Platelet concentrates and arthrocentesis as therapeutic options for temporomandibular joint osteoarthritis: A systematic review of systematic reviews

Advances in Oral and Maxillofacial Surgery Pub Date : 2025-08-20 DOI:10.1016/j.adoms.2025.100571

Faisal Alzahrani , Sally Issa , Akram Alshirah , Noha Seoudi

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Abstract

Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative condition that leads to chronic pain and restricted jaw function, significantly reducing quality of life. Minimally invasive treatments such as platelet concentrate (PC) and arthrocentesis have emerged as promising therapeutic options. This systematic review of systematic reviews (SR of SRs) aimed to evaluate the effectiveness of intra-articular injection (IAI) of PC alone or in combination with arthrocentesis, compared to hyaluronic acid (HA), corticosteroids (CS), arthrocentesis alone, or placebo.

A comprehensive search of PubMed, Scopus, the Cochrane Library, and Google Scholar identified 18 systematic reviews and meta-analyses published between 2012 and 2024. Studies evaluating pain reduction and maximum mouth opening (MMO) were included. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) and Risk of Bias in Systematic Reviews (ROBIS) tools.

PC, offer superior and sustained pain relief compared to HA, CS, and placebo, especially when combined with arthrocentesis. However, results regarding MMO improvement were inconsistent, likely due to variations in PC preparation, follow-up periods, and patient characteristics. Risk of bias analysis revealed 51 % low risk, 26 % high risk, and 22 % unclear risk, highlighting the need for more standardised high-quality research protocols.

PC show promising potential in managing pain associated with TMJ OA through a minimally invasive approach. Further research is needed to optimise protocols and confirm long-term therapeutic outcomes.

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血小板浓缩和关节穿刺作为颞下颌关节骨性关节炎的治疗选择：系统综述的系统综述

颞下颌关节骨性关节炎（tmjoa）是一种退行性疾病，导致慢性疼痛和颌骨功能受限，显著降低生活质量。微创治疗如血小板浓缩（PC）和关节穿刺已成为有前途的治疗选择。本系统评价的系统评价（SR of SRs）旨在评价与透明质酸（HA）、皮质类固醇（CS）、单独关节穿刺或安慰剂相比，单独关节内注射（IAI） PC或联合关节穿刺的有效性。对PubMed、Scopus、Cochrane图书馆和b谷歌Scholar进行了全面搜索，确定了2012年至2024年间发表的18篇系统综述和荟萃分析。包括评估疼痛减轻和最大张嘴（MMO）的研究。使用关键评估技能计划（CASP）和系统评价偏倚风险（ROBIS）工具评估方法学质量。与HA， CS和安慰剂相比，PC提供了更好的和持续的疼痛缓解，特别是当与关节穿刺联合使用时。然而，关于MMO改善的结果是不一致的，可能是由于PC准备、随访时间和患者特征的差异。偏倚风险分析显示低风险为51%，高风险为26%，不明确风险为22%，强调需要更多标准化的高质量研究方案。PC在通过微创入路治疗TMJ OA相关疼痛方面显示出良好的潜力。需要进一步的研究来优化方案并确认长期治疗结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Advances in Oral and Maxillofacial Surgery

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