Search Results (751)

Temporomandibular joint osteoarthritis (TMJ-OA) is a multifactorial degenerative disorder characterized by progressive cartilage degradation, subchondral bone remodeling, and chronic inflammation, leading to pain and functional impairment in affected individuals. Despite its clinical impact, effective disease-modifying treatments remain limited, highlighting the need for innovative therapeutic approaches for treating this condition in the future. This manuscript examines the biological rationale, clinical applications, and therapeutic potential of platelet-rich plasma (PRP) and injectable platelet-rich fibrin (i-PRF) in the management of TMJ-OA. As autologous platelet-derived biomaterials, PRP and i-PRF contain high concentrations of growth factors and bioactive molecules that can modulate inflammatory responses and support tissue repair. PRP is associated with a relatively rapid release of these mediators, whereas i-PRF forms a fibrin matrix that may enable a more sustained release profile. Current clinical evidence suggests that both therapies show potential to contribute to pain reduction and may facilitate improvements in mandibular function. However, substantial heterogeneity in preparation protocols, study designs, and outcome measures limits the comparability and generalizability of these findings to the general population. Overall, PRP and i-PRF represent promising, minimally invasive regenerative strategies for managing TMJ-OA. Full article

Computed tomography (CT) is used to support the diagnosis of equine temporomandibular joint (TMJ) disease; however, its diagnostic accuracy remains unclear. This study aimed to evaluate the relationship between CT findings and histopathological manifestations of osteoarthritis (OA) in equine TMJs. A total of 82 TMJs were CT-imaged, sampled, grouped into age-related and OA-related groups, and analyzed for frequency distributions, correlations, and CT-based TMJ OA diagnosis. CT findings were observed in 79% of joints, including ‘CT anatomical variations’ considering to reflect age-related remodeling. Only 50% of joints showed co-occurrence of CT findings and histopathological manifestations of OA, confirming that not all CT findings are indicative of disease. Including all CT findings in the CT-based diagnosis of TMJ OA yielded a specificity of 0.41 (95% CI: 0.26–0.58), suggesting a high rate of false-positive diagnoses. Excluding all ‘CT anatomical variations’ resulted in a sensitivity of 0.56 (95% CI: 0.40–0.72), indicating a substantial number of false-negative diagnoses. However, inclusion of specific ‘CT anatomical variation’—subchondral bone cysts—into the studied CT-based diagnosis increased sensitivity to 0.79 (95% CI: 0.62 to 0.89) while maintaining high specificity of 0.92 (95% CI: 0.80–0.98). Including this subset of CT findings in the diagnosis of equine TMJ OA may improve the accuracy of disease detection; however, the clinical relevance of the present cadaver investigation needs to be confirmed in in vivo studies. Full article

Juvenile idiopathic arthritis (JIA) is the most common systemic chronic inflammatory connective tissue disease in children, characterized by joint inflammation lasting at least six months. Temporomandibular joint (TMJ) involvement can occur in conjunction with other joints and may often be asymptomatic in its early stages. Objective: This study aims to evaluate the relationship between clinical symptoms of the stomatognathic system and radiologically confirmed cone beam computed tomography (CBCT)-detected structural TMJ changes in children with JIA. The research hypothesis posits that specific clinical symptoms are more prevalent in patients with CBCT-confirmed structural TMJ changes. Methods: A cohort of children diagnosed with JIA was examined. Clinical symptoms, including facial asymmetry, limited mandibular movement, and joint and masticatory muscle pain upon palpation, were assessed. CBCT imaging was performed to assess osseous TMJ structural changes. Results: The frequency of orofacial clinical symptoms was assessed and compared between patients with and without radiological evidence of TMJ involvement. Children with CBCT-confirmed TMJ changes demonstrated significantly higher rates of facial asymmetry, reduced maximum mouth opening, mandibular deviation during opening, and limitations in lateral or protrusive movements compared with those without TMJ involvement. Pain-related symptoms (TMJ pain, muscle tenderness, and pain during movement) and joint sounds occurred at similar frequencies in both groups. Conclusions: Facial asymmetry, mandibular deviation during opening and reduced mandibular mobility are the clinical signs most strongly associated with structural TMJ involvement in JIA and should prompt targeted imaging. Pain-related symptoms show limited diagnostic value, highlighting the need for focused clinical assessment and future studies integrating CBCT and MRI to refine early screening protocols. Full article

Background/Objectives: Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic disorder causing progressive heterotopic ossification. The dental phenotype has never been systematically characterised. We quantified dental pathologies and oral health-related quality of life across three age groups of genetically confirmed FOP patients and compared them with 156 matched healthy controls (2022–2025). Methods: A total of 52 FOP patients (Group I: 1–5 y, n = 14; Group II: 6–17 y, n = 21; Group III: 18–35 y, n = 17) underwent standardised dental examination (Decayed, Missing, and Filled Teeth index (DMFT), Oral Hygiene Index Simplified (OHI-S), Angle classification, temporomandibular joint (TMJ) assessment), computed tomography (CT) densitometry, sialometry, salivary crystal analysis, and Oral Health Impact Profile-14 (OHIP-14). Statistical analysis used Kruskal–Wallis, Mann–Whitney U, Benjamini–Hochberg false discovery rate (FDR) correction, and effect sizes. Results: Caries (DMFT ≥ 4) was highly prevalent across all FOP groups (82–86%) and significantly higher than in controls (84.6% vs. 38.5%, p < 0.001). Chronic stomatitis showed large age-group differences: 7.1% in Group I vs. 100% in Group III (p < 0.001); it was universal in FOP adults vs. 6.4% in controls. Enamel hypoplasia (21.4% → 58.8%) and Angle class II malocclusion (0% → 47.1%) also showed large age-group differences. Total TMJ disorders were observed in 7.1% of Group I and 100% of Group III (p < 0.001); maximal mouth opening was lower by 17.4 mm in Group III (Cohen’s d = 2.1). Salivary flow rate was 20% lower in adults (0.35 → 0.28 mL/min, p = 0.01). Calcium phosphate crystals were detected in 3/17 adults (17.6%) and showed a preliminary correlation with CT calcification grade (ρ = 0.67, p = 0.003); given the small number of crystal-positive patients, this finding should be considered hypothesis-generating. OHIP-14 total score was higher (worse) in Group III (48.9 vs. 12.4 in Group I, Cohen’s d = 1.95). Conclusions: This cross-sectional study provides a systematic characterisation of the dental phenotype in FOP across three age groups. It shows that chronic stomatitis and TMJ dysfunction become nearly universal by early adulthood, severely impairing quality of life. The correlation between salivary calcium phosphate crystals and CT calcification generates the hypothesis of a non-invasive biomarker, requiring prospective validation. The proposed clinical phenotype and minimally invasive recommendations provide a framework for safer dental management of FOP patients. Full article

In condylar hyperplasia (CH), one of the condylar processes of the mandible (CPs) grows more than its counterpart, leading to facial asymmetry. Using a mouse model of asymmetric masticatory loading, we investigated a possible mechanical origin of CH by evaluating the association between morphometric parameters of CP cartilage and bone and the mandibular load regime. Thirty-nine adult male and female mouse hemimandibles that underwent different loading regimes were used: underloaded (UL), overloaded (OL), and symmetrically loaded (SL) controls. Micro-CTs were used to assess macroscopic shape and trabecular bone (TB) parameters, and articular cartilage features were studied histologically. Data were compared using multivariate and pairwise statistics. Principal component analysis showed that OL CPs exhibit a wide range of shape variation and show thicker cartilage but display TB features indicative of ongoing remodeling. Female OL tended to show more variable and larger parameters than males. However, differences in traits between sexes and load groups were not always statistically significant. We conclude that an asymmetric increase in mandibular loading may be associated with changes in the macro-/microscopic structure of the CP, affecting males and females differently. Signs of cartilage growth and bone remodeling are found in OL individuals, which are compatible with CH features. Full article

Objectives: To analyze the prevalence of bone changes in the temporomandibular joint (TMJ) and describe their distribution regarding age and sex using Cone Beam Computed Tomography (CBCT). Methods: This retrospective study analyzed CBCT images of 483 individuals (326 females, 157 males) retrieved from a computer database and assessed using the iCAT Workstation. Right and left condyles were evaluated for the presence of flattening, osteophytes, sclerosis, erosion, and subchondral cysts. Pearson’s chi-square test was used to identify potential associations between these alterations and demographic variables (p < 0.05). Results: At least one TMJ alteration was observed in 91.5% of the participants. Flattening was the most frequent finding (76.4%), followed by osteophytes (53%), sclerosis (32.3%), erosion (20.1%), and subchondral cysts (2.7%). No statistically significant association was found between gender and the presence of alterations (p > 0.05), with a high prevalence in both females (91.1%) and males (92.4%). However, specific degenerative changes showed a significant upward trend with age: osteophytes increased from 43.9% in patients under 20 to 68.9% in those over 60, while erosion doubled from 12.2% to 24.4% in the same groups (p < 0.05). Alterations were slightly more frequent on the left side (81.6%) than on the right side (76.6%). Conclusions: Degenerative TMJ changes are highly prevalent in the studied population, with flattening appearing as a widespread finding across all groups. While some specific alterations, such as osteophytes and erosion, show an increased prevalence in older age groups, these associations reflect a descriptive trend of bone remodeling over time rather than a direct causal relationship. Full article

Purpose: Ganglion cysts of the temporomandibular joint (TMJ) are uncommon periarticular lesions and may be diagnostically challenging because symptoms are often nonspecific. When these lesions arise posterior to the joint, they can produce otologic complaints through dynamic narrowing of the external auditory canal (EAC). Herein, we report on a histologically confirmed TMJ ganglion cyst causing position-dependent hearing loss and review the relevant literature. Case description: A 72-year-old woman presented with a 3-year history of bilateral preauricular pain, left-sided tinnitus, left aural fullness, and near-complete hearing loss in the left ear when the mandible was closed in occlusion. Clinical examination showed marked narrowing of the left EAC with mandibular closure. Magnetic resonance imaging demonstrated bilateral anterior disc displacement with reduction and a posterior meniscal cyst associated with the left TMJ. The lesion was excised using a preauricular approach. Results: Intraoperatively, the cyst was adherent to the posterior aspect of the TMJ disc and retrodiscal tissues and was noted to obstruct the EAC in the closed-mouth position. Gross examination showed a cystic structure measuring 2.4 × 2.1 × 1.0 cm which contained gelatinous material, while histopathology confirmed that the structure was a ganglion cyst. The patient’s hearing improved substantially by 4 months after surgery and had returned to normal 2 years later, with no clinical evidence of recurrence. Conclusions: Posterior TMJ ganglion cysts should be considered in patients with fluctuating otologic symptoms that vary with mandibular movement. MRI is valuable for diagnosis and surgical planning, and open excision can provide durable symptom resolution. Full article

The evolution of TMJ-replacements has been driven by advancements in personalization, materials and digital planning technologies. However, there is little data on how surgeons perceive the prosthetic systems and their limitations in practice. The perspective from surgeons is critical to identifying the gap between current technology and clinical need. Using an international, structured survey based on a modified Delphi methodology, including expert validation, pilot testing and global distribution through professional networks, the status of the TMJ-replacement ecosystem was obtained. The questions covered aspects such as the workflow, the integration of components, the design features, the use of materials, the fixation strategy for each component, and usability of surgical guides. The responses were quantitatively analyzed using descriptive statistics. 250 surgeons were included; the majority of surgeons preferred to have all elements of the TMJ-replacement system provided by a single system or company (i.e., the prosthesis and plates), with 86.0% of surgeons indicating this preference and 71.2% of surgeons indicating that having access to STL files for use in surgical navigation is an important feature. Approximately 88.4% of surgeons indicated that flexibility in the design of the prosthesis is important, while 61.6% of respondents indicated that design issues contribute to failures of TMJ prostheses. Issues related to the fixation of the prosthetic components, particularly screw loosening, were also commonly reported by surgeons with respect to failure. Surgeons also indicated concerns with regard to the bulkiness (73.2%) and the fit accuracy (68.4%) of the surgical guides. In terms of material selection, 78.0% of respondents preferred to be able to choose the type of metal alloy for the TMJ replacement system. TMJ replacement is viewed by surgeons as a system-dependent procedure that requires the integration of design, materials, fixation and digital workflow. The currently available prosthetic solutions only partially meet the needs of surgeons. Full article

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterised by motor and non-motor symptoms, including pain. Temporomandibular disorder (TMD)-like pain, defined as self-reported pain modified by jaw activities, has been suggested to be more prevalent in PD, but its association with PD severity remains unclear. This study aimed to investigate the association between pain modified by jaw activities and PD severity and the temporal stability of such pain in PD. Methods: This prospective study recruited 28 individuals with PD. Motor symptom severity and disability levels were evaluated using the modified Hoehn and Yahr (mHY) staging and modified Rankin Scale (mRS), respectively. Based on the diagnostic criteria for TMD, a questionnaire assessing pain modified by jaw activities and clinical examination were utilised. Pain modified by jaw activities was reassessed at one, two, and three months. Statistical analyses included Spearman’s rank correlation test and Friedman test, with p < 0.05 considered significant. Results: The participants’ mean age was 69.2 ± 9.6 years; 53.6% were male. Eight participants reported pain modified by jaw activities. Clinical examination identified painful palpation sites in 14 participants, most commonly in the masseter muscle body. Pain modified by jaw activity count showed significant positive correlations with mHY stage (rho = 0.48, p = 0.015) and mRS score (rho = 0.41, p = 0.04). Twenty-four participants completed follow-up, with no significant changes in pain reports over three months. Conclusions: Some individuals with PD may experience persistent TMD-like pain, which is correlated with motor symptom severity and disability levels, highlighting the importance of routine TMD screening in PD. Full article

Background: Postmenopausal osteoporosis is associated with cellular senescence and the accumulation of the senescence-associated secretory phenotype (SASP). While mesenchymal stem cell (MSC)-derived exosomes show tissue repair potential, the efficacy and mechanisms of MSC-derived apoptotic vesicles (apoVs) remain unclear. This study compared MSC-apoVs and exosomes in postmenopausal osteoporosis and investigated the underlying epigenetic mechanisms. Methods: Therapeutic efficacy was evaluated in an ovariectomized (OVX) mouse model and senescent human bone marrow mesenchymal stem cells (hBMMSCs). Small RNA sequencing identified differential microRNA (miRNA) cargos between vesicle types. SASP-related cytokine expression (IL-6, TNF-α, MCP-1) and pathway activation were assessed by RT-qPCR, ELISA, and Western blot. Results: MSC-apoV treatment attenuated bone loss in OVX mice and reduced SASP expression in senescent hBMMSCs to a greater extent than exosomes. Small RNA sequencing revealed that apoVs were enriched with a specific miRNA cluster, including hsa-let-7b-5p, hsa-miR-92a-3p, and hsa-miR-98-5p. Bioinformatic analyses identified BRAF and CRKL as downstream targets of this miRNA cluster, supported by reduced protein levels after apoV treatment. Subsequent molecular assays showed that apoV treatment inhibited the phosphorylation of both the MAPK (p38 and JNK) and NF-κB (p65) signaling pathways, which correlated with reduced local inflammation in the bone marrow microenvironment and preserved osteogenic differentiation capacity. Conclusions: MSC-apoVs attenuate postmenopausal osteoporosis more effectively than exosomes. This enhanced efficacy is associated with the delivery of an enriched miRNA cluster that inhibits MAPK and NF-κB signaling, together with suppression of BRAF and CRKL protein expression. ApoVs may represent a cell-free therapeutic strategy for age-related bone loss. Full article

Background/Objectives: Skeletal Class II malocclusion due to mandibular retrusion is frequently treated with functional appliances, yet their impact on temporomandibular joint (TMJ) structures, specifically the articular disc, remains debated. This systematic review aimed to critically assess quantitative morphological and positional TMJ changes (disc, condyle and glenoid fossa) evaluated with CBCT or MRI in growing skeletal Class II patients treated with functional appliances and to explore whether these changes are associated with the onset or prevention of temporomandibular disorders (TMDs). Methods: The review followed PRISMA guidelines and was registered in PROSPERO (CRD420251028803). Electronic searches were performed in PubMed, Scopus, Web of Science, Cochrane Library, and Embase from inception to December 2025, complemented by manual screening. Inclusion criteria comprised controlled clinical studies in patients aged 8–16 years with skeletal Class II malocclusion due to mandibular deficiency, treated with removable or fixed functional appliances, with pre- and post-CBCT/MRI quantitative TMJ assessment. Risk of bias was evaluated using RoB 2 (RCTs) and ROBINS-I (non-randomized studies); overall certainty was appraised with GRADE. Results: From 937 records, 8 studies met the inclusion criteria. Articular disc outcomes were reported in fewer studies: disc position/morphology was generally stable, and when changes were observed they were favourable (partial improvement/normalization in selected cases). Importantly, no included study reported new treatment-induced disc displacement or new-onset TMD symptoms at the end of treatment. Across studies, the most consistent findings concerned condylar adaptations, commonly described as anterior and/or superior positional changes and remodelling of the condyle–fossa unit. Evidence certainty was limited by heterogeneity and methodological constraints, resulting in low to very low confidence for several outcomes. Conclusions: Functional appliance therapy in growing skeletal Class II patients may be associated with TMJ adaptations, predominantly involving the mandibular condyle, while limited available data may suggest disc stability and no reported short-term clinical TMD onset in included controlled studies. However, due to the limited and heterogeneous evidence base, these findings should be interpreted cautiously, and well-designed prospective studies with standardized 3D imaging outcomes and longer follow-up are needed, particularly for disc-specific endpoints. Full article

Radiation-induced trismus (RIT) is a common and function-limiting late complication of radiotherapy for head and neck cancers, particularly when the masticatory muscles and temporomandibular joint receive high doses. Despite advances in intensity-modulated radiotherapy, RIT remains a significant survivorship problem, and robust biological biomarkers capable of predicting individual susceptibility are lacking. Heat shock protein 27 (HSP27; HSPB1) is a small heat shock protein that regulates multiple cellular stress responses, including proteostasis, cytoskeletal dynamics, redox homeostasis, apoptosis, and inflammatory signaling. In head and neck malignancies, HSP27 overexpression has been associated with treatment resistance and fibrosis-prone tissue remodeling. Experimental studies further demonstrate that HSP27 promotes transforming growth factor-β-mediated myofibroblast differentiation and extracellular matrix deposition, whereas pharmacologic or genetic inhibition attenuates radiation- or bleomycin-induced pulmonary fibrosis in vivo. Evidence from skeletal muscle biology also indicates that HSP27 modulates muscle integrity, denervation-associated atrophy, inflammatory signaling, and cytoskeletal stability. Although HSP27 has been widely investigated in radiation responses, fibrosis, and skeletal muscle stress adaptation, its potential involvement in the pathogenesis of RIT has not been systematically examined. This review proposes a conceptual framework in which HSP27 functions as an integrative molecular mediator linking radiation-induced oxidative stress, endothelial injury, and fibro-atrophic remodeling within the masticatory apparatus. By integrating current evidence on the epidemiology, dosimetric determinants, imaging correlates, and pathophysiology of RIT with the structural and functional biology of HSP27, this review provides the first tissue-specific synthesis of molecular stress signaling and clinical mechanisms relevant to RIT susceptibility. We further suggest that HSP27 signaling may influence susceptibility to fibro-neuromuscular injury in irradiated masticatory tissues. Given the absence of direct experimental or clinical evidence in this setting, these considerations are derived from mechanistic convergence across related biological systems and should be interpreted as biologically plausible but unproven, with potential implications for future biomarker development and biologically informed prevention strategies. Full article

The safety of mandibular anesthesia is directly dependent on a precise understanding of the spatial relationships in the pterygomandibular space, particularly the risk of injury to the highly vascularized pterygoid venous plexus (PVP). In vivo studies of PVP displacement during mandibular movements face significant technical challenges. Objective: The study aims to study the spatial displacements of the pterygoid venous plexus during various physiological positions of the mandible using computer modeling with the finite-element method (FEM). Materials and Methods: A three-dimensional finite-element model was developed based on computed tomography data and the BodyParts3D anatomical atlas. The model included the bony structures of the skull, mandible, temporomandibular joint, masticatory muscles, and blood vessels. Simulations were performed for vertical displacements of the jaw at 15, 25, and 35 mm, as well as horizontal displacements of 5 mm to the left and right. Results: It was found that the magnitude of PVP displacement is proportional to the degree of mouth opening. The maximum total displacement (1.24 mm) was recorded at a 35 mm opening along the “posterior–medial–inferior” vector. Lateral excursions revealed asymmetry: displacement to the right caused plexus movement posteriorly, medially, and inferiorly (0.66 mm), while displacement to the left resulted in movement anteriorly, laterally, and superiorly (0.64 mm). Conclusions: This study demonstrates the significant mobility of the pterygoid venous plexus, which depends on the direction and amplitude of mandibular movements. The obtained data have important practical implications for planning regional anesthesia and minimizing the risk of iatrogenic complications. From a biomechanical perspective, maximum mouth opening produces the greatest displacement of the PVP, which may hypothetically reduce the risk of vascular puncture. Clinical studies are required to confirm this. Full article

Background and Objectives: Temporomandibular disorders (TMDs) are prevalent conditions affecting the temporomandibular joint and associated musculature, arising from a complex interplay of biomechanical, neuromuscular, and psychosocial factors. Increasing evidence supports functional interconnections among the TMJ, cervical spine, and shoulder girdle, suggesting that dysfunction in one region may influence others; however, these relationships remain incompletely understood. This study aimed to evaluate the association between scapulohumeral trauma, postural abnormalities, and TMDs, and to assess their evolution following interdisciplinary rehabilitation. Materials and Methods: A retrospective observational study with prospective follow-up was conducted in patients with scapulohumeral fractures associated with TMD and postural abnormalities. Postural parameters and the clinical features of temporomandibular disorders (TMDs) were evaluated at baseline and follow-up using a structured clinical assessment informed by the DC/TMD framework, together with clinical examination, electromyographic analysis, and mandibular mobility measurements. Postural evaluation was performed using digital baropodometric analysis (Free Med™ platform with FreeStep™ software, standard Medica sensor, Rome, Italy. Patients received individualized multidisciplinary treatment, including orthopaedic rehabilitation, occlusal splint therapy, physiotherapy (twice weekly), pharmacological management, and odonto-periodontal care. Statistical analyses were performed using non-parametric tests (p < 0.05). Results: Significant postural improvement was observed (p < 0.01), with the proportion of patients with normal posture increasing from 0% to 22.2% and the proportion with moderate forward lean decreasing from 53.3% to 15.6%. TMD severity decreased progressively across evaluations (Friedman χ² = 72.35, p < 0.01). No statistically significant differences were found between treatment groups with respect to postural outcomes, although descriptive differences in TMD improvement were observed at later evaluation points. Conclusions: Interdisciplinary rehabilitation was associated with significant improvements in both postural alignment and TMD severity. Scapulohumeral trauma may be associated with alterations in TMJ function and overall posture, while multimodal therapy supports functional recovery. Further randomized controlled studies are needed to confirm these findings. Full article

Background/Objectives: Intra-articular injectable platelet-rich fibrin (I-PRF) is increasingly used in the management of joint-origin temporomandibular joint (TMJ) disorders, but variability in follow-up TMJ disease severity remains substantial. This study assessed whether baseline oral behaviors were associated with follow-up TMJ disease severity after intra-articular I-PRF therapy, using baseline-adjusted analyses of follow-up HI. Methods: This secondary exploratory cohort analysis was conducted within the framework of a registered clinical trial (NCT05883982). Fifty-one consecutive adult patients treated with intra-articular I-PRF were included. Baseline oral behaviors were assessed using the Oral Behaviors Checklist (OBC-21), and TMJ disease severity was quantified using the Helkimo Index (HI) at baseline and final follow-up. Associations between baseline predictors and follow-up HI were evaluated using baseline-adjusted linear regression models including baseline HI as a covariate. Results: Mean (SD) HI decreased descriptively from 7.0 (6.2) at baseline to 2.5 (3.0) at final follow-up (p < 0.001). Baseline HI was strongly associated with follow-up HI (β = 0.32, 95% CI 0.22 to 0.41, p < 0.001), whereas symptom duration (β = 0.02, 95% CI −0.10 to 0.15, p = 0.70) and injection laterality (β = −0.42, 95% CI −1.73 to 0.89, p = 0.52) were not. No OBC-21 item showed a clear baseline-adjusted association with follow-up HI after correction for multiple comparisons. The largest absolute baseline-adjusted regression coefficients were observed for awake bruxism (β = 0.80, 95% CI 0.08 to 1.52, FDR-adjusted p = 0.60) and singing (β = −0.58, 95% CI −1.41 to 0.25, FDR-adjusted p = 0.83). Conclusions: Baseline oral behaviors did not emerge as strong standalone baseline-adjusted factors associated with follow-up HI after intra-articular I-PRF therapy. However, the observed associations may still have been influenced by baseline disease severity dimensions not fully captured by total baseline HI, such as structural disease stage, pain intensity, psychosocial burden, or other unmeasured clinical severity features. The observed nominal and directional item-level patterns should be interpreted only as hypothesis-generating and require confirmation in larger, better-characterized cohorts. Full article