Comparative Outcomes of Hyaluronic Acid Versus Platelet-Rich Plasma Infiltrations in Temporomandibular Joint Disorders

Abstract Background: Temporomandibular disorders (TMD) are prevalent musculoskeletal conditions that impair function and quality of life. Intra-articular therapies such as hyaluronic acid (HA) and platelet-rich plasma (PRP) have emerged as minimally invasive options, yet comparative real-world evidence remains limited. Methods: A total of 100 patients with TMD were analyzed in two parallel cohorts: 50 treated with HA and 50 with PRP. Baseline characteristics, treatment protocols, and outcomes were extracted from clinical databases. Primary outcomes included changes in mouth opening (mm) and pain intensity (VAS, 0–10). Secondary outcomes included imaging findings and patient-reported improvement. Statistical analysis was performed using SPSS version 29.0. Results: Patients in the HA group were older on average (47.3 ± 17.9 years) compared with PRP patients (38.6 ± 10.8 years). HA-treated patients more frequently presented with degenerative or structural etiologies, whereas PRP was preferred in cases of parafunctional habits and post-traumatic etiologies. HA was associated with greater improvement in mouth opening (+10.7 mm), while PRP provided superior pain relief (VAS reduction: –4.3 vs. –3.6). Imaging revealed more frequent disc displacement in HA patients (16%), whereas PRP patients more often presented with effusion and degenerative changes (24% and 76%, respectively). Patient-reported outcomes favored PRP, with major improvement or remission more commonly reported. Conclusion: Both HA and PRP provided clinically meaningful improvements in TMD management but with distinct therapeutic profiles. HA appeared most effective in improving function in degenerative disease, whereas PRP offered superior analgesia and higher patient satisfaction. These findings support a patient-tailored approach, with future trials needed to confirm long-term comparative effectiveness and the potential role of combination therapy.