Injectable Platelet-Rich Fibrin (I-PRF) Administered to Temporomandibular Joint Cavities: A Scoping Review

Abstract

The aim of this review was to systematically map the research on the intra-articular administration of injectable platelet-rich fibrin (I-PRF) to the temporomandibular joints (TMJs). Medical databases covered by the ACM, BASE, Google, NLM, and ResearchGate were searched on 23 February 2023. The assessment of the level of evidence was based on the Oxford Center for Evidence-Based Medicine 2011 scale. The risk of bias was assessed for randomized controlled trials with the RoB2 tool. Extracted data were tabulated, and the changes in effect values were calculated. A total of eight studies qualified, of which five trials on 213 patients were randomized and controlled (RCTs). In each of the RTC study groups, arthrocentesis was performed, and 1–2 mL per joint of I-PRF (700 rpm/3 min/60 g centrifugation) was administered. Articular pain in three months decreased to 0–25% of the initial pre-interventional values in the study and 38–50% in the control groups. Mandible mobility increased to 121–153% and 115–120% in the I-PRF groups and controls, respectively. The main limitations of the evidence were the small number of RCTs and the lack of any RCT study groups receiving I-PRF without prior arthrocentesis. In conclusion, supplementing the temporomandibular joint rinsing with I-PRF administration further relieves pain and improves mandible mobility. The lack of RCTs on the intra-articular administration of I-PRF as a stand-alone procedure encourages further research. This research received no external funding. The review protocol has not been previously published.

Efficacy of Injectable Platelet-Rich Fibrin (I-PRF) in Managing Temporomandibular Joint Pain: A Prospective Clinical Study

“…The reduction in TMJ pain intensity observed in the intervention group, as measured by the VAS, is consistent with previous studies that have explored the analgesic effects of PRF in various medical and dental applications [ 12 ]. The significant decrease in pain scores at multiple time points, starting from six weeks post intervention and continuing throughout the 24-week follow-up, suggests that I-PRF may offer sustained pain relief for individuals with TMJ pain.…”

“…The significant improvement in jaw function, as evidenced by increased maximal mouth opening and enhanced lateral excursions, is a crucial outcome supporting the potential clinical benefits of I-PRF. Similar positive effects on jaw function have been reported in studies investigating PRF in the context of oral and maxillofacial surgery [ 8 , 12 ]. The improvement observed in the intervention group suggests that I-PRF may positively impact the functional aspects of the TMJ, contributing to increased mobility and flexibility.…”

Temporomandibular Joint (TMJ) Replacement Affects Quality of Life: A Systematic Review and Synthesis of Clinical Trials

“…Improvements in health-related quality of life as a result of minimally invasive intra-articular interventions have been repeatedly demonstrated. However, in cases where (1) the improvement is so short-lived that the need to repeat therapy is too burdensome or too expensive, (2) in patients who, for various reasons, cannot attend regular visits, and (3) in the event of unsatisfactory effectiveness of less invasive treatments, TMJ replacement appears to be justified [23][24][25]27,29,39].…”

“…Albeit degenerative disease can reach a severity that exceeds the possibilities of conservative and minimally invasive treatment. Then, TMJ replacement should be considered as a real alternative to more conservative pain relief approaches [6,[24][25][26][27][28][29][30][31][32].…”

Temporomandibular Joint Injections and Lavage: An Overview of Reviews

“…Combining AC with the administration of CS does not provide any superior effect compared to AC alone [54]. Sole TMJ rinsing was proved to have an inferior effect compared to AC followed by I-PRF administration [36]. Combining AC with HA led to similar effects to combining it with I-PRF [62].…”