Single intra-articular administration of injectable platelet-rich fibrin (I-PRF) in alleviating temporomandibular joint pain: A pilot clinical trial.

Abstract

Background: Intracapsular injections are a recognized therapeutic method for temporomandibular joint (TMJ) pain and limited mandibular mobility. Among many injectables, injectable platelet-rich fibrin (I-PRF) is noteworthy for its safety, promising clinical results and potential regenerative effects. The minimal invasiveness of a single injection makes it attractive as compared to arthrocentesis or a series of administrations.

Objectives: This single-arm, open-label clinical trial aimed to verify the research hypothesis that a single administration of I-PRF into TMJ relieves articular pain.

Material and methods: The study sample included adults with a history of TMJ articular pain treatment. A single injection of I-PRF into the affected TMJ was performed. Each patient assessed (1) articular pain within the last 7 days, (2) the articular pain provoked by a physical examination, (3) muscular pain, (4) headache, and (5) neck pain before and 14 days after the intervention. The investigator measured (6) pain-free and (7) maximal voluntary mandibular abduction.

Results: The study sample included 33 patients and 44 TMJs. No adverse events were observed at the recipient sites (TMJs). The treatment reduced the spontaneous articular pain by 0.5 ±1.5 and the provoked articular pain by 1.2 ±1.9 visual analog scale (VAS) points, with the differences being statistically significant (p < 0.05). Improvement was observed in 39-48% of Wilkes II-V patients, and 5-14% experienced deterioration up to 2 VAS points. Mandibular mobility decreased by an average of 1-2 mm, and no statistically significant effect on muscle pain, headache or neck pain was recorded.

Conclusions: A single intra-articular injection of I-PRF into TMJ brings statistically significant articular pain relief, regardless of the assessment method. In non-respondents, subsequent administrations may be considered.