Ross Hauser, MD, Danielle Matias, PA-C, Demi Foster, APRN
In this article, we discuss research on the clinical benefits of Platelet Rich Plasma Therapy (PRP).
- PRP treatment takes your blood, like going for a blood test, and re-introduces the concentrated blood platelets from your blood into areas of chronic joint deterioration.
- Your blood platelets contain growth and healing factors. When concentrated through simple centrifuging, your blood plasma becomes “rich” in healing factors, thus the name Platelet RICH plasma. Platelets play a central role in blood clotting and wound/injury healing.
A September 2025 study in the Journal of Clinical Medicine (1) found PRP to be among the promising regenerative medicine treatments for patients with TMJ. The study suggests that the growth factors in PRP can potentially enhance tissue healing, reduce inflammation, and restore function in affected areas. These biologically active substances not only promote tissue regeneration but also may contribute to improved overall quality of life for patients suffering from chronic pain and dysfunction associated with TMD.
The authors also write that a problem with PRP is the inconsistencies in clinical protocols and that many practitioners lack adequate training in the techniques required for effective autologous cell extraction and injection.
An October 2025 study in the journal Pain Medicine (2) looked at the data of 31 studies involving 1359 patients. They found that:
- Compared to joint aspiration, PRP significantly reduced pain at 6 months and improved mandibular movement at 3 months and 6 months.
- Compared to hyaluronic acid, PRP significantly reduced pain at 3 months and improved mandibular movement at 6 months.
- Compared to corticosteroids, PRP reduced pain at 1 month, 3 months, and 6 months, and improved mandibular movement at 6 months).
PRP increases chondrocyte proliferation (rapid production of collagen cells) and production of matrix molecules (the structures and cells need to build new tissue at the site of damage) and helps maintain the integrity of the chondral (cartilage) surface, thereby facilitating joint movement, whereas corticosteroids are more potent anti-inflammatory agents and they act by inhibiting prostaglandin synthesis (part of the body’s immune system) which is the mediator of inflammation. Thus, the use of PRP has been proven to show better results in reducing the symptoms of TMDs and also helped in articular disc repair.
A 2020 study published in the Journal of Oral & Facial Pain and Headache (3) examined the effect of Platelet-Rich Plasma Injections on pain reduction in patients with Temporomandibular Joint Osteoarthritis. In this paper, the research team examined 6 study outcomes and found according to the results of these trials, intra-articular injections of PRP were more effective than placebo for pain reduction (6 months post-injection and 12 months post-injection.
A 2015 study in the Journal of Oral and Maxillofacial Surgery (4) shows emerging evidence suggesting platelet-rich plasma (PRP) might be of assistance in the treatment of degenerative conditions of the jaw joint.
In this study, PRP and hyaluronic acid treatments in temporomandibular joint (TMJ) osteoarthritis patients were compared over a long-term follow-up.
A total of 50 patients with TMJ-osteoarthritis were enrolled in the study (29 women and 21 men, age range 31 to 49 years, mean age 38.6).
- In group I, 25 patients received 3 injections of 1 mL of PRP.
- In group II, 25 patients received 3 injections of 1 mL of low-molecular-weight hyaluronic acid.
The hyaluronic acid group showed significant improvements at 1 and 3 months. However, at 6 and 12 months, the PRP group exhibited better performance compared with the hyaluronic acid group in terms of the recurrence of pain and joint sounds.
The PRP group performed better than the hyaluronic acid group in the treatment of TMJ-osteoarthritis during long-term follow-up in terms of pain reduction and increased interincisal distance.
Researchers at the Department of Oral and Maxillofacial Surgery, Jaipur Dental College, in India, published their findings in the National Journal of Maxillofacial Surgery (5) of their assessment of the effectiveness of PRP injections compared to hydrocortisone with local anesthetic in the conservative management of anterior disc displacement with reduction. The researchers found: “In the group of PRP injection, the pain was markedly reduced than the group of hydrocortisone with a local anesthetic; mouth opening was increased similarly in both groups, and TMJ sound was experienced lesser in patients who received PRP.”
An October 2022 paper in the journal Bioinformation (6) assessed outcomes in 40 patients (64 TMJs treated) treated with local anesthesia combined with hydrocortisone against intra-articular injection of PRP to weigh the benefits of treatments for pain reduction, increase mouth opening, and minimize joint sound.
- PRP was applied to 36 joints of 20 patients.
- Hydrocortisone combined with local anesthetic was applied to 28 joints of 20 patients.
Patients were evaluated for tenderness, maximum inter incisal opening (distance between upper and lower teeth on opening), and clicking sound at TMJ prior to and following treatment at intervals of one week, one month, and 6 months of the first week and third month.
Although both types of study participants got a reduction in pain, increased opening of mouth, and reduction in clicking sound, the difference between the two groups was not significant statistically however the results were slightly better in study participants receiving platelet rich plasma injections. This study demonstrated that intra-articular injection of PRP was more successful in treating patients in this trial than local anesthetic combined with hydrocortisone.
PRP and hyaluronic acid injections
A 2019 study from the University of Verona in Italy published in the International Journal of Molecular Sciences (7) evaluated the effectiveness of arthrocentesis (TMJ aspiration) or injections with platelet-rich plasma in temporomandibular affections and compared them to arthrocentesis alone or with hyaluronic acid or to hyaluronic acid injections.
The researchers found:
- TMJ aspiration with platelet-rich plasma and platelet-rich plasma injections in temporomandibular disorders’ management were found to be effective in reducing pain and joint sound (clicking and popping) as well as in improving mandibular motion in a maximum follow-up of 24 months. Comparison to arthrocentesis alone or to hyaluronic acid injections used in arthrocentesis or injections provided encouraging results in terms of the effectiveness of platelet-rich plasma use.
Platelet-rich plasma (PRP) after arthrocentesis
A November 2023 paper published in the Journal of Oral Rehabilitation (8) reviewed the data of seven previously published studies to assess the effectiveness and patient satisfaction of intra-articular injections of platelet-rich plasma (PRP) after arthrocentesis and compare those results with other treatments, such as injections of hyaluronic acid or saline after arthrocentesis. Five of the studies found that PRP injections have led to significant improvements in mandibular range of motion and pain intensity up to 12 months after treatment as compared to hyaluronic acid or saline after arthrocentesis, while the remaining two studies found similar results for the different treatments.
PRP combined with physical therapy
A September 2021 study in the Journal of Oral Rehabilitation (9) assessed the effectiveness of platelet-rich plasma injection combined with physical therapy for the treatment of temporomandibular joint osteoarthritis. These are the summary highlights of this paper:
- This prospective cohort study included 40 patients with TMJ-osteoarthritis who received PRP injection or PRP injection combined with individualized comprehensive physical therapy.
- Pain intensity, maximum mouth opening, temporomandibular joint sounds, and the Jaw Functional Limitation Scale (JFLS) scores and imaging findings were compared before treatment and during follow-up.
Results:
- The pain intensity, maximum mouth opening, and temporomandibular joint sounds of the two groups significantly improved with an increase in treatment time.
- The pain improvement in the combined treatment group was greater than that in the PRP injection group at three and six months.
- The improvement of mouth opening was better in the combined treatment group, whereas the improvement of joint sounds was better in the PRP injection group.
- The improvement in Jaw Functional Limitation Scale scores in the combined treatment group was greater than that in the PRP injection group at 6 months. The imaging improvement rates of the two groups were similar.
Conclusions:
“Platelet-rich plasma injection can significantly improve pain, mouth opening, abnormal joint sound, and mandibular function in patients with TMJ-osteoarthritis and has good repair effect on condylar bone defects. PRP injection combined with individualized comprehensive physical therapy can effectively control the medium- and long-term pain of patients.”
More reading
Our published research
The association between mandibular position to cervical spine and internal jugular vein diameters in upright position. Have we been ignoring critical generators of head and neck pathology? Lockerman LZ, Hauser R. The association between mandibular position to cervical spine and internal jugular vein diameters in upright position. Have we been ignoring critical generators of head and neck pathology? Cranio. 2023 Sep;41(5):403-406. [Google Scholar]
Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction Hauser R., Hauser H, Blakemore KA. Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction. (2007) [Google Scholar]
References
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