Remaining Hurdles for Tissue-Engineering the Temporomandibular Joint Disc

Abstract

Current treatments for TMDs lack long-term efficacy and are palliative, motivating tissue-engineering for repair or replacement of the injured or ailing tissues in the TMJ, such as the disc. Scaffold-based or scaffold-free approaches, cell sources, biochemical stimuli, and mechanical stimuli are all elements of the tissue-engineering process that need to be considered to tailor TMJ disc construct properties. Large animals can serve as models of human TMDs orthotopic implantation in large animal models is a necessary translational step.

Acellular matrix hydrogel for repair of the temporomandibular joint disc

“…Previous studies have suggested that passaged costal chondrocytes outperform TMJ disc cells in TMJ disc engineering and concluded that passaged costal chondrocytes appear to be the most promising cell source for scaffold‐free tissue engineering of the TMJ disc (Anderson & Athanasiou, 2008; Donahue, Hu, & Athanasiou, 2019). Therefore, costal chondrocytes were selected in this study to evaluate the cellular compatibility of the hydrogel in vitro.…”

Therapeutic Agents for the Treatment of Temporomandibular Joint Disorders: Progress and Perspective

“…However, systematic side effects from oral drugs, such as gastrointestinal damage, cardiovascular risk, and anaphylaxis, and those from frequent intra-TMJ injections, including dizziness, dry mouth, and possible drug addiction, are raising concern. Meanwhile, conventional palliative drug treatments show limitation in the regeneration of chronic and severe TMD (Dashnyam et al, 2018;Donahue et al, 2019). Therefore, novel IA systems, several of which show potential in animal TMD model, that contain biomaterials, cells, and/or bioactive molecules for sustained drug release and TMJ tissue regeneration are attracting attention (Table 3).…”

“…For the severe types of TMD, such as internal derangement, disc thinning, disc perforation, and osteochondral damage of condyle, regenerative tissue engineering approaches are in demand. Such systems typically consist of bioactive agents, including scaffold, cells, and/or GFs (Donahue et al, 2019;Aryaei et al, 2016;Acri et al, 2019).…”

“…On the other hand, the scaffold-free approaches for regenerative systems are also attractive because they present no problems compared with their scaffold-based counterparts, whose scaffolds may degrade faster than the formation of new tissue or wreaked by toxic degraded polymers (Donahue et al, 2019;Acri et al, 2019). With the passaged, redifferentiated, and self-assembled costal chondrocytes delivered orthotopically as scaffold-free implant, Vapniarsky et al successfully regenerated the thinned minipig TMJ disc.…”

“…Attempts to develop intra-TMJ delivery systems in animal models are emerging but still limited to several studies thus far. Nevertheless, various novel designs, which have the potential to be applied to IA TMD treatment, are reported in in vitro studies for TMJ and in research on other joint disorders (Dashnyam et al, 2018;Donahue et al, 2019). Importantly, recent studies raised quotable ideas to facilitate the improvement of current intra-TMJ delivery systems.…”