PLATELET CONCENTRATES AND ARTHROCENTESIS AS A THERAPEUTIC OPTION FOR TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS: A SYSTEMATIC REVIEW OF SYSTEMATIC REVIEWS

Abstract

Abstract Aims/Purpose This systematic review of systematic reviews (SR of SRs) investigates the efficacy of intra-articular injections (IAIs) of platelet-rich concentrates (PCs) combined with arthrocentesis for managing temporomandibular joint osteoarthritis (TMJ OA). The comprehensive analysis compares the effectiveness of PCs combined with arthrocentesis to hyaluronic acid (HA), corticosteroids (CS), arthrocentesis alone, and placebo in reducing pain and improving maximum mouth opening (MMO). Methods Comprehensive database searches were performed in PubMed, Scopus, Cochrane Library, and Google Scholar, studies from 2012 to 2023, with the final search conducted in December 2023. Studies were critically appraised using the Critical Appraisal Skills Programme (CASP) and Risk of Bias in Systematic Reviews (ROBIS) to ensure rigorous evaluation. Results The search identified 74 articles, with 17 meeting the inclusion criteria after deduplication and screening. An additional three studies were found through manual reference list searches. Overall risk of bias in the reviews showed 39% of the studies had a low risk of bias, 44% showed a high risk, and 17% were unclear. While a significant proportion of the studies showed a low risk of bias in some areas, high and unclear risks were also prevalent across various aspects of the reviews. Conclusion The SR of SRs demonstrates the strong potential benefit of PCs with arthrocentesis in reducing the pain of TMJ OA and provides guidance for future research to address the shortcomings of current trials. While the quality of the evidence varies, the positive outcomes highlighted warrant further investigation. Future research with standardised protocols and robust methodologies is crucial to definitively assessing the effectiveness of PCs with arthrocentesis in TMJ OA treatment. This review paves the way for advancements in managing TMJ OA and invites further exploration in this promising field.