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

Abstract

Background: Temporomandibular joint disorders (TMDs) are manifested, inter alia, by pain and limited scope of the mandibular abduction. Among the treatment strategies for these ailments, intra-articular injections of autologous blood preparations, including platelet-rich plasma (PRP), are administered. This prospective case series was aimed at assessing the effectiveness of repeated platelet-rich plasma (PRP) administration to the TMJ cavities in terms of reducing articular pain and increasing the mobility of the mandible. Material and methods: 40 consecutive patients diagnosed with TMJ pain qualified for the case series. The entire treatment program consisted of five PRP administrations and a summary appointment. Regression was analyzed for (1) intensity of spontaneous pain; (2) effectiveness of spontaneous pain relief; (3) mastication efficiency values; (4) painless mandibular abduction; (5) maximum mouth opening. The correlations between the abovementioned variable series were analyzed. Results: The mean spontaneous pain decreased consistently with successive PRP administrations in line with the regression model: −0.4x + 4.2 (R2 = 0.98). Articular pain improvement was reported in 71% of joints treated. Improvement in chewing quality at the end of the entire injection cycle was found in 63% of patients. The equations for the linear regression models for painless mandibular abduction (five applications of PRP) and maximum mouth opening (the first four applications of PRP) were x + 34 (R2 = 0.89) and 0.6x + 43.6 (R2 = 0.96), respectively. Improvement in these domains was found in 78% and 53% of patients, respectively. The strongest correlations were found between pain and chewing efficiency (−0.95), pain and painless mandible abduction (−0.96), and painless mandibular abduction and mastication efficiency (0.94). Conclusion: PRP injections into TMJ cavities should be considered as a low invasive, highly accessible form of treatment for various TMDs causing pain and mandible movement limitation.

Autologous Stem Cells Transplants in the Treatment of Temporomandibular Joints Disorders: A Systematic Review and Meta-Analysis of Clinical Trials

“…For various morphological and physiological reasons, the function of this complex system can be disturbed [ 25 ]. The characteristics of TMJs disorders (TMDs) includes inflammation and degeneration [ 26 , 27 ]. TMDs are caused by multiple reasons, such as malocclusion, malformations of the structure of the temporomandibular joint, degeneration of the joint surfaces and/or articular disc, and muscle and ligamentous apparatus disorders.…”

“…These may result in restricted movement of the mandible and articular pain [ 28 ]. The pain itself, along with inflammatory processes, further limits the opening of the mouth [ 26 , 27 , 29 ].…”

“…[ 32 , 33 ]. Therefore, the effects of administration of various substances into TMJs cavities are being investigated [ 27 , 32 , 33 , 34 , 35 , 36 , 37 ]. The most frequently reported results are from the use of hyaluronan, corticosteroids, blood products, analgesics, and dextrose [ 35 ].…”

“…The supplementation of hyaluronic acid reduces the friction between the articular surfaces, which limits degenerative changes and alleviates pain [ 26 , 38 ]. The use of self-derived platelet-rich plasma in injections aims to regenerate damaged tissues [ 27 , 39 ]. Thanks to the action of growth factors, such a therapy, results in the enhancement of articular cartilage [ 27 , 39 ].…”

“…The use of self-derived platelet-rich plasma in injections aims to regenerate damaged tissues [ 27 , 39 ]. Thanks to the action of growth factors, such a therapy, results in the enhancement of articular cartilage [ 27 , 39 ]. Intra-articular injections of various substances turned out to be effective by improving the mobility of the mandible and reducing articular pain [ 32 , 33 , 35 ].…”