Platelet-Rich Plasma in Treatment of Temporomandibular Joint Dysfunctions: Narrative Review
Abstract
:1. Introduction
2. Research Methods
3. Results
3.1. Outcome of Pain Improvement
3.2. Outcome of Joint Sound
3.3. Mandibular Motion Outcome
3.4. Risk of Bias Assessment
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Step | General Activities | Specific Activities |
---|---|---|
I | Formation of working group | One maxillofacial surgeon expert in arthrocentesis of TMJ, as clinical and methodological operator |
One medical doctor expert in head and neck anathomy and PRP, as clinical and methodological operator | ||
One researcher expert in TMJ disorders, as methodological operator | ||
II | Formulation of the review questions | Evaluation of the state of art inTMJ osteoarthritis and arthrocentesis. Analysis of main effects of osteoarthritis in TMJ and its treatment |
III | Identification of relevant studies on PubMed, PMC, Cochrane | 1. Identification of keywords in the field of interest 2. Use of Boolean operators (AND; OR; NOT) 3. Advanced search (Table 2 for serach strategy) 4. Inclusion criteria: papers published from 1950 to 2018; language: english; all types of full text articles 5. Elimination of duplicate 6. Manual search through the references in selected articles |
IV | Anaysis and presentation | Data extrapolated from all revised studies were shown in tables in form of narrative review |
Search | Database |
---|---|
((“platelet-rich plasma”[MeSH Terms] OR (“platelet-rich”[All Fields] AND “plasma”[All Fields]) OR “platelet-rich plasma”[All Fields] OR (“platelet”[All Fields] AND “rich”[All Fields] AND “plasma”[All Fields]) OR “platelet rich plasma”[All Fields]) AND (“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields] OR “tmj”[All Fields])) NOT (extraction[All Fields] AND (“tooth”[MeSH Terms] OR “tooth”[All Fields] OR “teeth”[All Fields])) | PMC |
(((“joint diseases”[MeSH Terms] OR (“joint”[All Fields] AND “diseases”[All Fields]) OR “joint diseases”[All Fields] OR “arthrosis”[All Fields]) AND (“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields] OR “tmj”[All Fields])) AND ((“arthritis”[MeSH Terms] OR “arthritis”[All Fields]) AND (“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields] OR “tmj”[All Fields]))) AND (“platelet-rich plasma”[MeSH Terms] OR (“platelet-rich”[All Fields] AND “plasma”[All Fields]) OR “platelet-rich plasma”[All Fields] OR (“platelet”[All Fields] AND “rich”[All Fields] AND “plasma”[All Fields]) OR “platelet rich plasma”[All Fields]) | PMC |
((((“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields]) AND (“osteoarthritis”[MeSH Terms] OR “osteoarthritis”[All Fields])) AND (“osteoarthritis”[MeSH Terms] OR “osteoarthritis”[All Fields] OR “osteoarthrosis”[All Fields])) AND (disk[All Fields] AND (“displacement (psychology)”[MeSH Terms] OR (“displacement”[All Fields] AND “(psychology)”[All Fields]) OR “displacement (psychology)”[All Fields] OR “displacement”[All Fields]))) AND (“platelet-rich plasma”[MeSH Terms] OR (“platelet-rich”[All Fields] AND “plasma”[All Fields]) OR “platelet-rich plasma”[All Fields] OR (“platelet”[All Fields] AND “rich”[All Fields] AND “plasma”[All Fields]) OR “platelet rich plasma”[All Fields]) | PMC |
(((“joint diseases”[MeSH Terms] OR (“joint”[All Fields] AND “diseases”[All Fields]) OR “joint diseases”[All Fields] OR “arthrosis”[All Fields]) AND (“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields] OR “tmj”[All Fields])) AND ((“arthritis”[MeSH Terms] OR “arthritis”[All Fields]) AND (“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields] OR “tmj”[All Fields]))) AND (“platelet-rich plasma”[MeSH Terms] OR (“platelet-rich”[All Fields] AND “plasma”[All Fields]) OR “platelet-rich plasma”[All Fields] OR (“platelet”[All Fields] AND “rich”[All Fields] AND “plasma”[All Fields]) OR “platelet rich plasma”[All Fields]) | PubMed |
((Therapy/Broad[filter] AND ((“platelet-rich plasma”[MeSH Terms] OR (“platelet-rich”[All Fields] AND “plasma”[All Fields]) OR “platelet-rich plasma”[All Fields] OR (“platelet”[All Fields] AND “rich”[All Fields] AND “plasma”[All Fields]) OR “platelet rich plasma”[All Fields]) AND maxillofacial[All Fields])) NOT extraction[All Fields]) AND ((“osteonecrosis”[MeSH Terms] OR “osteonecrosis”[All Fields]) AND (“jaw”[MeSH Terms] OR “jaw”[All Fields])) | PubMed |
(((“platelet-rich plasma”[MeSH Terms] OR (“platelet-rich”[All Fields] AND “plasma”[All Fields]) OR “platelet-rich plasma”[All Fields] OR (“platelet”[All Fields] AND “rich”[All Fields] AND “plasma”[All Fields]) OR “platelet rich plasma”[All Fields]) AND (“temporomandibular joint disorders”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields] AND “disorders”[All Fields]) OR “temporomandibular joint disorders”[All Fields] OR (“tmj”[All Fields] AND “disorders”[All Fields]) OR “tmj disorders”[All Fields])) AND maxillofacial[All Fields]) NOT (extraction[All Fields] AND (“tooth”[MeSH Terms] OR “tooth”[All Fields] OR “teeth”[All Fields])) | PubMed |
((“temporomandibular joint”[MeSH Terms] OR (“temporomandibular”[All Fields] AND “joint”[All Fields]) OR “temporomandibular joint”[All Fields] OR “tmj”[All Fields]) AND (“Pharmacol Res Perspect”[Journal] OR “prp”[All Fields])) AND (“surgery”[Subheading] OR “surgery”[All Fields] OR “surgical procedures, operative”[MeSH Terms] OR (“surgical”[All Fields] AND “procedures”[All Fields] AND “operative”[All Fields]) OR “operative surgical procedures”[All Fields] OR “surgery”[All Fields] OR “general surgery”[MeSH Terms] OR (“general”[All Fields] AND “surgery”[All Fields]) OR “general surgery”[All Fields]) | PubMed |
tmj, arthrocentesis, prp, osteoarthritis:ti, ab, kw (Word variations have been searched) | Cochrane |
Subgroups | Outcome | Topic | Specific Keywords Searched in Papers |
---|---|---|---|
1 | Signs and symptoms improvement | Pain, Mandibular motion, Joint sounds | “Pain”; “Maximum mouth opening”; “VAS scale”; “Joint sound”; “Chewing”; “Stiff”, “Mandibular mobility” |
2 | Effectiveness of PRP-associated arthrocentesis | Arthrocentesis alone, Arthrocentesis hyaluronic acid (HA) associated, Arthrocentesis PRP associated, Arthrocentesis associated with other biomaterials or drugs | “Arthrocentesis”; “Platelet-rich-plasma”; “Hyaluronic acid”, “Corticosteroid”, “Growing factors” |
Studies | Affection | Study Design | Diagnostic Criteria | Intervention | Sample | Endpoint | Outcomes | Results |
---|---|---|---|---|---|---|---|---|
Gicomello et al., 2014 | Osteoarthritis, Non-reducing Anterior Displacement | Observational Study | Ortopantomography and magnetic resonance imaging (MRI) | 2 PRP injections at 30 days | SG, N = 13, Mean age: 47.64 | 6 months | Pain (visual analogue scale, VAS); Mandibular opening (MMO) | Pain improvement from 7.69 ± 1.9 to 0.23 ± 0.63 (*). MMO improvement from 30.15 ± 4.44 to 39.54 ± 4.55 (*) |
Hanci et al., 2014 | Reducing Anterior Displacement | Randomized Controlled Trial (RCT) | MRI | SG: 1 singole PRP Injection, CG: Arthrocentesis | SG, N = 10, Mean age: 27.2. CG, N = 10, Mean age: 25.4 | 6 months | Pain (VAS); Minimal Interincisal Opening (MIO); Joint Sound (Number of Joints affected) | Pain improvement: SG from 6.69 ± 2.21 to 0.07 ± 0.27. CG: from 6.52 ± 2.29 to 2.76 ± 1.48 (*). MIO improvement: SG from 32 ± 8.53 to 39.7 ± 10.39. CG from 30.2 ± 9.41 to 36.3 ± 5.51 (**). Joint Sound improvement: SG: from 12 to 2. CG from 12 to 5 (*) |
Pihut et al., 2014 | Temporomandibular disfunctions | Clinical Study (Preliminary) | Clinical (RDC/TMD questionnaire) | PRP injection | SG, N = 10, Mean age: 37.6 | 6 weeks | Pain (VAS); Mandibular Motion (MM); Joint Sound (Number of patients) | Pain improvement: from 6.5 to 0.6 (*); MM decrease to 1 (not clear); Joint Sound: from 4 to 1 |
Hegab et al., 2015 | Osteoarthritis | RCT | Radiography or MRI | SG: 3 PRP Injections, CG: 3 HA Injections | SG: N = 25, Mean age: 39. CG: N = 25, Mean age: 38.2 | 12 months | Pain (VAS); Mouth Voluntary Opening (MVMO); Joint Sound (Number of Joints affected) | Pain improvement: SG from 7.36 ± 1.14 to 0.4 ± 0.763. CG: from 6.96 ± 1.24 to 1.64 ± 1.35 (*). MVMO improvement: SG from 33.88 ± 3.08 to 41.56 ± 2.31. CG from 32.40 ± 2.72 to 39.28 ± 2.80 (*). Joint Sound improvement: SG > CG at 1 month, SG = CG at 12 months (**) |
Al-Delayme et al., 2016 | Non-reducing Anterior Displacement | Observational Study | Bilateral palpation and measurement of mouth opening | 2 PRP injections | SG: N = 44, Mean age: 36.6 | 6 months | Pain (VAS); Maximum Mouth Opening (MMO); Joint Sound (VAS) | Pain improvement from 33.5 ± 22.4 to 18.3 ± 17.9 (*). MMO improvement from 26.4 ± 11.3 to 41.5 ± 8.65 (*). Joint Sound imprvement from 79.3 ± 12.8 to 2.9 ± 15 (*) |
Kiliç et al., 2015 | Osteoarthritis | RCT | Clinical (DC/TMDs) and CBCT | SG: Arthrocentesis + PRP 4 monthly PRP Injections, CG: Arthrocentesis | SG: N = 18, 32 Joints, Mean age: 32.22. CG: N = 12, 15 Joints, Mean age: 35.08 | 12 months | Pain (VAS); Maximum Mouth Opening (MMO) (VAS); Joint Sound (VAS) | Pain improvement: SG from 5.70 ± 1.35 to 1.02 ± 1.88. CG: from 6.83 ± 2.28 to 2.43 ± 4.08 (*). MMO improvement: SG: from 38.72 ± 7.84 to 38.39 ± 8.02 (**). Joint Sound: SG from 5.48 ± 3.46 to 0.70 ± 0.85. CG from 5.45 ± 3.27 to 0.75 ± 1.42 (*) |
Kiliç et al., 2016 | Osteoarthritis | RCT | Clinical (DC/TMDs) and CBCT | SG: Artrocentesis+PRP and 4 PRP Injections. CG: 1 singole Arthrocentesis + HA | SG: N = 18, 32 Joints, Mean age: 32.22. CG: N = 13, 17 Joints, Mean age: 28.08 | 12 months | Pain (VAS); Maximum Mouth Opening (MMO) (VAS); Joint Sound (VAS) | Pain improvement: SG from 5.70 ± 1.35 to 1.02 ± 1.88. CG: from 5.71 ± 2.54 to 0.54 ± 0.87 (*). MMO imrovement: SG from 38.72 ± 7.84 to 38.39 ± 8.02. CG from 44.23 ± 8.14 to 43.77 ± 6.39 (*). Joint Sound: SG from 5.48 ± 3.46 to 0.70 ± 0.85. CG from 5.81 ± 3.16 to 1.81 ± 3.04 (*). |
Fernandez-Ferro et al., 2017 | Osteoarthritis, Reducing or Non-reducing disc displacement | Randomized Prospective Study | MRI | SG: PRP Injection; CG: HA Injection | SG: N = 50, Mean age: 38.4. CG:N = 50, Mean age: 33.2 | 18 months | Pain (VAS); Mouth Opening (MO) | Pain improvement: SG from 8.35 ± 0.90 to 1.55 ± 1.90. CG from 8.14 ± 0.60 to 2.20 ± 1.43 (*). MO improvement: SG from 27.74 ± 4.65 to 37.23 ± 4.94. CG from 27.92 ± 5.08 to 36.54 ± 5.78 (**) |
Yang et al., 2017 | Non-reducing disc displacement | Retrospective Cohort Study | Clinical (DC/TMDs) and MRI | SG: LPCGF Injection + Centric Relation Occlusal Splint (Cros) | SG: N = 29, Mean age: 39.55 | 24 monts | Pain (VAS); Joint Sound (Number of joints affetcted) | Pain improvement from 4.72 ± 2.58 to 1.10 ± 1.72. Joint Sound improvement from 36 to 10 (*). |
Lin et al., 2018 | Osteoarthritis | Retrospective Study | Clinical (DC/TMDs) and CBCT | SG: Arthrocentesis + PRP: CG: PRP Injection | SG: N = 30, Mean age: 42.73; CG: N = 60, Mean age: 38.73 | 12 months | Pain (VAS); Range motion (>6 mm); Mouth Assisted Opening (MAO); Joint Crepitus Sound (Number of patients) | Pain improvement: SG = CG no improvement. Range Motion: SG from 47% to 0%, CG from 20% to 2% (*). MAO: SG and CG no improvementJoint crepitus sound: SG from 100% to 47% (**). SG vs. CG: differences not statistically significant. |
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Zotti, F.; Albanese, M.; Rodella, L.F.; Nocini, P.F. Platelet-Rich Plasma in Treatment of Temporomandibular Joint Dysfunctions: Narrative Review. Int. J. Mol. Sci. 2019, 20, 277. https://doi.org/10.3390/ijms20020277
Zotti F, Albanese M, Rodella LF, Nocini PF. Platelet-Rich Plasma in Treatment of Temporomandibular Joint Dysfunctions: Narrative Review. International Journal of Molecular Sciences. 2019; 20(2):277. https://doi.org/10.3390/ijms20020277
Chicago/Turabian StyleZotti, Francesca, Massimo Albanese, Luigi Fabrizio Rodella, and Pier Francesco Nocini. 2019. "Platelet-Rich Plasma in Treatment of Temporomandibular Joint Dysfunctions: Narrative Review" International Journal of Molecular Sciences 20, no. 2: 277. https://doi.org/10.3390/ijms20020277