Exploring the efficacy and safety of platelet-rich plasma without arthrocentesis in temporomandibular joint degenerative disease treatment: A systematic review and meta-analysis

OBJECTIVE: Temporomandibular joint degenerative disease (TMJ-DJD) is a progressive disorder marked by cartilage loss, pain, and dysfunction. This systematic review aimed to evaluate the efficacy and safety of platelet-rich plasma (PRP) injections without arthrocentesis in adults with TMJ-DJD. MATERIALS AND METHODS: Following PRISMA guidelines (PROSPERO: CRD42020183384), we included randomized controlled trials (RCTs) assessing PRP in adults with TMJ-DJD. Searches were conducted in six databases up to June 2024. Two reviewers independently selected studies, extracted data, and assessed bias. Meta-analyses and GRADE evaluations were performed. RESULTS: Six RCTs were included. PRP showed comparable effects to arthrocentesis and arthrocentesis + PRP in reducing pain and improving mouth opening. At 3 months, PRP may offer greater pain relief than hyaluronic acid. No trials assessed quality of life. Evidence certainty ranged from moderate to low. CONCLUSIONS: PRP appears to be a safe and potentially effective treatment for TMJ-DJD, though further high-quality studies are needed.