Evaluation of the Short-Term Influence of Intra-Articular Platelet-Rich Plasma Injection in Patients with Temporomandibular Joint Internal Derangement: A Randomised, Saline-Controlled Clinical Study

Authors

• Hussein Salam Abdulraheem Twayej, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Anbar, Ramadi, IraqFollow
• Sabah Abdul Rasool Hammoodi Alheeti, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Anbar, Ramadi, Iraq

Abstract

Temporomandibular joint disc displacement commonly causes pain, joint sounds, and limited mouth opening, yet the optimal minimally invasive treatment remains uncertain. Platelet-rich plasma, an autologous concentrate of growth factors, has been proposed to encourage intra-articular repair, but placebo-controlled evidence is limited. This randomised, saline-controlled trial compared a single intra-articular injection of platelet-rich plasma with normal saline over the short term. Twenty joints were randomised 1:1 to platelet-rich plasma or to 0.9% normal saline as a control. Pain (10-point visual analogue scale), joint sound (0–2 ordinal scale), and maximum interincisal opening (in millimetres) were recorded at baseline and at one week. Within-group change was assessed with the exact Wilcoxon signed-rank test and between-group differences with the Mann–Whitney U test (two-sided; significance level 0.05). The groups were comparable at baseline (all p > 0.05). With platelet-rich plasma, median pain fell from 7.5 to 2.0 (p = 0.002), clicking resolved in 70% of joints, and median opening rose from 43.5 to 44.5 mm (p = 0.008). Saline changed none of the three outcomes (pain p = 1.000; opening p = 0.625; no joint lost its click). Between groups, platelet-rich plasma was superior for pain (p < 0.001), joint sound (p < 0.001), and opening (p = 0.020), with large effect sizes. Because saline produced no change, the improvements are unlikely to reflect the needle or a placebo effect and more plausibly indicate a genuine, though preliminary, treatment response. Platelet-rich plasma appears to be a potentially useful, minimally invasive option for temporomandibular joint internal derangement, although larger trials with longer follow-up are needed to confirm this.

Recommended Citation

Twayej, Hussein Salam Abdulraheem and Hammoodi Alheeti, Sabah Abdul Rasool (2026) "Evaluation of the Short-Term Influence of Intra-Articular Platelet-Rich Plasma Injection in Patients with Temporomandibular Joint Internal Derangement: A Randomised, Saline-Controlled Clinical Study," Maaen Journal for Medical Sciences: Vol. 5 : Iss. 3 , Article 9.
Available at: https://doi.org/10.55810/2789-9136.1106

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