Jaw Joint Study: Fat Tissue Injection Shows Promise for TMJ Pain

Randomized trial compares two treatments for jaw disorders

This Italian study tested whether injecting processed fat tissue into the jaw joint could work better than the current standard treatment. Researchers at the University of Udine enrolled 40 patients with temporomandibular joint (TMJ) disorders. All participants had tried conservative treatments like mouth guards, pain medications, and physical therapy without success.

The patients were randomly divided into two groups of 20. Both groups received arthrocentesis, a procedure that flushes out the jaw joint with saline solution. The difference was what came next: one group received a standard hyaluronic acid injection, while the other received micro-fragmented adipose tissue (specially processed fat from their own body) using Lipogems® technology.

Both treatments reduced pain and improved jaw movement

All 40 patients experienced meaningful improvements after treatment. Researchers tracked two main measures: pain levels and how wide patients could open their mouths. At checkups 10 days, one month, and six months after the procedure, both groups showed significant progress compared to their starting point.

This confirms that arthrocentesis itself is an effective treatment for TMJ internal derangement and osteoarthritis. The flushing action helps remove inflammatory substances from the joint and reduces friction that causes pain.

Fat tissue injection showed superior overall success rate

When researchers compared the two groups directly, patients who received the fat tissue injection had a statistically significant higher success rate. At the six-month follow-up:

• Pain reduction nearly reached statistical significance (P = .0546)

• Jaw opening improvement was statistically significant (P = .0327)

• Overall treatment success favored the fat tissue group (P = .018)

These results suggest that the regenerative cells preserved in micro-fragmented fat tissue may provide additional healing benefits beyond what hyaluronic acid offers.

Minimally invasive procedure using your own tissue

The Lipogems® technique involves harvesting a small amount of fat tissue, typically from the abdomen, then processing it through a special device. This process breaks down the fat into tiny fragments while preserving the helpful cells within it. These include pericytes (helper cells that support blood vessel healing) and mesenchymal stem cells (regenerative cells that can support tissue repair).

Because the treatment uses your own tissue, there is no risk of rejection or allergic reaction. The entire procedure can be performed under local anesthesia in an outpatient setting.

First study to test this approach for jaw joints

While micro-fragmented adipose tissue has been studied extensively for knee and hip problems, this trial represents the first application specifically for TMJ disorders. The researchers note that the promising results encourage further investigation into this treatment option.

Researchers call for longer follow-up studies

The study authors acknowledge some limitations. The six-month follow-up period, while encouraging, may not capture the full picture of long-term outcomes. They recommend future studies with longer observation periods to confirm whether the improvements remain stable over time.

Additionally, the sample size of 40 patients, while sufficient for this preliminary trial, would benefit from larger studies to strengthen the findings.

For patients with TMJ internal derangement or osteoarthritis who have not responded to conservative treatments, this research suggests that arthrocentesis combined with micro-fragmented adipose tissue injection may offer meaningful advantages over standard hyaluronic acid treatment.

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Source: Sembronio et al., Journal of Oral and Maxillofacial Surgery, 2021.