Autologous Stem Cells Transplants in the Treatment of Temporomandibular Joints Disorders: A Systematic Review and Meta-Analysis of Clinical Trials

Abstract

This systematic review aims to analyze the outcomes of the treatment of temporomandibular joint (TMJ) articular pain (AP) and restricted maximum mouth opening (MMO) with intra-articular administration of mesenchymal stem cells (MSCs). The inclusion criteria allowed primary studies involving AP and/or MMO pre-treatment and post-intervention values. Medical databases that were covered by ACM Digital, BASE, EBSCOhost, Google Scholar, PubMed, Scopus, and Web of Science engines were searched. The risk of bias was assessed with RoB 2 and ROBINS-I tools. The results were tabulated, plotted, and analyzed for regression. A total of 5 studies involving 51 patients/69 TMJs were identified, and 4 studies on 50 patients/67 TMJs were synthesized. Interventions were each time effective in decreasing AP and increasing MMO in a 6-month follow-up period by an average of about 85% and over 40%, respectively. Regression analysis showed a good fit of the logarithmic model for AP relief (5.8 − 0.8 ln x; R2 = 0.90) and MMO increase (33.5 + 2.4 ln x; R2 = 0.89). The results for AP and MMO were based on 3 studies in 39 patients and 4 studies in 50 patients, respectively, all at high risk of bias. The intra-articular administration of MSCs to TMJs, based on weak evidence, may be highly effective in reducing AP and improving MMO. This study received no funding.

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

“…Efficient in immediate ailment relief, intra-articular injections also provide satisfactory effects in several months of observation [ 21 , 22 ]. They allow for TMJ cavity rinsing (arthrocentesis) and the administration of autogenous preparations (blood derivatives and cell transplants) or drugs [ 6 , 23 , 24 , 25 , 26 , 27 ]. Arthrocentesis can be used as a stand-alone technique or precede the injection of a selected substance [ 23 , 28 , 29 ].…”

Global Trends and Future Research Directions for Temporomandibular Disorders and Stem Cells

“…The most cited paper (67 citations in WoS-CC, 5,07%) was by Wu et al in 2014, entitled “The pilot study of fibrin with temporomandibular joint derived synovial stem cells in repairing TMJ disc perforation” [ 36 ], and published in the journal “BioMed research international” which deals with a pilot study for the use of scaffold fibrin/chitosan hybrids and mesenchymal stem cells, to evaluate the repair of the TMJ joint disc. Twelve articles received only one citation [ 11 , 18 , 28 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. Ten articles were not cited in Wos-CC [ 27 , 29 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ].…”

“…The use of these cells occurs at the process of repairing damaged tissues or those with impaired function, in order to replace and repair their normal physiology, in addition to suppressing and modulating the inflammatory process [ 11 , 15 , 17 ]. This would provide a decrease in painful symptoms, prevent progressive degeneration of cartilage and subchondral bone, therefore favoring the reestablishment of TMJ function [ 18 ].…”

Complicated Relationships between Anterior and Condylar Guidance and Their Clinical Implications—Comparison by Cone Beam Computed Tomography and Electronic Axiography—An Observational Cohort Cross-Sectional Study

“…On the other hand, multiple studies present the correlation between occlusion and the prevalence of TMD. A broad view of the etiology and diagnostics of TMD ensures the further development of more effective and modern treatment methods, which underlines a persistent need to reevaluate our knowledge all over in light of more current research [ 41 , 42 , 43 , 44 , 45 ]. Celebic et al report that different indicators of condylar and incisal guidance affect the activity of anterior and posterior temporal muscles [ 30 ].…”