Does Single Intra-Articular Plasma-Rich Plasma (PRP) Injection for Temporomandibular Joint (TMJ) Internal Derangement Relieve Joint Pain?

Abstract

Introduction: The temporomandibular disorder (TMD) is a common pathological entity and is found in 31% of the adult population. Different minimally invasive techniques, such as the injection of diverse substances into the joint, arthrocentesis have exhibited good clinical results and such modalities would be considered either for severe TMDs or after the failure of conservative treatments. Several studies endorsed intra-articular injections of platelet- rich plasma (PRP) as an effective procedure to decrease TMD tenderness. The primary aim of this study is to assess the effectiveness of a single PRP injection in terms of reducing pain, and improving mandibular motion in patients affected by internal derangement of the TMJ. Materials & Methods: The study consisted of 10 patients who reported to the oral and maxillofacial surgery clinic with painful dysfunction of the temporomandibular joint who received a single injection of PRP in the TMJ. Variables measured including pain score and mouth opening were assessed preoperatively and postoperativel. SPSS 24.0 was used for data management and statistical analysis. The level of significance was set at 0.05 for all statistical tests using chi-square. Results:The group of 10 patients consisted of 9 women and 1 man. The age of the participants ranged from 27 to 75 years, and a median age of 45.5. Upon the follow up visit within 1-3 months: 7/10 patients showed a significant reduction of the pain intensity (more than 50% reduction of pain intensity), 2/10 patients showed a partial resolution of the symptoms with minimal reduction of pain and one patient showed no improvement in either pain or mouth opening and subsequently underwent arthrocentesis. The PRP injections were successful in decreasing pain intensity scores to below 5 in most cases. A Chi-squared test was performed to test for an association between the PRP injections and pain intensity score and the outcome supports the conclusion that there is a strong correlation between the PRP injection and pain and that it is statistically significant. Conclusions:TMD symptoms and movement limitations disrupt everyday life and in cases with severe illness, studies showed that the conservative treatment measures lead to insignificant or low improvement in quality of life. For this reason, a fast acting and effective method of reducing pain and movement limitations is essential and our study findings support the role of PRP injections. It exhibited a very strong negative relationship, which indicates that the PRP injection and pain scores are inversely related.