Non-Cochrane · intervention · PM40914979
Effectiveness of Platelet-Rich Fibrin for Temporomandibular Disorders Management: A Systematic and Meta-Analysis.
de Araújo Júlia Silva Gomes, de Oliveira da Rosa Wellington Luiz, Meirelles Luiz Augusto Duarte, et al. · Oral diseases · 2026 · PubMed · doi:10.1111/odi.70089
Findings
16 findings
| Population | ||||
|---|---|---|---|---|
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | Intra-articular injection of injectable platelet-rich fibrin (i-PRF) alone | Before treatment (baseline, within-group pre-post) | Maximum mouth opening (MMO) 3-6 months | MD -1.26 [-4.51, 1.99] Very low Downgraded: risk of bias, inconsistency, publication bias 1 study · 37 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | Intra-articular injection of injectable platelet-rich fibrin (i-PRF) alone | Before treatment (baseline, within-group pre-post) | Pain (visual analog scale, VAS) 8-12 months | MD 3.94 [2.66, 5.22] Very low Downgraded: risk of bias, inconsistency, publication bias 1 study · 37 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | Intra-articular injection of i-PRF alone | Baseline (before treatment, same patients) | Pain (VAS) 3-6 months Unresolved: the two extractors disagree on this row. | MD -2.64 [-4.27, -1.01] GRADE not reported 2 studies · 71 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | Intra-articular injection of injectable platelet-rich fibrin (i-PRF) alone | Before treatment (baseline, within-group pre-post) | Maximum mouth opening (MMO) 8-12 months | MD -7.29 [-10.45, -4.13] Very low Downgraded: risk of bias, inconsistency, publication bias 1 study · 37 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | i-PRF combined with arthrocentesis | Before treatment (baseline, within-group pre-post) | Maximum mouth opening (MMO) 8-12 months | MD -8.99 [-10.14, -7.84] Moderate Downgraded: imprecision 5 studies · 143 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | i-PRF combined with arthrocentesis | Before treatment (baseline, within-group pre-post) | Pain (visual analog scale, VAS) 8-12 months | MD 5.83 [4.12, 7.54] Low Downgraded: risk of bias, imprecision 2 studies · 24 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | Intra-articular injection of i-PRF combined with arthrocentesis | Baseline (before treatment, same patients) | Maximum mouth opening (MMO) 3-6 months Unresolved: the two extractors disagree on this row. | MD -7.94 [-9.51, -6.38] GRADE not reported 8 studies · 227 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | Intra-articular injection of i-PRF combined with arthrocentesis | Baseline (before treatment, same patients) | Pain (VAS) 3-6 months Unresolved: the two extractors disagree on this row. | MD 5.88 [4.37, 7.39] GRADE not reported 7 studies · 188 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | i-PRF combined with arthroscopy | Before treatment (baseline, within-group pre-post) | Maximum mouth opening (MMO) 8-12 months | MD -16.00 [-20.49, -11.51] Very low Downgraded: risk of bias, inconsistency, publication bias 1 study · 17 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | i-PRF combined with arthroscopy | Before treatment (baseline, within-group pre-post) | Pain (visual analog scale, VAS) 3-6 months | MD 5.70 [4.89, 6.51] Very low Downgraded: risk of bias, imprecision, inconsistency 1 study · 17 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | i-PRF combined with arthroscopy | Before treatment (baseline, within-group pre-post) | Maximum mouth opening (MMO) 3-6 months | MD -13.80 [-18.39, -9.21] Very low Downgraded: risk of bias, inconsistency, publication bias 1 study · 17 participants |
| Symptomatic individuals with articular temporomandibular disorder (osteoarthritis and/or internal derangement of the TMJ) | i-PRF combined with arthroscopy | Before treatment (baseline, within-group pre-post) | Pain (visual analog scale, VAS) 8-12 months | MD 6.00 [5.28, 6.72] Very low Downgraded: risk of bias, inconsistency, publication bias 1 study · 17 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | i-PRF injection plus arthrocentesis | Arthrocentesis alone | Pain (VAS) 3-6 months Unresolved: the two extractors disagree on this row. | MD 2.24 [1.04, 3.44] GRADE not reported 6 studies · 367 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | i-PRF injection plus arthrocentesis | Arthrocentesis alone | Maximum mouth opening (MMO) 8-12 months Unresolved: the two extractors disagree on this row. | MD -3.25 [-4.61, -1.89] GRADE not reported 5 studies · 367 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | i-PRF injection plus arthrocentesis | Arthrocentesis alone | Maximum mouth opening (MMO) 3-6 months Unresolved: the two extractors disagree on this row. | MD -2.90 [-4.20, -1.59] GRADE not reported 8 studies · 479 participants |
| Patients with symptomatic painful articular temporomandibular disorders (osteoarthritis and/or internal derangement of the TMJ) | i-PRF injection plus arthrocentesis | Arthrocentesis alone | Pain (VAS) 8-12 months Unresolved: the two extractors disagree on this row. | MD 1.51 [1.05, 1.96] GRADE not reported 2 studies · 121 participants |
Included primary studies 23
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Karadayi 2021 Randomised controlled trial of arthrocentesis with or without PRF for internal derangement of the TMJ. PMID:33581954 | 2021 | 4 other reviews | not stated | not extracted yet |
| Isik 2022 Injectable platelet-rich fibrin as treatment for temporomandibular joint osteoarthritis: A randomized controlled clinical trial. PMID:35798596 | 2022 | 3 other reviews | not stated | not extracted yet |
| Ghoneim 2021 Treatment of temporomandibular joint disc displacement using arthrocentesis combined with injectable platelet rich fibrin versus… PMID:35028072 | 2022 | 2 other reviews | not stated | not extracted yet |
| Isik 2023 Does the Use of Injectable Platelet-Rich Fibrin After Arthrocentesis for Disc Displacement Without Reduction Improve Clinical Outcomes? PMID:36924792 | 2023 | 2 other reviews | not stated | not extracted yet |
| Kumar 2025 Evaluation of injectable platelet-rich fibrin (I-PRF) as a treatment in internal derangement of temporomandibular joint. PMID:40510726 | 2025 | 1 other review | not stated | not extracted yet |
| Sharma 2023 A comparative analysis between intra articular injections of injectable platelet rich fibrin versus platelet rich plasma in the management… PMID:37661973 | 2023 | 1 other review | not stated | not extracted yet |
| Torul 2021 The efficacy of intra-articular injectable platelet-rich fibrin application in the management of Wilkes stage III temporomandibular joint… PMID:33771436 | 2021 | 1 other review | not stated | not extracted yet |
| Albilia 2018 Liquid platelet-rich fibrin injections as a treatment adjunct for painful temporomandibular joints: preliminary results DOI:10.1080/08869634.2018.1516183 | 2018 | this review only | not stated | not extracted yet |
| Albilia 2018 Liquid platelet-rich fibrin injections as a treatment adjunct for painful temporomandibular joints: preliminary results. PMID:30231809 | 2020 | this review only | not stated | not extracted yet |
| Bera 2022 DOI:10.1016/j.oralsurg.2022.02.002 | NR | this review only | not stated | not extracted yet |
| Ghoneim 2021 DOI:10.1016/j.jdsci.2021.10.004 | NR | this review only | not stated | not extracted yet |
| Gonzalez 2021 Comparison between TMJ arthrocentesis techniques with different needle positions: A randomized single-blind controlled clinical trial DOI:10.1016/j.jcms.2021.02.011 | 2021 | this review only | not stated | not extracted yet |
| Gonzalez 2021 Clinical outcomes of operative arthroscopy and temporomandibular medical infiltration with platelet-rich fibrin in upper and lower… PMID:34384651 | 2021 | this review only | not stated | not extracted yet |
| Isik 2022 DOI:10.1016/j.jcms.2021.12.015 | NR | this review only | not stated | not extracted yet |
| Isik 2023 Outcome of the Management of Salivary Gland Diseases by Sialendoscopy: A University Hospital's Experience DOI:10.1016/j.joms.2022.11.010 | 2023 | this review only | not stated | not extracted yet |
| Karadayi 2021 A retrospective analysis of the surgical outcomes of different free vascularized flaps used for the reconstruction of the maxillofacial… DOI:10.1016/j.jcms.2020.12.015 | 2021 | this review only | not stated | not extracted yet |
| Tepecik 2025a Do I-PRF adjuvant injections in TMJ arthrocentesis have a cumulative physiological effect? A retrospective cohort study DOI:10.1186/s12903-025-05824-7 | 2025 | this review only | not stated | not extracted yet |
| Tepecik 2025a Do I-PRF adjuvant injections in TMJ arthrocentesis have a cumulative physiological effect? A retrospective cohort study. PMID:40148835 | 2025 | this review only | not stated | not extracted yet |
| Tepecik 2025b Efficacy of adjunctive injectable platelet-rich fibrin as a first-line treatment in temporomandibular joint osteoarthritis: a… DOI:10.1016/j.ijom.2025.02.012 | 2025 | this review only | not stated | not extracted yet |
| Tepecik 2025b Efficacy of adjunctive injectable platelet-rich fibrin as a first-line treatment in temporomandibular joint osteoarthritis: a… PMID:40082134 | 2025 | this review only | not stated | not extracted yet |
| Torul 2021 DOI:10.1016/j.ijom.2021.04.013 | NR | this review only | not stated | not extracted yet |
| Yuce 2020 Facial Reanimation With Free Latissumus Dorsi Muscle Transfer, a Comparative Study Between Lateral and Supine Approach DOI:10.1097/scs.0000000000007053 | 2020 | this review only | not stated | not extracted yet |
| Yuce 2020 Comparison of the Efficiacy of Intra-Articular Injection of Liquid Platelet-Rich Fibrin and Hyaluronic Acid After in Conjunction With… PMID:32433129 | 2020 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Symptomatic individuals diagnosed with osteoarthritis and/or internal derangement of the TMJ by RDC, DC/TMD or Wilkes classification | Patients with TMJ osteoarthritis or internal derangement (n=13 studies; 5 RCTs and 8 nonrandomized studies) |
| Intervention | TMJ minimally invasive procedures: i-PRF alone or combined with arthrocentesis or arthroscopy | i-PRF alone; i-PRF + arthrocentesis; i-PRF + arthroscopy (n=1 study) |
| Comparison | Within-group pre- and post-treatment (i-PRF alone, i-PRF + arthrocentesis, i-PRF + arthroscopy); between-group arthrocentesis alone vs i-PRF + arthrocentesis | Before treatment (within-group); arthrocentesis alone (between-group) |
| Outcomes | VAS pain scores and maximum mouth opening (MMO) | VAS pain and MMO |
| Study designs | Randomized and nonrandomized clinical trials | Randomized trials (n=5) and nonrandomized studies (n=8) |
| Timing | Follow-up of at least 1 month; categorized as up to 6 months and 8 to 12 months | 3-6 months and 8-12 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Partial Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | No | Yes | no |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |