Temporomandibular joint regeneration: proposal of a novel treatment for condylar resorption after orthognathic surgery using transplantation of autologous nasal septum chondrocytes, and the first human case report

摘要: Upon orthognathic mandibular advancement surgery the adjacent soft tissues can displace distal bone segment and increase load on temporomandibular joint causing loss of its integrity. Remodeling condyle temporal fossa with destruction condylar cartilage subchondral leads to postsurgical resorption, arthralgia functional limitations. Patients severe lesions are refractory conservative treatments, leading more invasive therapies that range from simple arthrocentesis open prosthesis. Although aggressive a high risk for patient, surgical treatments not always efficient in managing degenerative lesions. We propose regenerative medicine approach using in-vitro expanded autologous cells nasal septum applied first proof-of-concept patient. After required quality controls, were injected into each by arthrocentesis. Results monitored assays image analysis computed tomography. The cell injection fully reverted structural regeneration after 6 months. Computed tomography images showed new cortical formation filling former cavity space, partial recovery bones. superposition models defect, reconstructing original form. treatment resorption subsequent surgery, presently treated only alloplastic total replacement. an intra-articular septum. selected patient had no alternative therapeutic proposal has given promising results, reaching full both at months therapy, which was maintained 1 year. This case is being followed inclusion patients similar pathological profile complete ongoing stage I/II study. clinical trial approved National Commission Ethics Medical Research (CONEP), Brazil, CAAE 12484813.0.0000.5245, retrospectively registered Brazilian Clinical Trials Registry USA under Universal Trial Number (UTN) U1111–1194-6997 .