Temporomandibular joint biosupplementation using platelet concentrates: a narrative review

Abstract

The study aims to identify the latest treatment protocols implementing platelet concentrates (PCs) to treat temporomandibular joint internal derangement (TMJ-ID) alone or in combination with arthroscopy/arthrocentesis.Background: Biosupplementation to treat TMJ-ID refers to the injection of an autologous product which possesses biological activity in the synovial joint, insofar as modulation of the inflammatory process, and can set the stage for tissue repair and/or tissue regeneration. PCs are increasingly used and tested, as an easily accessible biosupplement, for TMJ-ID.Methods: A systematic approach was used to perform the literature search. The study involves a presentation of recent data and a general discussion in the form of a narrative review regarding the biological characteristics and preparation protocols of PCs, the treatment protocols for TMJ-ID and clinical outcomes. Conclusions:The PCs described in the literature to treat TMJ-ID are platelet rich plasma (PRP), plasma rich in growth factors (PRGF), platelet-rich fibrin (PRF) and concentrated growth factors (CGF). All studies reported PCs as a beneficial therapeutic for TMJ-ID, in terms of arthralgia, joint noises and mandibular range of motion. Despite the biological differences among the various PCs, there exists similarities that could explain the reported benefits. The authors recommend clinicians the implementation of the acronym AR2T3 to standardize the reporting of PC preparations in future studies. Our findings suggest that non-surgical treatment through biosupplementation using PCs provides an alternative therapy or adjunct for painful TMJ-ID. The reduction in pain and dysfunction may avoid the need for TMJ surgery.