Abstract
Background:
Temporomandibular joint (TMJ) disorders affect a significant proportion of the population, leading to pain, joint dysfunction, and reduced quality of life. Arthrocentesis and platelet-rich plasma (PRP) injections are two widely used conservative treatments. This study aims to compare the effectiveness of arthrocentesis and PRP in improving pain relief, mouth opening, and functional outcomes in TMJ disorder patients.
Methods:
A total of 60 patients diagnosed with TMJ disorders were enrolled and divided into two groups (n = 30 each). Group A underwent arthrocentesis, while Group B received PRP injections. Outcomes were measured based on pain reduction (VAS score), maximum mouth opening (maximum mouth opening [MMO] in mm), and functional improvement using the Jaw Function Limitation Scale. Measurements were recorded at baseline, 1 month, and 3 months post-treatment. Statistical analysis was conducted using paired t-tests and analysis of variance (ANOVA).
Results:
Both treatment groups showed significant improvement. The PRP group demonstrated superior long-term pain relief (VAS: 7.2 to 2.1) compared to arthrocentesis (VAS: 7.4 to 3.5) at 3 months. MMO improved in both groups, with PRP showing a greater increase (35.5 mm to 43.8 mm) than arthrocentesis (34.9 mm to 41.2 mm). Functional limitation scores also improved more significantly in the PRP group.
Conclusion:
PRP injections provided better long-term outcomes in terms of pain relief and functional improvement compared to arthrocentesis, suggesting its potential as a more effective conservative treatment for TMJ disorders.
KEYWORDS: Arthrocentesis, joint dysfunction, pain management, platelet-rich plasma, temporomandibular joint disorders
INTRODUCTION
Temporomandibular joint disorders (TMDs) are a group of conditions affecting the temporomandibular joint (TMJ) and surrounding structures, leading to symptoms such as pain, clicking, and restricted jaw movement. It is estimated that approximately 5–12% of the global population suffers from TMDs, with a higher prevalence in females than males.[1]
Arthrocentesis, a minimally invasive technique, involves flushing the joint with sterile fluid to remove inflammatory mediators and improve function.[2] On the other hand, platelet-rich plasma (PRP) is an autologous blood derivative rich in growth factors that stimulate tissue healing, cartilage regeneration, and pain reduction.[3] Recent studies suggest that PRP may provide superior long-term benefits compared to arthrocentesis.[4,5]
This clinical study aims to compare the effectiveness of arthrocentesis versus PRP injections in TMJ disorders by evaluating pain relief, jaw mobility, and functional outcomes over a 3-month follow-up period.
MATERIALS AND METHODS
Study design and participants
This prospective, randomized clinical trial was conducted on 60 patients diagnosed with TMJ disorders. Participants were randomly assigned into:
Group A (n = 30): Underwent arthrocentesis using Ringer’s lactate solution.
Group B (n = 30): Received PRP injections, prepared from autologous blood using centrifugation.
Inclusion and exclusion criteria
Inclusion: Patients aged 18–50 years with TMJ pain, limited mouth opening, and no prior TMJ surgery.
Exclusion: Patients with systemic diseases, rheumatoid arthritis, or severe joint degeneration.
Outcome measures and statistical analysis
Pain assessment: Visual Analog Scale (VAS, 0–10).
Maximum mouth opening (MMO): Measured in millimeters.
Functional limitation: Jaw Function Limitation Scale (JFLS).
Data were analyzed using paired t-tests and ANOVA to compare intragroup and intergroup changes.
RESULTS
The results of this study demonstrate that both arthrocentesis and PRP injections significantly improved pain scores (VAS), MMO, and jaw function (JFLS) over the 3-month follow-up period. However, PRP injections yielded superior long-term benefits compared to arthrocentesis.
Pain scores (VAS) decreased significantly in both groups, but the PRP group exhibited greater pain reduction (7.2 to 2.1) compared to arthrocentesis (7.4 to 3.5) at 3 months. Similarly, MMO improved more in the PRP group (31.8 mm to 41.2 mm) than in the arthrocentesis group (32.1 mm to 38.4 mm), indicating better joint mobility restoration [Table 1].
Table 1.
Comparison of pain reduction (VAS Score) between groups
| Time Interval | Arthrocentesis (Mean±SD) | PRP Injection (Mean±SD) | P |
|---|---|---|---|
| Baseline | 7.4±1.2 | 7.2±1.1 | >0.05 |
| 1 Month | 4.5±1.1 | 3.2±1.0 | <0.05 |
| 3 Months | 3.5±1.0 | 2.1±0.9 | <0.01 |
Functional improvement, measured by JFLS scores, was also greater in the PRP group (22.1 to 10.2) compared to arthrocentesis (21.3 to 12.5). These findings suggest that PRP injections not only alleviate pain but also enhance joint function and mobility more effectively than arthrocentesis, making it a promising long-term treatment option for TMJ disorders [Table 2].
Table 2.
Comparison of maximum mouth opening (MMO) between groups
| Time Interval | Arthrocentesis (Mean±SD) | PRP Injection (Mean±SD) | P |
|---|---|---|---|
| Baseline | 32.1±2.3 mm | 31.8±2.5 mm | >0.05 |
| 1 Month | 36.2±2.5 mm | 38.5±2.7 mm | <0.05 |
| 3 Months | 38.4±2.8 mm | 41.2±3.0 mm | <0.01 |
DISCUSSION
Pain reduction
Pain relief is a key goal in TMJ disorder management. The VAS scores in both groups showed significant reductions over time, with arthrocentesis decreasing from 7.4 to 3.5 and PRP from 7.2 to 2.1 at 3 months. The superior pain reduction in the PRP group may be attributed to its regenerative and anti-inflammatory properties, which promote tissue healing beyond mechanical lavage effects of arthrocentesis. These findings are consistent with studies by Guarda-Nardini et al.[6] and Liu et al.,[7] which reported better pain relief with PRP compared to traditional TMJ interventions.
Arthrocentesis functions primarily by flushing inflammatory mediators and increasing joint lubrication, leading to immediate short-term relief. However, because it does not stimulate tissue repair, pain relief may plateau or regress over time. Conversely, PRP releases platelet-derived growth factors (PDGF), transforming growth factor-beta (TGF-β), and vascular endothelial growth factor (VEGF), all of which contribute to soft tissue healing, angiogenesis, and pain modulation.[8,9] This explains the prolonged analgesic effect observed in PRP-treated patients.
Improvement in maximum mouth opening (MMO)
Patients receiving PRP showed greater increases in MMO (from 31.8 mm to 41.2 mm) compared to arthrocentesis (from 32.1 mm to 38.4 mm). This improvement suggests enhanced joint mobility due to PRP’s ability to stimulate fibroblast proliferation and extracellular matrix synthesis, promoting cartilage repair and synovial fluid regeneration.[10] The sustained effect of PRP on joint mobility has been documented in prior studies, such as those by Guarda-Nardini et al.,[11] demonstrating superior functional outcomes when compared to lavage-only treatments.
Arthrocentesis does improve joint mobility by reducing intra-articular pressure and adhesions, but its effects may diminish over time if the underlying degenerative or inflammatory changes persist.[12] PRP, in contrast, actively enhances cartilage and soft tissue regeneration, making it a more durable intervention.
Functional Outcomes (Jaw Function Limitation Scale – JFLS)
Both groups exhibited improvements in jaw function limitation, but PRP-treated patients had greater reductions in JFLS scores (from 22.1 to 10.2) compared to arthrocentesis (21.3 to 12.5). These findings support the hypothesis that PRP provides greater joint stabilization and prolonged functional improvement.
Functional improvement in TMJ disorders is often correlated with synovial fluid quality and intra-articular pressure regulation. PRP’s sustained effects on reducing inflammation and improving joint lubrication contribute to long-term restoration of normal function. Similar trends have been reported in previous randomized clinical trials comparing PRP with traditional conservative therapies.
CONCLUSION
Overall, this study demonstrates that PRP injections provide superior long-term pain relief and functional improvement compared to arthrocentesis. PRP’s regenerative effects make it a promising alternative to conventional lavage-based therapies. Future research should focus on longer follow-ups, larger sample sizes, and objective imaging-based assessments to further establish the role of PRP in TMJ disorder management.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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