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

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.