Aartje Jorien Tuin’s research while affiliated with University of Groningen and other places

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Publications (3)


Volume and patient satisfaction, 5 years of follow up after facial fat grafting
  • Article

March 2025

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6 Reads

Journal of Plastic Reconstructive & Aesthetic Surgery

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A.J. Tuin

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[...]

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Figure 2. Follow-up.
Figure 3. Inclusion test.
Intra-Articular Injection of Adipose-Derived Stromal Vascular Fraction in Osteoarthritic Temporomandibular Joints: Study Design of a Randomized Controlled Clinical Trial
  • Article
  • Full-text available

February 2024

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42 Reads

Bioengineering

Introduction: Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease of the TMJ. It is characterized by progressive degradation of the extracellular matrix components of articular cartilage, with secondary inflammatory components leading to pain in the temporomandibular region and reduced mouth opening. Current treatments do not halt disease progression, hence the need for new therapies to reduce inflammation and, consequently, improve symptoms. The aim of our randomized controlled clinical trial protocol is to investigate the efficacy of adjuvant intra-articular injections of autologous tissue-like stromal vascular fraction (tSVF), compared to arthrocentesis alone, in reducing pain and improving mouth opening in TMJ osteoarthritis patients. Materials and Methods: The primary endpoint analysis will consist of the visual analogue scale (VAS) for pain. The secondary endpoint analyses will include maximal interincisal mouth opening measurements; assessment of oral health and mandibular function based on the oral health impact profile (OHIP) questionnaire and mandibular functional impairment questionnaire (MFIQ); complications during the follow up; synovial cytokine analysis at baseline and after 26 weeks; and nucleated cells and tSVF (immuno)histochemistry analyses of the intervention group. Discussion: Our randomized clinical trial protocol will be applied to evaluate the efficacy of a new promising tSVF injection therapy for TMJ osteoarthritis. The safety of intra-articular injections of tSVF has been proven for knee osteoarthritis. However, since a tSVF injection is considered a heterologous application of cell therapy, the regulatory requirements are strict, which makes medical ethical approval challenging.

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Fig. 2. Progression of (a) pain during movement (VASm), (b) pain at rest (VASr), and (c) perceived mandibular function (MFIQ score) over time for non-surgical intervention and arthrocentesis. The graphs are based on the raw data (not the linear mixed models), presented as the median and interquartile range error bars.VASm, visual analogue scale during mandibular movement (and/or function); VASr, visual analogue scale at rest; MFIQ, mandibular function impairment questionnaire; T0, baseline; T1, 3-week followup; T2, 12-week follow-up; T3, 26-week follow-up; T4, ≥ 5-year follow-up.
Arthrocentesis versus non-surgical intervention as initial treatment for temporomandibular joint arthralgia: a randomized controlled trial with long-term follow-up

September 2022

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94 Reads

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11 Citations

International Journal of Oral and Maxillofacial Surgery

Arthrocentesis for arthralgia of the temporomandibular joint (TMJ) is often only indicated when conservative, non-surgical interventions have failed. However, performing arthrocentesis as initial therapy may facilitate earlier and better recuperation of the joint. The aim of this study was to assess the efficacy of this therapy with a long-term follow-up. Eighty-four patients were randomly allocated to receive either arthrocentesis as initial treatment (n = 41) or non-surgical intervention (n = 43). Pain (100-mm visual analogue scale, VAS) and mandibular function impairment questionnaire scores (MFIQ, 0-100) were recorded at 3, 12, and 26 weeks, and ≥ 5 years (median 6.2, interquartile range 5.6-7.4 years). Univariable analyses were performed and linear mixed-effect models were constructed. Patients in the arthrocentesis group experienced significantly lower TMJ arthralgia compared to those treated non-surgically (pain during movement: -10.23 mm (95% confidence interval -17.86; -2.60); pain at rest: - 8.39 mm (95% confidence interval -13.70; -3.08)), while mandibular function remained similar in the two groups (MFIQ -2.41 (95% confidence interval -8.61; 3.78)). Of the final sample, 10 patients (10/39, 26%) in the non-surgical intervention group and two patients (2/34, 6%) in the arthrocentesis group received additional treatment during follow-up. Thus, initial treatment with arthrocentesis reduced TMJ arthralgia more efficaciously than non-surgical intervention in the long term, while maintaining similar mandibular function.

Citations (1)


... During this procedure, lavage of the upper TMJ space is facilitated (Nitzan et al., 1991) with the aim to reduce symptoms by removing pro-inflammatory cytokines, degradation products and matrix degrading enzymes (Kaneyama et al., 2004;Gulen et al., 2009). Recent studies have advocated to perform arthrocentesis at an earlier stage (Al-Moraissi et al., 2020;Tran et al., 2022;Tang et al., 2023), since patients with chronic symptoms (e.g., after prolonged ineffective conservative treatment) are less likely to respond positively to subsequent surgical interventions (Emshoff and Rudisch, 2004;Israel et al., 2010). To address this, a pair-wise systematic review comparing arthrocentesis versus conservative treatments for TMJ disorders has been performed previously (Thorpe et al., 2023). ...

Reference:

Arthrocentesis versus conservative treatments for temporomandibular joint disorders: A systematic review with meta-analyses and trial sequential analyses
Arthrocentesis versus non-surgical intervention as initial treatment for temporomandibular joint arthralgia: a randomized controlled trial with long-term follow-up

International Journal of Oral and Maxillofacial Surgery