Abstract

Single-Center Retrospective Study of Flowable Umbilical Cord Tissue Allograft Application in Temporomandibular Joint Defects: An Investigative Study

Ryan Phillip Robinson, Rachel Arlene Reynolds, John Jiang Shou, Naomi Elaine Lambert*, Ryaan Bennani, Nicole A Dyer, Summiah T Laviba and Tyler Chad Barrett

Introduction: Temporomandibular Dysfunction (TMD) is a chronic condition affecting bone, muscle, and other tissues of the temporomandibular joint and surrounding areas. The symptoms of temporomandibular dysfunction vary depending on the severity of the case. They can include muscle spasms, restricted jaw and cheek movement, difficulty opening and closing the mouth, tenderness, lockjaw, and pain in the ear and neck. While temporomandibular dysfunction is multifaceted, this study will focus on patients with intraarticular cartilage defects of the temporomandibular joint. Cartilage defects are usually caused by wear and tear, but some patients may develop them as a result of disease, infection, or trauma.

Methods: This study documents observational data from five refractory temporomandibular dysfunction patients at the Pain and Sleep Therapy Center, ages 16-81, whose primary pathology is articular cartilage damage. Each patient received a comprehensive medical exam and history evaluation. All patients gave informed consent. Patients received one Wharton’s Jelly (WJ) tissue allograft application in addition to standard care practices. Progress was tracked over 90 days with Cone-Beam Computed Tomography (CBCT) scans, patient-recorded pain scales, and range of motion evaluations.

Results: There were no adverse events recorded. All patients reported 50%-100% improvement in symptomatic pain. CBCT scans showed marked improvement in two patients and the recorded range of motion measurements displayed improved mobility.

Conclusion: This preliminary data shows positive patient outcomes and provides grounds for future research on Wharton’s jelly tissue allografts in cases of treatment-resistant temporomandibular defects.

Future research: This preliminary data observed through an Institutional Review Board (IRB)-approved retrospective study is the basis for a more extensive and in-depth prospective cohort study that will further analyze patient outcomes with Wharton’s jelly applications to treatment-resistant Temporomandibular Joint (TMJ) defects compared to a control group receiving standard care treatments. The study was approved by the IRB at the Institute of Cellular and Regenerative Medicine on March 29, 2023.

Published Date: 2023-10-03; Received Date: 2023-08-31