Evaluation of the efficacy of platelet rich fibrin (I-PRF) intra-articular injections in the management of internal derangements of temporomandibular joints – a controlled preliminary prospective clinical study

Abstract

Background The temporomandibular joint (TMJ) is one of the most complex joints in the body. Temporomandibular disorders (TMD) are among the most troublesome disorders for patients, as they can cause pain, affect oral functions and disturb dentists on the level of diagnosis and treatment. The most common symptoms of temporomandibular joint disorders are articulated sounds (such as clicking or TMJ crepitation), joint pain in comfort and function situations (jaw movements), pain or strain in masseter and jaw muscles and or restricted mandibular movements. One of the most modern biocompatible substances used to treat joint disorders, including the TMJ, is platelet-rich plasma (PRP) and injectable platelet-rich fibrin (I-PRF). This study aims to evaluate the efficacy of platelet-rich fibrin (I-PRF) intra-articular injections in managing internal derangements of temporomandibular. Methods Twenty patients suffering from a unilateral click due to temporomandibular disorders were individually injected with 1 mL of (I-PRF) twice 1 week apart into the superior joint space of the TMJ with the internal disorder. Data were recorded and evaluated by the Helkimo index. This evaluation was conducted three times; 1 week after the first injection, 1 week after the second injection, and 6 months after the first injection. Results The clicking disappeared entirely in 14 out of 20 patients after 1 week of getting the first injection, and in all patients after 1 week of getting the second injection, and returned to two of them after a six-month since the first injection. Conclusion Preliminary results showed the efficacy of the Injectable Platelet-Rich Fibrin (I-PRF) in managing articular clicking in patients with internal disorders of the temporomandibular joint. Injectable Platelet Rich Fibrin has significant clinical efficacy in treating the articular clicking resulting from internal temporomandibular joint disorders.

Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series

“…However, it is known that major growth factors and growth factor families from PRP, such as tissue growth factor-β (TGF-β), insulin-like growth factor 1 (IGF- 1), bone morphogenetic proteins (BMP), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), and hepatocyte growth factor (HGF), take part in the process of OA healing [ 42 , 43 , 44 ]. The detailed composition of blood products results not only from the properties of the patient’s blood but also from the method of preparation; hence, apart from PRP used for injection into TMJs cavities, there are also other substances including I-PRF (injectable platelet-rich fibrin) and PRGF (plasma-rich in growth factors) [ 45 , 46 , 47 ]. Various growth factors play a role in the proliferation and differentiation of chondrocytes, chondrocyte mitosis and extracellular matrix synthesis, and vascular structure formation and regeneration, which are the basis for cartilage regeneration [ 43 ].…”

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

“…Platelets are involved in the identification and neutralization of pathogenic microorganisms. They also recruit leukocytes to Frontiers in Pharmacology frontiersin.org sites of infection and inflammation and regulate their function (Shubhra Bhattacharya et al, 2020;Pietruszka et al, 2021;Manafikhi et al, 2022).…”

Patient-Reported Quality of Life versus Physical Examination in Treating Temporomandibular Disorders with Intra-Articular Platelet-Rich Plasma Injections: An Open-Label Clinical Trial

“…The endless development of new therapies for increasingly better understood diseases is an indispensable element in the development of medicine. This is also the case for TMDs, which are gradually becoming more and more understandable in terms of classification, etiopathogenesis, and treatment [ 34 , 35 ], and in this field, new therapeutic methods are constantly searched for, including intra-articular injections [ 6 , 8 , 14 , 17 , 20 , 36 ]. As with any emerging therapy, clinicians face the risk of unexpected adverse events that may result in serious complications [ 37 , 38 , 39 , 40 , 41 ].…”

“…As with any emerging therapy, clinicians face the risk of unexpected adverse events that may result in serious complications [ 37 , 38 , 39 , 40 , 41 ]. A more subtle issue is to assess the effectiveness of emerging treatments and see if they are any better than the existing ones [ 8 , 14 , 16 , 17 , 25 , 42 ]. The process of therapy validation must be carried out not only objectively and parametrically by researchers, but also subjectively by patients, so as to approach the state of full multidimensional well-being, and not only the absence of disease [ 5 , 9 , 10 , 11 , 12 ].…”

“…One of the effective therapies in some cases of TMDs are intra-articular injections [ 14 , 15 , 16 , 17 , 18 , 19 ]. The detailed treatment techniques with proven effectiveness include rinsing the joint cavity, administration of hyaluronic acid, and autologous blood products [ 7 , 8 , 14 , 17 , 19 , 20 , 21 ]. Among the latter, platelet-rich plasma (PRP) is the best studied so far ( Figure 2 ) [ 8 , 15 , 16 , 21 , 22 , 23 , 24 , 25 ].…”