In a 2026 study of 44 patients with joint-related TMD, arthrocentesis reduced pain for at least 12 months whether it was followed by injectable platelet-rich fibrin (iPRF), platelet-rich plasma with hyaluronic acid (PRP-HA), or plain saline. The main result showed no difference between the three injected substances.
What is arthrocentesis?
Arthrocentesis rinses the upper space of the jaw joint through two thin needles under local anesthesia. A substance is sometimes injected afterward in the hope of adding benefit.
What did the study do?
Surgeons in Mainz, Germany reviewed 44 patients with arthrogenic (joint-related) TMD treated with arthrocentesis between 2022 and 2024. After rinsing, 18 received iPRF, 12 received PRP-HA, and 14 received saline. The main outcome was pain at rest. Pain while chewing, tenderness of the joint and jaw muscles, mouth opening and joint noises were also tracked at 1 week and at 1, 3, 6 and 12 months (Kyyak 2026).
What did it find?
- Pain at rest and during chewing improved in all three groups, with no difference between groups for the main outcome.
- The PRP-HA group had the fewest joint noises at several time points, the most stable mouth opening, and the least temporalis muscle tenderness over 12 months.
- The iPRF group had temporarily more muscle tenderness; the saline group varied more.
What are the limits?
The study was retrospective and small, with uneven group sizes, so the secondary findings favoring PRP-HA need confirmation in a randomized trial. The authors concluded that arthrocentesis itself provided lasting relief regardless of the injectate. A 2023 BMJ guideline on chronic TMJ pain makes conditional recommendations against arthrocentesis and against hyaluronic acid injection, and its strongest recommendations favor conservative care such as supervised jaw exercise, manual therapy and cognitive behavioral therapy (Busse 2023).
What does this mean for you?
Arthrocentesis may be discussed for a confirmed joint problem that has not improved with conservative care. This study suggests the rinsing itself matters more than what is injected afterward. See TMJ treatment without surgery.
When to get evaluated
Joint pain, catching, locking or reduced opening that persists deserves an evaluation. Dr. Masudian, DDS, MPH, an orofacial pain specialist, sees adults at 23101 Sherman Pl, Suite 415, West Hills. The office is expected to open on January 24, 2027. Call (818) 877-0118.
References
- Kyyak S, Heimes D, Blatt S, et al. Arthrocentesis with iPRF, PRP + hyaluronic acid, or saline in arthrogenic TMD: 12-month outcomes from a retrospective cohort study. J Craniomaxillofac Surg. 2026. PMID 42247967. doi:10.1016/j.jcms.2026.104607
- Busse JW, Casassus R, Carrasco-Labra A, et al. Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline. BMJ. 2023. PMID 38101929. doi:10.1136/bmj-2023-076227
