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Purpose A device composed of extracellular matrix (ECM) was investigated as an inductive template in vivo for reconstruction of the TMJ disk following discectomy. Methods A scaffold material composed of porcine derived ECM was configured to mimic the shape and size of the TMJ. This device was implanted in a canine model of bilateral TMJ discectomy. Following discectomy, one side was repaired with an ECM scaffold material and the contralateral side was left empty as a control. At 6 months post-implantation the joint space was opened, the joints evaluated for signs of gross pathologic degenerative changes, and newly formed tissue was excised for histologic, biochemical, and biomechanical analysis. Results The results show that implantation of an initially acellular material supported the formation of site-appropriate, functional host tissue which resembled that of the native TMJ disk. Further, this prevented gross degenerative changes in the temporal fossa and mandibular condyle. No tissue formation and mild to severe gross pathologic changes were observed in the contralateral controls. Conclusion These results suggest that an ECM based bioscaffold may represent an off-the-shelf solution for TMJ disk replacement.

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