Biological Treatments for Temporomandibular Joint Disc Disorders: Strategies in Tissue Engineering

Abstract

The temporomandibular joint (TMJ) is an important structure for the masticatory system and the pathologies associated with it affect a large part of the population and impair people’s lifestyle. It comprises an articular disc, that presents low regeneration capacities and the existing clinical options for repairing it are not effective. This way, it is imperative to achieve a permanent solution to guarantee a good quality of life for people who suffer from these pathologies. Complete knowledge of the unique characteristics of the disc will make it easier to achieve a successful tissue engineering (TE) construct. Thus, the search for an effective, safe and lasting solution has already started, including materials that replace the disc, is currently growing. The search for a solution based on TE approaches, which involve regenerating the disc. The present work revises the TMJ disc characteristics and its associated diseases. The different materials used for a total disc replacement are presented, highlighting the TE area. A special focus on future trends in the field and part of the solution for the TMJ problems described in this review will involve the development of a promising engineered disc approach through the use of decellularized extracellular matrices.

Research of the major approaches to temporomandibular disorders and space maintainers: a concise systematic review

“…Beside, TMD have a very broad interpretation and represent a population that has been suffering from muscle and/or joint pain. When installed, it represents joint pain in the TMJ and/or muscle, because of this scenario, we see that the most affected population is the female sex, in a proportion of 4:1 [5].…”

“…MedNEXT Journal of Medical and Health Sciences masticatory muscles caused by TMD is characterized by pain associated with the soft and hard tissues of the head, face, neck, and other intraoral structures [3,4]. The etiology is multifactorial and TMJ problems can be divided into muscle disorders, and joint disorders, with muscle disorders affecting muscles of mastication, including myofascial pain, myositis, and trismus, while joint pain encompasses problems that occur within the joint capsule, and these changes are in the shape of the articular surfaces due to remodeling of the surfaces of the articular disc causing disc displacements [4,5].…”

From Animal to Human: (Re)using Acellular Extracellular Matrices for Temporomandibular Disc Substitution

“…The decellularization technique has been progressively explored and investigated over the years [ 2 ]. With it, it is possible to remove the cellular content that leads to the transmission of infection and diseases by applying chemical, enzymatic, and/or physical methods, maintaining an undamaged ECM structure and the biochemical components such as proteins (collagen and elastin), cell adhesion proteins (fibronectin and laminin), glycosaminoglycans (GAGs), and growth factors [ 11 , 12 ].…”

“…Decellularization is a technique with tremendous potential for temporomandibular disc substitution, since it allows the retention of the native ECM, which serves as a support, and biochemical signals. This is crucial for the success of the implanted disc in terms of the cells’ fate [ 1 , 2 ].…”

Interdisciplinary Methods for Zoonotic Tissue Acellularization for Natural Heart Valve Substitute of Biomimetic Materials

“…In addition, the deleterious in vivo effects of residual cellular material are becoming more recognized [ 31 , 32 , 33 , 34 ]. Currently, the most popular and extensively investigated protocols regarding decellularization processes include chemical and enzymatic methods [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. However, there are lately emerging reports [ 51 ] indicating that these conventional methods used for decellularization are harsh in nature and destructive to essential components of the ECM structure.…”