Research ArticleTissue Engineering

Tissue engineering toward temporomandibular joint disc regeneration

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Science Translational Medicine  20 Jun 2018:
Vol. 10, Issue 446, eaaq1802
DOI: 10.1126/scitranslmed.aaq1802

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Disjointed no more

Temporomandibular joint (TMJ) dysfunction causes pain and limits movement of the jaw joint. Thinning of the TMJ disc, a fibrocartilage structure that allows for smooth joint movement, is an early sign of TMJ dysfunction. To help prevent joint degeneration, Vapniarsky et al. implanted engineered discs derived from rib cartilage cells into a minipig model of TMJ disc thinning. The implants had biomechanical and biochemical properties similar to native discs and improved closure of disc defects, reduced osteoarthritis scores, and reduced degenerative changes in the jaw joint. This scaffold-free approach to tissue engineering disc implants could help advance development of regenerative therapies for TMJ dysfunction.

Abstract

Treatments for temporomandibular joint (TMJ) disc thinning and perforation, conditions prevalent in TMJ pathologies, are palliative but not reparative. To address this, scaffold-free tissue-engineered implants were created using allogeneic, passaged costal chondrocytes. A combination of compressive and bioactive stimulation regimens produced implants with mechanical properties akin to those of the native disc. Efficacy in repairing disc thinning was examined in minipigs. Compared to empty controls, treatment with tissue-engineered implants restored disc integrity by inducing 4.4 times more complete defect closure, formed 3.4-fold stiffer repair tissue, and promoted 3.2-fold stiffer intralaminar fusion. The osteoarthritis score (indicative of degenerative changes) of the untreated group was 3.0-fold of the implant-treated group. This tissue engineering strategy paves the way for developing tissue-engineered implants as clinical treatments for TMJ disc thinning.

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