Sylwia Orzeszek, Andrzej Malysa, Andrej Jenca, Magdalena Gebska, Katarzyna Sluzalec-Wieckiewicz, Marek Zietek, Piotr Seweryn
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The risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the Joanna Briggs Institute (JBI) Critical Appraisal Tools. <b>Results</b>: Thirteen studies met the inclusion criteria. Six were randomized controlled trials (RCTs) and seven were non-randomized clinical studies. Ten studies evaluated intra-articular conditions such as disc displacement or Temporomandibular Joint (TMJ) osteoarthritis, while three focused on myofascial pain. Platelet-Rich Plasma (PRP) was the most frequently investigated agent. Most studies reported statistically significant reductions in pain and improvements in mandibular mobility following autogenous injections, with PRP generally outperforming comparators such as hyaluronic acid, corticosteroids, or saline. No serious adverse events were reported. <b>Conclusions</b>: All PRP and Platelet-Rich Fibrin (PRF) injection protocols reviewed were effective in reducing pain and improving mobility in patients with TMD. 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引用次数: 0
摘要
背景/目的:颞下颌关节紊乱(TMD)是一种影响颞下颌关节和咀嚼肌的异质性肌肉骨骼疾病。近年来,自体注射已被研究作为减轻疼痛和改善功能的微创治疗选择。然而,这些疗法在不同TMD表型中的临床有效性仍然不确定。方法:在MEDLINE、Embase和Web of Science中检索2015年1月至2025年5月期间发表的论文。包括关节内或肌肉内自体注射TMD患者的研究。使用Cochrane risk of bias 2工具和Joanna Briggs Institute (JBI) Critical Appraisal Tools评估偏倚风险。结果:13项研究符合纳入标准。6项为随机对照试验(rct), 7项为非随机临床研究。10项研究评估关节内疾病,如椎间盘移位或颞下颌关节(TMJ)骨关节炎,而3项研究关注肌筋膜疼痛。富血小板血浆(PRP)是最常被调查的药物。大多数研究报告了自体注射后疼痛的显著减少和下颌活动能力的改善,PRP通常优于透明质酸、皮质类固醇或生理盐水等比较物。无严重不良事件报告。结论:所有PRP和富血小板纤维蛋白(PRF)注射方案都能有效减轻TMD患者的疼痛和改善活动能力。然而,方案和随访时间的差异阻碍了meta分析的进行。需要更多标准化的随机对照试验来确定明确的临床指南。
Autogenous Injections in Temporomandibular Disorders: A Systematic Review.
Background/Objectives: Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal conditions affecting the temporomandibular joints and masticatory muscles. In recent years, autogenous injections have been investigated as minimally invasive therapeutic options to alleviate pain and improve function. However, the clinical effectiveness of such therapies across different TMD phenotypes remains uncertain. Methods: Electronic searches were performed in MEDLINE, Embase, and Web of Science for articles published between January 2015 and May 2025. Studies involving intra-articular or intra-muscular autogenous injections in TMD patients were included. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Results: Thirteen studies met the inclusion criteria. Six were randomized controlled trials (RCTs) and seven were non-randomized clinical studies. Ten studies evaluated intra-articular conditions such as disc displacement or Temporomandibular Joint (TMJ) osteoarthritis, while three focused on myofascial pain. Platelet-Rich Plasma (PRP) was the most frequently investigated agent. Most studies reported statistically significant reductions in pain and improvements in mandibular mobility following autogenous injections, with PRP generally outperforming comparators such as hyaluronic acid, corticosteroids, or saline. No serious adverse events were reported. Conclusions: All PRP and Platelet-Rich Fibrin (PRF) injection protocols reviewed were effective in reducing pain and improving mobility in patients with TMD. However, differences in protocols and follow-up times prevented a meta-analysis from being conducted. More standardized RCTs are needed to determine clear clinical guidelines.
期刊介绍:
Journal of Clinical Medicine (ISSN 2077-0383), is an international scientific open access journal, providing a platform for advances in health care/clinical practices, the study of direct observation of patients and general medical research. This multi-disciplinary journal is aimed at a wide audience of medical researchers and healthcare professionals.
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