Effect of Fat Graft on Temporomandibular Joint Disc Disorders

Yıl 2018, Cilt: 44 Sayı: 3, 159 - 166, 01.12.2018

Ayşe Kalay , Ramazan Kahveci , Zeynep Kahveci Kıymet Zülal Halk

https://doi.org/10.32708/uutfd.419856

Cited By: 1

Öz

Temporomandibular joint (TMJ) is the growth
center of the mandible and has a critical importance for functions such as
chewing, breathing and speech. Osteoarthritis is the most common type of
arthritis of the TMJ.It is difficult to treat cartilage damage due to the poor
blood supply of the cartilage tissue and the low potential for healing.In this
study,we investigated the effects of fat graft,which has the potential of
transforming into many cells and has many growth factors,on damaged
temporomandibular articular cartilage. In this study,joint degeneration model
was created by creating 3 mm defects in both TMJ disc laterals of subjects.A
fat graft from the inguinal region was placed on the left side and the right
side was closed as a control group without further treatment. Histopathological
evaluation of joint surface structure,chondrocyte density,cell clustering and
Safranin O staining loss parameters were scored by a single expert histologist
in both groups. As a result,it was seen that the deterioration of joint surface
structure was statistically significantly lower in the experimental
group.Although the cluster score was low in the experimental group,no
statistically significant difference was found.Chondrocyte density and safranin
O staining showed similar values between the two groups.

Anahtar Kelimeler

temporomandibular joint, fat graft, osteoarthritis

Temporomandibular Eklem Disk Bozukluklarında Yağ Greftinin Etkisi

Öz

Temporomandibular
eklem (TME) mandibulanın büyüme merkezidir ve çiğneme, nefes alma, konuşma gibi
fonksiyonlarda kritik bir öneme sahiptir.Osteoartrit TME'nin en sık görülen
artrit tipidir. Kıkırdak dokusunun iyi kanlanmaması ve iyileşme potansiyelinin
düşük olması nedeni ile kıkırdak hasarlarını tedavi etmek zordur.Bu çalışmada
birçok hücreye dönüşme potansiyeli olan ve bir çok büyüme faktörü barındıran
yağ greftinin, hasarlı TME kıkırdağı üzerindeki etkileri araştırıldı. Çalışmada
deneklerin her iki TME disk laterallerinde 3 mm’lik defektler oluşturularak
eklem dejenerasyon modeli oluşturuldu.Sol tarafa inguinal bölgeden alınan yağ grefti
yerleştirildi, sağ taraf kontrol grubu olarak başka işlem yapılmadan
kapatıldı.Histopatolojik değerlendirmede her iki grupta eklem yüzey
yapısı,kondrosit yoğunluğu,hücre kümelenmesi ve Safranin O boyanma kaybı
parametreleri tek bir uzman histolog tarafından skorlandı. Sonuç olarak eklem
yüzey yapısındaki bozulmanın, deney grubunda istatistiksel olarak anlamlı
derecede düşük olduğu görüldü.Kümelenme skor olarak deney grubunda düşük
olmasına rağmen istatistiksel olarak anlamlı fark saptanmadı.Kondrosit
yoğunluğu ve Safranin O boyanma kaybı iki grup arasında benzer değerler
gösterdi.

Anahtar Kelimeler

yağ grefti, temporomandibular eklem, osteoartrit

Kaynakça

• 1-) Embree M.C., Iwaoka G.M., Kong D. ,Martin B.N., Patel R.K. ,et al. Soft tissue ossification and condylar cartilage degeneration following TMJ disc perforation in a rabbit pilot study. Osteoarthritis and Cartilage 2015;23;629-639
• 2-) Kütük N., Baş B., Soylu E., et al. Effect of platelet rich plasma on fibrocartilage, cartilage and bone repair in temporomandibular joint. J. Oral and Maxillofacial Surg. 2014; 72:277-284
• 3) Suzuki T., Bessho K. , Fujimura K. , et al. regeneration of defects in the articular cartilage in rabbit temporomandibular joints by bone morphogenetic protein-2. British Journal of Oral and Maxillofacial Surgery. 2002;40:201-206
• 4) Takafuji H., Suzuki T., Okubo Y., et al. regeneration of articular cartilage defects in the temporomandibular joint of rabbits by fibroblast growth factor-2:a pilot study . J. Oral and Maxillofacial Surg. 2007;36:934-937
• 5) Balestreri L, Canzonieri V, Innocente R, Cattelon A, Perin T. Temporomandibular joint metastatasis from rectal carsinoma: CT findings before and after radiotherapy. Tumori. 1997;83: 718-720
• 6) Okeson J.P. Temporomandibular disorders and occlusion.4. ed. St. Louis : Mosby Inc ;1995.302-328
• 7) Pu LLQ, Coleman SR, Cui X, et al. autologous fat grafts harvested and refined by the Coleman technique: A comparative study. Plast Reconstr Surg 2008;122:932-937.
• 8) S. Laverty, C.A. Girard, J.M. Williams, E.B. Hunziker, K.P.H. Pritzker. The OARSI histopathology initiative-recommendations for histological assessments of osteoarthritis in the rabbit. Osteoarthritis and Cartilage. 2010;18:53-65.
• 9) Meghan K. Murphy, Regina F. Macbarb, Mark E. Wong, Kyriacos A. Athanasiou. Temporomandibular Joint Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies. Int J. Oral Maxilofac Implants. 2013 ; 28 (6): 393- 414.
• 10) Candırlı C, Esen A, Taskesen F, et al. Evaluation of discectomy and dermis-fat grafting on the contralateral side. J Craniofacial Surg. 2012;23:1654-1657.
• 11) Pei Shen, ShanYong Zhang, Chi Yang, Liang Huo. Experimental study of free fat grafts in temporomandibular joint disc anchor. J Craniofacial Surg 2014;25: 253-257.
• 12) Frese L, Dijkman P.E, Hoerstrup S. P. Adipose tissue derived stem cells in regenerative medicine. Transfusion Medicine and Hemotherapy.2016;43:268-274.