Mehmet KÖSE, Senem Esin YAVAŞ, Semiha ERSOY, Ramazan KAHVECİ

Temporomandibular Eklem Bozukluklarında Yağ Grefti ve Trombositten Zengin Fibrinin Doku Onarımı Üzerine Kombine Etkisi

Temporomandibular eklem (TME), memeli çenesinin hareketleri için gerekli olan sinoviyal bir eklemdir, vücutta en sık kullanılan eklemlerden biridir. Yaşlı hastalarda primer olarak görülebilen, bazı patolojik durumlarda (travma ve internal derangement) sekonder olarak gelişen osteoartrit TME’de en sık görülen artrit tipidir. TME patolojilerinin, kıkırdak dokunun histolojik yapısı gereği iyileşme potansiyeli düşük olduğu için, klinik tedavileri sınırlıdır. Bu çalışmada farklı hücrelere dönüşme potansiyeli olan yağ doku kaynaklı kök hücrelerin, birçok büyüme faktörü barındıran Trombositten Zengin Fibrin (PRF) ile uyarılarak, hasar oluşturulan TME kıkırdağı üzerindeki kombine etkilerinin araştırılması amaçlandı. Çalışmada tavşanların her iki TME eklem disk laterallerinde 3 mm’lik defektler oluşturuldu. Sağ tarafa ense-sırt bölgesinden alınan yağ grefti ve tavşanın kendi kanından hazırlanan PRF yerleştirildi, sol tarafı sham grubu olarak planlanıp başka işlem yapılmadan kapatıldı. 8 hafta sonunda eklem kondil ve diskleri çıkarıldı, Hematoksilen&Eozin (H&E) ve Safranin O-Fast Green metodları ile boyanarak incelendi. Her iki grup için eklem yüzey yapısı, kondrosit yoğunluğu, hücre kümelenmesi ve Safranin O-Fast Green boyanma kaybı histopatolojik olarak derecelendirildi. Değerlendirilen parametreler arasında anlamlı fark saptanmadığı için, deneysel TME defekt modelinin onarımında yağ grefti ve PRF kombinasyonu etkili bulunmadı.

Anahtar Kelimeler:

Temporomandibular Eklem, Yağ Grefti, Trombositten Zengin Fibrin

Combined Effect of Fat Graft and Platelet–Rich Fibrin on Tissue Recovery in Temporomandibular Joint Defect

Temporomandibular joint (TMJ), is a synovial joint necessary for the movements of mammal chin and one of the most frequently utilized joints of the body. Osteoarthritis that is formed primarily on elder patients or secondarily on some pathological cases (trauma and internal derangement) is the most common type of arthritis of TMJ. Recovery potential of TMJ pathologies is low due to the histological structure of the cartilage tissue and therefore, clinical treatment of these pathologies is limited. In this study, the effects of fat tissue-derived stem cells that have the ability to differantiate into different cells and is stimulated with Platelet-Rich Fibrin (PRF) that contains many growth factors on artificially damaged TMJ is investigated. In this study, 3 mm defects were created on the lateral sides of both TMJ discs of the rabbits. Fat grafts obtained from the neck-dorsal region and PRF prepared from the rabbits’ own blood were placed on the right side and the left side of each rabbit is planned as the sham group and closed without further treatment. After eight weeks, joint condyles and discs were removed, stained with Haematoxylen&Eosin (H&E) and Safranin O/Fast Green and histologically examined. Joint surface structures, chondrocyte densities, cell aggregations and losses of Safranin O/Fast Green staining of both of the groups were scored histopathologically. There was no significant difference between investigated parameters and thus, fat graft and PRF combination wasn’t concluded to be effective on experimental TMJ defect model recovery.

Keywords:

Temporomandibular Joint, Fat Graft, Platelet-Rich Fibrin,

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