Intra-Articular Injection of Platelet Rich Plasma in Treatment of Temporomandibular Disc Displacement and Osteoarthritis: A Systematic Review and Meta-Analysis

• Main Authors: Krystle Marie Romillo, 羅晶晶
• Other Authors: Wen-Liang Lo
• Format: Others
• Language: en_US
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/5p45bt

碩士 === 國立陽明大學 === 牙醫學系 === 106 === Background: Platelet-rich plasma (PRP) is non-invasive and offers an alternative treatment option for managing the symptoms of disc displacements and osteoarthritis Despite some clinical studies demonstrating its effects, uncertainty still exists whether PRP is an effective treatment for disc displacement and TMJ-OA. Objectives: This review aims to investigate the effectiveness of PRP in reducing pain and increasing mouth opening in patients diagnosed with disc displacement and TMJ-OA. Search methods: We performed an electronic database search using MEDLINE for relevant studies published up to May 2018. To identify other additional studies, citation lists and manual hand searched for reference lists was conducted to prevent missing any articles. Selection criteria: RCTs of studies that utilized the intra-articular injection of platelet-rich plasma in patients known to have disc displacement with or without osteoarthritis of the TMJ that assessed VAS and MMO outcomes. Data collection and analysis: Data were extracted and analyzed using Revman software 5.2 version. The Cochrane collaboration tool for bias assessment was utilized to validate the quality of studies included in this review. The authors of the included studies were contacted to clarify and request for additional information. Main results: A total of 293 participants are included in this review, 145 participants for the study group and 148 participants for the control group. All studies in this review were RCTs of patients diagnosed with ADDwR, ADDwoR, ADDwOR, and OA. In the experimental group, one study utilized PRP alone whereas five studies combined PRP injection with either arthrocentesis and arthroscopy. On the other hand, the control group includes arthrocentesis alone, arthrocentesis with HA and arthroscopy with HA. Outcome measures were assessed from 1 month to 24 months. A pooled analysis for VAS showed a clinical statistical significance in pain reduction with an overall effect of (SMD 0.74, 95% CI 0.40 to 1.0, P< 0.05, I2 57%) whereas MMO only showed clinical benefit at 3 months (SMD -0.50, 95% CI -0.88,-0.13,P = 0.009, I2 39%). Conclusions: The results of this meta-analysis showed that PRP might be effective one year after injection in managing pain and increasing mouth opening for patients with disc displacements and osteoarthritis. Keywords: disc displacement, osteoarthritis, platelet-rich plasma