Regenerative treatments

Regenerative treatments for the jaw

Mr Luke Cascarini is the only surgeon in the UK using pioneering regenerative treatments for the jaw.

Jaw joint disorder or temporomandibular (TMJ) joint disorder, caused by arthritis, infection, injury or overuse, has traditionally been treated using massage, physio, anti-inflammatory medication, muscle relaxants or simply by changing the way in which a patient chews. More severe cases may require steroids or invasive surgery.

The latest advances suggest that regenerative treatments such as Activated Mesenchymal Pericyte Plasma injections (AMPP®), Platelet Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC), all of which offer the potential to tackle the root cause of temporomandibular joint disorder (TMJ) by regenerating the damaged jaw joint, could provide a more effective answer.

How do Activated Mesenchymal Pericyte Plasma (AMPP®), Platelet Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) work on a jaw disorder?

AMMP®, PRP and BMAC work by harnessing the body’s natural capacity for self-repair through the re-injection of growth-promoting cells taken from elsewhere in the patient’s body to promote healing in the damaged jaw.

Activated Mesenchymal Pericyte Plasma (AMPP®) injections contain a combination of fat and blood cells. The Lipogems® procedure, which involves taking fat tissue from the thigh or stomach, is used to separate the regenerative cells taken from the patient’s own fat tissue and these cells are then combined with platelets extracted from the patient’s blood (Platelet Rich Plasma – PRP) and injected into the jaw joint. Read more about Lipogems®.

Platelet Rich Plasma (PRP) involves extracting platelets from the patient’s blood and re-injecting them into the damaged jaw to encourage cell repair and regeneration. Read more about PRP.

Bone Marrow Aspirate Concentrate (BMAC) is a non-operative, minimally invasive procedure that uses stem cells harvested from bone marrow, the spongy tissue in the middle of bones, to promote healing in the damaged jaw, by accelerating the body’s natural ability to repair and regenerate itself.

Which jaw conditions are suitable for regenerative treatment therapy?

Jaw joint disorder or temporomandibular joint disorder (TMJ) is suitable for AMPP®, PRP and Bone Marrow Aspirate Concentrate (BMAC). Each of these regenerative treatments works by regenerating the cell tissue in the jaw joint and thereby reducing pain and inflammation, increasing the mobility of the jaw and even avoiding the need for a jaw joint replacement in some cases.

When did regenerative treatments for jaw conditions become available?

Regenerative treatments are already being used by orthopaedic surgeons as an alternative to invasive surgery or steroid injections to promote healing in the major joints of the body, such as the hip, knee and shoulder. Leading Oral and Maxillofacial Surgeon Mr Luke Cascarini is, in partnership with The Regenerative Clinic, pioneering the application of regenerative treatments for temporomandibular joint (TMJ) disorders.

Regenerative treatment is a new treatment and although its use for TMJ disorders is yet to be approved for mainstream use by the National Institute of Clinical Excellence (NICE), early results in trials are extremely promising.

How are regenerative treatments administered to the jaw?

Activated Mesenchymal Pericyte Plasma injections (AMPP®), Platelet Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) treatments are administered to the jaw using injections in clinic as follows:

Activated Mesenchymal Pericyte Plasma injections (AMPP®)

1. Under local anaesthetic, fat is removed from the thigh or abdomen.
2. For the Platelet Rich Plasma (PRP) part of the procedure, a small blood sample of blood is taken from the arm and placed into a centrifuge to separate out the platelets.
3. The Lipogems® system is used to separate the regenerative cells from your fat tissue.
4. The fat cells and blood sample are combined and the AMPP® injection is given using ultrasound to guide it into the jaw.

Platelet Rich Plasma (PRP) 

1. A small blood sample is taken from a vein in the arm.
2. This is spun in a centrifuge to separate the PRP from the rest of the sample.
3. Your jaw will be prepared, and Luke will inject the PRP into it.
4. Once administered to the jaw, the solution will spread to all parts of the joint.

How long do AMPP® and PRP treatments for the jaw take?

AMPP® is performed in an operating theatre under local anaesthetic (with sedation) and takes about an hour.

The PRP procedure usually takes 20 minutes to carry out in an outpatients treatment room, and although PRP can be injected as a single injection, a course of three injections is recommended to maximise benefits.

Bone Marrow Aspirate Concentrate (BMAC)

Under local anaesthetic, bone marrow is taken from the pelvis bone using a needle and syringe.

The bone marrow is separated into its component parts using a centrifuge.

The plasma, which carries essential proteins, is reduced to a general fluid concentrate (GFC).

The bone marrow containing mesenchymal stem cells (BMSC or bone marrow-derived mesenchymal stem cells) is turned into the Bone Marrow Aspirate Concentrate (BMAC).

The Bone Marrow Aspirate Concentrate (BMAC) and general fluid concentrate (GFC) are infused in separate injections into the damaged jaw under local anaesthetic and sterile conditions.

What are the risks of AMPP®, PRP and BMAC for the jaw?

Because fat, platelets and bone marrow are autologous, that is, harvested from the patient’s own body and the regeneration of the cells in the jaw is stimulated using the body’s natural healing mechanisms, the risk factors for all three procedures are low. They are minimally invasive, with no major incisions or lengthy recovery times, which further reduces risk.