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

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.