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      Efficacy of Injectable Platelet-Rich Fibrin (I-PRF) in Managing Temporomandibular Joint Pain: A Prospective Clinical Study

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          Abstract

          Background: Temporomandibular joint (TMJ) pain is a common condition that can significantly impact an individual's quality of life. Current treatment options often fall short of providing long-lasting relief. So, this prospective clinical study aimed to investigate the efficacy of injectable platelet-rich fibrin (I-PRF) in mitigating TMJ pain.

          Methods: A total of 68 participants, aged 18-60 years, clinically diagnosed with TMJ pain, were recruited from dental clinics and specialist referrals. Participants were randomly assigned to either the intervention group (I-PRF injections) or the control group (placebo). Primary outcome measures included TMJ pain intensity and jaw function, assessed using the Visual Analog Scale and functional examinations, respectively. Secondary outcomes comprised patient-reported outcomes (PROs) on quality of life and satisfaction. Data were collected at baseline and six, 12, and 24 weeks post intervention.

          Results: Baseline characteristics demonstrated successful randomization, with no significant differences in age, gender, or TMJ pain duration between groups. Post intervention, the intervention group exhibited a significant and sustained reduction in TMJ pain intensity compared to controls (p<0.001). Improvements in jaw function were also notable in the intervention group at all follow-up time points (p<0.001). PROs related to quality of life and satisfaction substantially increased in the intervention group compared to controls (p<0.001).

          Conclusion: I-PRF demonstrated significant efficacy in reducing TMJ pain intensity, improving jaw function, and enhancing PROs. These findings support the consideration of I-PRF as a valuable therapeutic intervention for individuals with TMJ pain.

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          Most cited references22

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          Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

          Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects, and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.
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            Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry?

            Platelet rich plasma (PRP) has been utilized in regenerative dentistry as a supra-physiological concentrate of autologous growth factors capable of stimulating tissue regeneration. Despite this, concerns have been expressed regarding the use of anti-coagulants, agents known to inhibit wound healing. In this study, a liquid formulation of platelet rich fibrin (PRF) termed injectable-PRF (i-PRF) without the use of anti-coagulants was investigated.
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              Factors involved in the etiology of temporomandibular disorders - a literature review

              Background and aim This review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD). Method We conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence. Results The etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overloading and parafunctions (bruxism) are frequently involved as biomechanical factors; increased levels of estrogen hormones are considered biological factors affecting the temporo-mandibular-joint. Among bio-psychosocial factors, stress, anxiety or depression, were frequently encountered. Conclusions The etiopathogenesis of this condition is poorly understood, therefore TMDs are difficult to diagnose and manage. Early and correct identification of the possible etiologic factors will enable the appropriate treatment scheme application in order to reduce or eliminate TMDs debilitating signs and symptoms.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                17 February 2024
                February 2024
                : 16
                : 2
                : e54367
                Affiliations
                [1 ] Department of Oral and Maxillofacial Surgery, School of Dentistry, Central Asian University, Tashkent, UZB
                [2 ] Department of Oral and Maxillofacial Surgery, Sankalchand Patel University, Visnagar, IND
                [3 ] Department of Oral and Maxillofacial Surgery, RVS Dental College and Hospital, Coimbatore, IND
                [4 ] Department of Oral and Maxillofacial Surgery, Manubhai Patel Dental College, Vadodara, IND
                [5 ] Department of Oral and Maxillofacial Surgery, GITAM Dental College and Hospital, Visakhapatnam, IND
                [6 ] Department of Oral and Maxillofacial Surgery, Chandra Dental College and Hospital, Barabanki, IND
                Author notes
                Article
                10.7759/cureus.54367
                10945458
                38500930
                7ea8435a-3444-4af3-81f0-5a8c2208c487
                Copyright © 2024, Kumar et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 31 December 2023
                : 17 February 2024
                Categories
                Dentistry

                patient-reported outcomes,quality of life,pain management,injectable,platelet-rich fibrin,temporomandibular joint

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