Recent Tissue Engineering Advances for the Treatment of Temporomandibular Joint Disorders

Abstract

Temporomandibular disorders (TMDs) are among the most common maxillofacial complaints and a major cause of orofacial pain. Although current treatments provide short- and long-term relief, alternative tissue engineering solutions are in great demand. Particularly, the development of strategies, providing long-term resolution of TMD to help patients regain normal function, is a high priority. An absolute prerequisite of tissue engineering is to understand normal structure and function. The current knowledge of anatomical, mechanical, and biochemical characteristics of the temporomandibular joint (TMJ) and associated tissues will be discussed, followed by a brief description of current TMD treatments. The main focus is on recent tissue engineering developments for regenerating TMJ tissue components, with or without a scaffold. The expectation for effectively managing TMD is that tissue engineering will produce biomimetic TMJ tissues that recapitulate the normal structure and function of the TMJ.

Keywords: Condylar fibrocartilage; Scaffold-based tissue engineering; Scaffold-free tissue engineering; TMD treatment methods; Temporomandibular joint disc; Temporomandibular joint disorder.

Figure 1

A) Cone beam CT images of the human skull with focus on the TMJ. The soft tissue of the disc is not visible on CT scans of the skull, but it is shown in the schematic. During the closed mouth position, the disc is lodged between the anterior aspect of the mandibular condyle and glenoid fossa. As the mouth opens, the disc glides anteriorly onthe articular eminence as the mandibular condyle rotates anteriorly. B) Summary of TMJ tissue engineering approaches is based on characterization of the target tissues, and identification of the cell sources. Methods of tissue engineering include mechanical and biochemical stimuli to improve the properties of neotissues (new tissues produced). The feasibility of these methods is explored in a large animal model such as a pig.