Minimally invasive intraarticular platelet rich plasma injection for refractory temporomandibular joint dysfunction syndrome in comparison to arthrocentesis

Abstract

Context: Internal derangements of temporomandibular joint (TMJ) with associated symptoms which do not respond to conservative therapies are refractory cases of temporomandibular joint dysfunction syndrome (TMD). Minimally invasive techniques like arthrocentesis and platelet rich plasma (PRP) injections are usually employed to improve TMJ symptoms and function in these cases. Aims: To compare PRP with arthrocentesis for evaluating the effectiveness of PRP in relieving symptoms of refractory TMJ pain dysfunction syndrome. Setting and Design: A clinical study was carried out on 52 patients of refractory Temporomandibular joint dysfunction syndrome. The patients were divided in two groups that is Group A - test group and Group B -control Group. Methods and Material: Group A consisted of 26 patients who underwent intraarticular PRP injection in TMJ and Arthrocentesis of TMJ was done in 26 patients of Group B. TMJ pain, Maximium Interincisal opening and TMJ clicking were assessed among the group as well as between the groups over a period of 6 months. Statistical Analysis Used: Repeated Measure ANOVA was used to compare the parameters within the groups and T test was used for group comparison at 0.05 level of significance. Result: There was statistically significant difference in pain intensity improvement 1 ± 0.75 versus 3.17 ± 2.13, maximum interincisal opening 39.86 ± 2.86 versus 37.59 ± 4.03 and clicking 6 versus 16 between the PRP group and arthrocentesis group at P < 0.05. Conclusions: Intraarticular PRP injection for the management of refractory TMD is more effective than arthrocentesis in reducing symptoms and functional improvement.

Platelet‐rich plasma injections for the treatment of temporomandibular joint disorders: A systematic review

“…PRP injections have the dual function of replicating the inflammatory response and inhibiting excessive inflammation, which has a favourable effect on tissue recovery. Moreover, it helps in preserving the integrity the joint cartilage integrity and improves articular cartilage healing, allowing for more joint movement 39 …”

“…Moreover, it helps in preserving the integrity the joint cartilage integrity and improves articular cartilage healing, allowing for more joint movement. 39 A comparative study between PRP and arthrocentesis for the treatment of TMD patients, done by Rajput et al, concluded that both treatment modalities were efficient; however, arthrocentesis provided a better success rate for pain relief, in particularly for the short period, whereas PRP brought greater results regarding the joint noise and jaw deviation correction. 40 Recently, the application field of PRP has widen to include maxillofacial surgery, aesthetic plastic surgery, spinal fusion, heart by-pass surgery and treatment of soft-tissue ulcers.…”

Efficacy analysis of splint combined with platelet-rich plasma in the treatment of temporomandibular joint osteoarthritis

“…In addition, PRF also has large amounts of immune factors and immune cells that can fight both inflammation and infection and promote tissue healing. PRP has growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF),transforming growth factor beta 2 (TGF-β2) and insulin-like growth factor (IGF) ( Chandra et al, 2021 ). Polypeptide growth factors (PGFs) are thought to play an important role in the growth and differentiation of cells involved in periodontal wound healing.…”

Arthrocentesis, Injectable Platelet-Rich Plasma and Combination of Both Protocols of Temporomandibular Joint Disorders Management: A Single-Blinded Randomized Clinical Trial

“…This might be justified as a result of the synergy between TMJ arthrocentesis, which removed debris and inflammatory cytokines within the synovial fluid, reduced articular surface friction, and adjusted the hydraulic pressure within the articular cavity, with the PRP advantages that could aid in the healing process, analgesia, and elimination of inflammatory mediators, and could provide scaffold effect for stem cells migration [16][17][18]. Pain reduction after intra-articular PRP injection might be explained by the release of protease-activated receptors that possess potential anti-inflammatory and analgesic effect [19].…”