Effectiveness of platelet-rich plasma for treating temporomandibular joint disorders: a systematic review and meta-analysis of randomized controlled trials

Objective: To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on pain and mandibular movement in patients with temporomandibular joint disorder (TMJD). Design: Systematic review and meta-analysis of prospective controlled trials. A literature search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant studies published before August 31, 2024. Setting: Not applicable (systematic review and meta-analysis). Participants: Patients diagnosed with temporomandibular joint disorder included in the eligible studies. Intervention(s) or Exposure(s): PRP injection compared with arthrocentesis, hyaluronic acid, or corticosteroids. Main Outcome(s) and Measure(s): Pain intensity and maximal mandibular opening (MMO) were the primary outcomes. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool for randomized trials and ROBINS-I for nonrandomized studies. Mean difference (MD) or standardized MD with 95% confidence intervals (CIs) was used to evaluate effect size. Results:This meta-analysis included 31 studies involving 1359 patients. Compared to arthrocentesis, PRP significantly reduced pain at 6 months (MD, −1.56; 95% CI, −2.68 to −0.44) and improved mandibular movement at 3 months (MD, 2.16; 95% CI, 0.30 to 4.02) and 6 months (MD, 2.56; 95% CI, 0.76 to 4.35). Compared to hyaluronic acid, PRP significantly reduced pain at 3 months (MD, −2.18; 95% CI, −3.70 to −0.66) and improved mandibular movement at 6 months (MD, 3.67; 95% CI, 1.26 to 6.07). Compared to corticosteroids, PRP reduced pain at 1 month (MD, −0.41; 95% CI, −0.81 to −0.02), 3 months (MD, −2.18; 95% CI, −3.70 to −0.66), and 6 months (MD, −1.25; 95% CI, −1.52 to −0.97), and improved mandibular movement at 6 months (MD, 1.46; 95% CI, 0.27 to 2.64). Conclusions and Relevance: PRP injection may be an effective and safe treatment for patients with TMJD. These findings suggest that PRP could serve as a promising minimally invasive option for improving pain and mandibular function in clinical settings.