2014Centro Hospitalar de Lisboa Ocidental, 1349-019 Lisboa, Portugal"},{"name":"Clinica Universit\u00e1ria de Estomatologia, Centro Hospitalar Universit\u00e1rio Lisboa Norte (CHUNL), 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5750-2875","authenticated-orcid":false,"given":"Henrique Jos\u00e9","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"}]},{"given":"David","family":"Sanz","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-2107","authenticated-orcid":false,"given":"Francesco","family":"Maffia","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"},{"name":"Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 N\u00e1poles, Italy"}]},{"given":"Marcella","family":"Sarkis","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9729-0264","authenticated-orcid":false,"given":"Beatriz","family":"Mota","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"},{"name":"Clinica Universit\u00e1ria de Estomatologia, Centro Hospitalar Universit\u00e1rio Lisboa Norte (CHUNL), 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1095-8090","authenticated-orcid":false,"given":"Francisco","family":"Salvado","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisboa, Portugal"},{"name":"Clinica Universit\u00e1ria de Estomatologia, Centro Hospitalar Universit\u00e1rio Lisboa Norte (CHUNL), 1649-028 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"ref_1","unstructured":"National Academies of Sciences, Engineering, and Medicine (2020). 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