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The role of mesenchymal stem cells in the treatment of temporomandibular disorders
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A articulação temporomandibular (ATM) é uma articulação complexa, revestida por cartilagem não hialina, que tem capacidade de reparação limitada. A ATM pode apresentar patologias de etiologia diversa, levando a disfunção da ATM (DTM). A patologia da ATM é muito frequente e o tratamento da DTM é um desafio. As terapêuticas regenerativas surgiram como uma potencial solução para DTM mais complexas ou refratárias. As células estaminais mesenquimatosas (CEM) são células estromais adultas com capacidade de auto-renovação e diferenciação em múltiplas linhagens, com diferentes propriedades, como imunomodulação, efeitos pro-angiogénicos, anti-apoptóticos e antioxidantes. As CEM foram encontradas pela primeira vez na medula óssea, mas sabese atualmente que estão presentes em outros tecidos, como o tecido adiposo, o tecido derivado dos dentes, o tecido derivado do cordão umbilical e os tecidos derivados das articulações. As CEM demonstraram capacidade para regenerar cartilagem, in vitro mas também in vivo. Este trabalho final de mestrado é uma revisão narrativa da literatura, no que respeita ao potencial terapêutico das CEM na DTM. Para além disso, serão apresentados casos clínicos de pacientes com DTM grave, tratados com CEM.
Temporomandibular Joint (TMJ) is a complex joint covered by non-hyaline cartilage with limited repair capacity. The TMJ can have different pathologies of various etiologies, leading to TMJ disorders (TMD). The TMJ pathology is highly prevalent pathology and the treatment of TMD can be challenging. Regenerative therapies appeared as a potential solution to more complex or refractory TMD. Mesenchymal stem cells (MSC) are adult stromal cells with the ability to selfrenewal and multilineage differentiation, with different properties, like immunomodulation, proangiogenic, antiapoptotic, and antioxidant effects. MSC were first found in the bone marrow but it is known that they are present in other tissues, like adipose tissue, dental-derived tissue, umbilical cord-derived tissue, and joint-derived tissues. MSC have shown the capacity to regenerate cartilage, in vitro but also, in vivo. This master’s thesis is a narrative review of the literature, concerning the therapeutic potential of MSC in TMD. In addition, we will present clinical cases of patients with advanced TMD, treated with MSC.
Temporomandibular Joint (TMJ) is a complex joint covered by non-hyaline cartilage with limited repair capacity. The TMJ can have different pathologies of various etiologies, leading to TMJ disorders (TMD). The TMJ pathology is highly prevalent pathology and the treatment of TMD can be challenging. Regenerative therapies appeared as a potential solution to more complex or refractory TMD. Mesenchymal stem cells (MSC) are adult stromal cells with the ability to selfrenewal and multilineage differentiation, with different properties, like immunomodulation, proangiogenic, antiapoptotic, and antioxidant effects. MSC were first found in the bone marrow but it is known that they are present in other tissues, like adipose tissue, dental-derived tissue, umbilical cord-derived tissue, and joint-derived tissues. MSC have shown the capacity to regenerate cartilage, in vitro but also, in vivo. This master’s thesis is a narrative review of the literature, concerning the therapeutic potential of MSC in TMD. In addition, we will present clinical cases of patients with advanced TMD, treated with MSC.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Articulação temporomandibular Disfunção temporomandibular Células estaminais mesenquimatosas Terapêuticas regenerativas Estomatologia