Effect of Fat Graft on Temporomandibular Joint Disc Disorders

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. 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. 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. 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. 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. 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. 6) Okeson J.P. Temporomandibular disorders and occlusion.4. ed. St. Louis : Mosby Inc ;1995.302-328
7. 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. 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. 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. 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. 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. 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.