A 2026 systematic review and meta-analysis of 31 studies with 1,718 patients found that arthrocentesis improved mouth opening sooner, while platelet-rich plasma (PRP) injection gave better pain relief at 6 months, in TMJ disc displacement without reduction and osteoarthritis. The differences were small, and the included studies were not all randomized trials.
What did the review include?
Researchers at Sichuan University searched four major databases for studies published before November 2025 that compared arthrocentesis techniques with each other or with other treatments. They included randomized trials, non-randomized trials and observational studies in patients with disc displacement without reduction (“closed lock”) or joint osteoarthritis (Huang 2026).
What did it find?
- Ultrasound-guided arthrocentesis improved maximum mouth opening by about 2.3 mm more than unguided arthrocentesis.
- Single-needle and two-needle arthrocentesis worked equally well.
- Compared with PRP injection, arthrocentesis gave slightly more mouth opening at 1 week (about 2.6 mm), while PRP gave better pain relief at 6 months.
- In three randomized trials, arthrocentesis outperformed splint therapy for mouth opening and pain.
The authors suggested combining arthrocentesis for early function with PRP for longer pain relief in TMD that has not responded to other care.
How does this fit the BMJ guideline?
A 2023 BMJ guideline on chronic TMJ pain, built on a network meta-analysis of randomized trials, made conditional recommendations against arthrocentesis, hyaluronic acid injection and reversible splints, and strong recommendations in favor of conservative options such as supervised jaw exercise, manual therapy and cognitive behavioral therapy (Busse 2023). The two reviews differ in the patients and study types they included: the 2026 review focused on specific joint diagnoses and included observational studies.
What does this mean for you?
Conservative care comes first for most jaw pain. For a confirmed closed lock or joint osteoarthritis that has not improved, arthrocentesis or PRP may be discussed, including how uncertain the evidence still is. See TMJ treatment without surgery.
When to get evaluated
Dr. Masudian, DDS, MPH, an orofacial pain specialist, evaluates jaw joint problems at 23101 Sherman Pl, Suite 415, West Hills. The office is expected to open on January 24, 2027. Call (818) 877-0118.
References
- Huang X, Tao Y, Cen Z, et al. Comparative efficacy of arthrocentesis, platelet-rich plasma (PRP), and conservative therapies for TMJ disorders: A systematic review and meta-analysis. J Craniomaxillofac Surg. 2026. PMID 42302358. doi:10.1016/j.jcms.2026.104596
- 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
