Lubricin Levels in Temporomandibular Joint Disorders: A Scoping Review

Lubricin, also known as proteoglycan 4 (PRG4), is a key glycoprotein involved in boundary lubrication and maintenance of joint homeostasis in the temporomandibular joint (TMJ). However, the clinical evidence regarding synovial fluid (SF) lubricin levels remains limited and fragmented. This scoping review aimed to map and synthesize the available clinical evidence on lubricin levels in patients with temporomandibular disorders (TMDs) and their relationship to clinical outcomes, particularly pain and mandibular mobility. Searches were conducted in PubMed, Scopus, ACM, BASE, Cochrane, ClinicalTrials.gov, and Google Scholar. After duplicate removal and screening, two studies were included in the final synthesis. Preliminary findings from these studies suggest that (SF) lubricin levels may be lower in more advanced TMJ pathology, particularly in degenerative disease. Earlier stages of internal derangement showed lubricin concentrations closer to those observed in healthy controls, whereas advanced internal derangement and osteoarthritic disease were potentially associated with lower levels. One study also reported an inverse correlation between lubricin concentration and pain intensity, while the other demonstrated impaired boundary lubrication in TMD groups. Overall, the available clinical evidence is very limited and insufficient to establish PRG4 as a validated biomarker but suggests a possible association between reduced SF lubricin levels and more advanced TMJ disease. Further well-designed clinical studies are required to confirm these observations and clarify their diagnostic and therapeutic relevance.