Evaluation of the therapeutic potentials of adipose Derived stem cells in comparison to hyaluronic acid in temporomandibular joint osteoarthritis A multi assessment study

Abstract

Transforming growth factor β 1 (TGF β1) is a cytokine which is present normally in the synovial fluid of all healthy joints. Never the less, its concentration increases up to three folds in osteoarthritic joints. Thus, TGF β1 expression in TMJ/OA can be of value in predicting the therapeutic outcome of different treatment modalities on the progression of the disease according to the severity of the degenerative process [8-9]. Considering that TMJ/OA is a multifactorial condition with diverse clinical presentations made it a difficult ABSTRACT Objective: This study aims to assess the effectiveness of arthrocentesis followed by intraarticular injection of adipose derived stem cells versus hyaluronic acid in treatment of temporomandibular joint osteoarthritis and reversing the ongoing degenerative cascade. Evaluation was based on clinical radiographic and biochemical findings. Materials and Methods: The study included thirty patients suffering from TMJ/OA. Clinical criteria and Computerized Tomography (CT scan) confirmed the diagnosis. Patients were divided into two equal groups; both groups underwent arthrocentesis pursued by hyaluronic acid injection for Group I, and chondrogenic differentiated adipose derived stem cells for Group II. Synovial fluid samples were collected preoperative and at the end of the study (18 months) to assess the TGFβ1 concentration. Clinical data (maximal mouth opening, lateral, protrusive movements, pain and joint sounds) were collected at 3, 6, 12 and 18 months. CT scans were repeated at 18 months. Results: Group I showed initial improvement within clinical parameters but failed to sustain these results till the end of the study, no marked radiographic changes were noted. However, the TGF β1concentration showed significant decrease. Group II showed significant improvement within all parameters, Radiographic findings manifested remodeling of degenerative findings and TGFβ1 concentration was significantly decreased. Conclusion: Adipose derived stem cell is an effective therapeutic treatment for TMJ/OA. It subsided all related clinical dysfunction and abates the ongoing degenerative cycle.

Photobiostimulation conjugated with stem cells or their secretome for treatment of temporomandibular joint arthritis; a comparative study

“…In addition, they act by paracrine secretion of different soluble factors that induce repair and regeneration by the endogenous host cells (30). Therefore, ADSCs were reported to induce the regeneration of arthritic knees and TMJs (31,32).…”

Photobiostimulation conjugated with stem cells or their secretome for temporomandibular joint arthritis in a rat model

“…Therefore, ADSCs were reported to induce the regeneration of arthritic knees by reducing the expression of matrix metallopeptidase 13 (MMP13) and Collagen X and increasing Collagen II [ 38 ]. Moreover, clinically, ADSCs were found to alleviate TMJ osteoarthritis as confirmed by significant reduction in transforming growth factor beta 1 (TGFβ1) levels in patients’ synovial fluids, together with better clinical examination results [ 39 ].…”