Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis

Area of Science:

• Orthopedics
• Regenerative Medicine
• Oral and Maxillofacial Surgery

Background:

• Temporomandibular joint (TMJ) osteoarthritis and disc displacement cause significant pain and limited mouth opening.
• Platelet concentrates (PCs), hyaluronic acid (HA), and saline are used for TMJ injections, but their comparative efficacy is debated.

Purpose of the Study:

• To systematically review and compare the effectiveness of platelet concentrates (PCs) versus hyaluronic acid (HA) or saline/Ringer's solution injections for treating temporomandibular joint osteoarthritis and disc displacement.
• To evaluate outcomes related to pain reduction and maximum mouth opening (MMO).

Main Methods:

• A systematic review of randomized clinical trials (RCTs) was conducted, searching PubMed, Cochrane, and Scopus databases.
• Nine RCTs involving 407 patients were included. Risk of bias was assessed using the EPHPP tool.
• Meta-analysis using weighted mean difference was performed to compare treatment outcomes.

Main Results:

• Platelet concentrates (PCs) significantly reduced pain visual analogue scale (VAS) scores compared to hyaluronic acid (HA) at 3 months.
• PCs demonstrated greater pain reduction and improved maximum mouth opening (MMO) compared to saline at multiple follow-up points (3, 6, and 12 months).
• PC efficacy was comparable to HA for MMO, but superior to saline.

Conclusions:

• Platelet concentrates (PCs) are effective in reducing pain and improving maximum mouth opening (MMO) for temporomandibular joint disorders, particularly compared to saline.
• While PCs show promise, further standardized RCTs are needed due to heterogeneity in PC preparation and study designs.
• This review offers valuable insights for clinicians and researchers on the comparative effectiveness of TMJ injection therapies.