Comparison of intra-articular platelet-rich plasma and injectable platelet-rich fibrin in female patients with temporomandibular joint disorder: a pilot retrospective cohort study
摘要
Temporomandibular disorders (TMD) affect the temporomandibular joint (TMJ) and masticatory muscles. When conservative treatment is insufficient, arthrocentesis may be combined with adjunctive intra-articular agents, including hyaluronic acid, platelet-rich plasma (PRP), injectable platelet-rich fibrin (i-PRF), corticosteroids, or non-steroidal anti-inflammatory drug (NSAID) injections. This study compared the clinical effects of PRP and i-PRF injections on pain and function in female patients with TMD.
MethodsThis retrospective cohort study included female patients treated at the Department of Oral and Maxillofacial Surgery, University of Health Sciences, between 2019 and 2022. Patients diagnosed with disc displacement with reduction (DDwR) or disc displacement without reduction without limited opening (DDwoR) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), confirmed by magnetic resonance imaging (MRI), were evaluated. Eligible patients had undergone unilateral arthrocentesis followed by either PRP or i-PRF injection and had pain during mastication and functional jaw movements greater than 50 mm on a 0–100 mm Visual Analog Scale (VAS), subsequently confirmed as arthralgia by TMJ palpation. Patients were excluded in cases of pregnancy or lactation, systemic inflammatory joint disorders or chronic pain syndromes, head and neck malignancy and/or radiotherapy or chemotherapy, previous occlusal splint use, previous TMJ surgery or trauma, regular aspirin or anticoagulant use, NSAID use within one week before intervention, or bilateral joint pain with VAS scores ≥ 50 mm in both joints. Pain intensity was assessed using VAS, and unassisted maximum interincisal opening (MIO) was measured by caliper at baseline and at 1 (T1), 3 (T3), and 6 months (T6). Primary outcomes were changes in VAS and MIO at T6. Statistical significance was set at p < 0.05.
ResultsForty-one patients were included: 19 in the PRP group and 22 in the i-PRF group. The i-PRF group showed lower VAS scores than the PRP group throughout follow-up. The PRP group showed greater maximum intercincisal opening (MIO) values at T1 and T3, whereas the i-PRF group showed more pronounced MIO values at T6.
ConclusionsThis study preliminarily indicated that both treatments were associated with improvements in pain intensity and unassisted MIO. However, i-PRF may provide more favorable long-term pain reduction and late-stage unassisted MIO improvement.