Use of liquid platelet-rich fibrin (liquid PRF) in temporomandibular joint disorders: A narrative review with clinical recommendations

Abstract

Aim: This narrative review aimed to gather evidence from comparative and non-comparative clinical studies to assess: (1) whether the administration of liquid platelet-rich fibrin (liquid PRF) provides any clinical benefits for managing temporomandibular disorders (TMD), and if so, based on comparative clinical studies, (2) whether it offers more benefits than no treatment or other treatment modalities, either as a standalone therapy or as an adjunct. Materials and Methods: To compile all relevant data, we performed a systematic search of PubMed, Scopus, and Web of Science, supplemented by a Google Scholar search for gray literature and a manual screening of reference lists from eligible studies and relevant reviews, up to April 22, 2025. A total of 23 clinical studies (19 comparative and 4 non-comparative) were ultimately included in this review. Results: Across the included studies, the administration of liquid PRF has been shown to have beneficial effects in reducing pain and enhancing maximum mouth opening (MMO) in patients with TMD. In the majority of studies, the adjunctive use of liquid PRF following arthrocentesis demonstrated greater positive effects compared with arthrocentesis alone. When used adjunctively with arthrocentesis, liquid PRF also showed comparable or superior clinical outcomes in terms of pain reduction and MMO improvement compared with platelet-rich plasma (PRP) and hyaluronic acid (HA). Conclusions: Based on these findings, the administration of liquid PRF following arthrocentesis appears to be a promising approach for the management of TMD. To support clinical application, this review also presented a step-by-step protocol to guide dental and medical practitioners in the effective use of liquid PRF in patients with TMD. However, further well-designed randomized clinical trials with standardized methodologies are required to strengthen the evidence base and confirm the therapeutic benefits of liquid PRF in the management of TMD due to the high variability among the included studies.