Combined Surgical and Exosome-Based Therapy for Temporomandibular Joint Osteoarthritis: An Experimental Study

Temporomandibular joint osteoarthritis is a degenerative condition characterized by cartilage loss and structural joint alterations. Experimental evidence suggests that exosome-based therapies may influence joint repair processes. This study evaluated the effects of surgical debridement, exosome therapy, and their combination on structural and histologic outcomes in an experimental temporomandibular joint osteoarthritis model. Twenty-eight Wistar albino rats were randomly assigned to 4 groups: control, exosome, surgery, and surgery plus exosome. Osteoarthritis was chemically induced in all animals. Exosomes were administered by intra-articular injection, and surgical groups underwent standardized debridement. After a 5-week follow-up period, mandibular condyles were evaluated using microcomputed tomography and histopathologic analysis based on the Mankin scoring system. The combination therapy group demonstrated the highest bone volume to total volume ratio compared with the other groups (P<0.05). Trabecular number was significantly higher in the exosome group than in controls (P<0.05). Histologically, Mankin scores were lowest in the combination group and highest in controls (P<0.001), whereas differences between the combination and exosome groups were not statistically significant. Overall, combined surgical and exosome-based treatment was associated with improvements in selected structural and histologic parameters, whereas other outcomes were comparable among treatment groups.