Knee orthopedics as a template for the temporomandibular joint

Bielajew, Benjamin J.; Donahue, Ryan; Espinosa, Maximiliano; Arzi, Boaz; Wang, Dean; Hatcher, David; Paschos, Nikolaos K.; Wong, Mark E.; Hu, Jerry C.; Athanasiou, Kyriacos A.

doi:10.1016/j.xcrm.2021.100241

Cited by 22 publications

(20 citation statements)

References 89 publications

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“…However, the TMJ is one of the least understood joints of our body and performs activities such as communicating, eating, and smiling [ 3 ]. Recently, Bielajew et al reported that the knee and the TMJ have similar osteoarthritis incidence, but the latter lacks research and grant funding, cell-based therapies, and specialist doctors in the field [ 4 ]. Moreover, even one year after the end of lockdown induced by the COVID-19 pandemic, dental consultations were reduced, leading to further aggravation of TMJ dysfunctions (TMD) and bruxism [ 5 ].…”

Section: Why Is There a Need To Investigate Tmj Disc Substitutes?mentioning

confidence: 99%

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

Trindade

Alves

Moura

2022

JFB

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Current treatments for temporomandibular joint (TMJ) disc dysfunctions are not fully effective and lack regenerative capacity. Therefore, the search for tissue-engineered materials for TMJ disc substitution is critical to fill this gap. Decellularization presents tremendous potential, as it is possible to obtain an extracellular matrix with an adequate biomechanical structure and biochemical components. However, its application to the TMJ disc is still in progress, since there are few studies in the literature, and those that exist have many gaps in terms of characterisation, which is decisive to ensure its success. Ultimately, we intend to emphasize the importance of the decellularization technique for the development of an engineered TMJ disc.

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Section: Why Is There a Need To Investigate Tmj Disc Substitutes?mentioning

confidence: 99%

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

Trindade

Alves

Moura

2022

JFB

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“…Although there are many differences, the two joints manifest similar pathologies and disorders (17). [55] The prevalence of OA is similar, with approximately 14% of USA adults suffering from knee OA, compared with 8%-16% of the population suffering from TMJ OA (24,25). [56,57] Despite a similar incidence of OA, the knee joint has a sixfold higher number of related articles and a 2,000-fold higher total joint replacement frequency compared to the TMJ.…”

Section: Materials For Cartilage Reconstructionmentioning

confidence: 99%

“…At the same time, the field of knee orthopedics has more funding and more effective end-stage treatment options (17). [55] Bearing compressive, tensile and shear loads during joint movement, condylar cartilage is one of the most indispensable structures to maintain function of TMJ. TMJ OA leads to progressive degeneration of this important structure (50), so regeneration of the condylar cartilage is significant.…”

Section: Materials For Cartilage Reconstructionmentioning

confidence: 99%

“…[60] Tissue engineering is a fundamental treatment for OA, while knee implants lasting mostly more than 25 years, significantly longer than TMJ implants-mostly more than 10 years (26,17). [55,61] The success of tissue engineering is closely related to the composition and microstructure of the scaffolds, and the design and selection of appropriate materials is of great importance for tissue regeneration (22,23). [62,63] Therefore, we will compare the similarities and differences of scaffold materials between the two articular cartilages, which may get new ideas for TMJ treatment from the counterpart of knee joint through this comparison.…”

Section: Materials For Cartilage Reconstructionmentioning

confidence: 99%

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A Review of Composition–Structure–Function Properties and Tissue Engineering Strategies of Articular Cartilage: Compare Condyle Process and Knee Joint

Liu

Zhang

et al. 2022

Adv Eng Mater

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Temporomandibular joint (TMJ) and knee joint are two of the most important joints in human body. The TMJ, connecting mandible and skull, regulates mandibular movement. The movable circular upper end of the mandible is called condyle, and the upper concave part above the condyle is called articular fossa. Between condyle and articular fossa is a disc composed of fibrocartilage, which is called articular disc. The articular disc has a buffering effect of absorbing pressure, which makes the condyle easy to move in opening, closing, and chewing movement. [1][2][3] Knee joint is the largest and most complex joint in human body, composed of lower tibia, upper femur, and patella. Placed between the articular surfaces of the medial and lateral condyles of the femur and tibia, the semilunar fibrocartilage structure, called meniscus, can buffer the vibration of the joint and avoid direct bone friction. [4] The condylar cartilage of TMJ and the tibial cartilage of knee joint are highly comparable because they are in similar positions and mechanical environment. The superficial layer of condylar cartilage is fibrocartilage, and its deeper layer is hyaline-like cartilage. The hyaline cartilage rich in proteoglycan is covered with surface fibrocartilage layer rich in collagen. [5] However, the tibial artilage is consistent with most articular cartilage and belongs to hyaline cartilage.In terms of biomechanics, there are differences and similarities in the test methods of condylar cartilage and tibial plateau cartilage. Both use dynamic thermomechanical analysis (DMA) and nanoindentation technology to analyze the modulus of cartilage under dynamic compression, and establish finite element models to simulate the biomechanical state of real cartilage. [6,7] For condylar cartilage, indentation creep test is often used to test its compressive properties, which is a way to extract the data of aggregate modulus, Poisson's ratio, and solid matrix permeability by fitting creep data with curves. [8] Other research methods, such as dynamic small strain shear test using automatic dynamic viscoelastometer, have also been applied to measuring the biomechanical properties of condylar cartilage. Almost all biomechanical experiments of condylar cartilage are in vitro. [9] However, for the tibial cartilage, the stress force applied in the test is mostly the stress under the natural motion state, such as walking and jumping. And most of the experiments are in vivo. After a certain motion stimulus is applied, the specific strain response is measured by magnetic resonance imaging (MRI)

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“…The TMJ disc separates an upper and lower joint capsule and acts to distribute shear and compressive forces throughout the range of jaw movements [2]. Musculoskeletal conditions of the TMJ complex are classified by a wide range of symptoms including functional limitations and orofacial pain, which may be myogenous or arthrogenous [3][4][5]. Pain in the TMJ is prevalent, effecting approximately 10% of the population over the age of 18 [6].…”

Section: Introductionmentioning

confidence: 99%

A mechanical evaluation of polyvinyl alcohol hydrogels for temporomandibular joint disc replacement

Kuiper

Puttlitz²,

Rawlinson³

et al. 2022

Front. Phys.

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The temporomandibular joint (TMJ) is a bilateral ginglymoarthroidal joint containing a fibrocartilaginous disc which distributes compressive stress and reduces friction on the articulating surfaces of the joint. Initially, conservative treatments can address disorders of the TMJ, but surgical procedures such as discectomy may be employed if dysfunction persists. Unfortunately, discectomy increases friction and alters the mechanical behavior of the TMJ when the disc is not replaced. An ideal replacement for the TMJ disc would restore healthy function of the joint and prevent further degeneration. Rigorous evaluation of materials is necessary to ensure the safety and efficacy of novel implants. Poly(vinyl) alcohol (PVA) hydrogels have been suggested as a good candidate for artificial cartilage replacement in other applications and are promising for replacing the TMJ disc due to their biocompatibility, low friction, and biomimetic levels of hydration. The objective of this study was to mechanically characterize hydrogel formulations of 15, 20, and 25% PVA and to compare them with the ovine TMJ disc to investigate the appropriateness of PVA hydrogels for TMJ disc replacement in a translational model. Experimental evaluations were conducted in indentation, unconfined compression, friction, and uniaxial tension. There were no statistically significant differences in the coefficient of friction between the PVA hydrogels and ovine TMJ disc. No statistically significant differences were found between at least one PVA hydrogel group and the TMJ disc for the indentation properties or the unconfined compression properties at low stretch magnitudes. The 20% PVA and 25% PVA hydrogels exhibited significantly higher failure stretch as compared to the ovine TMJ disc, and they were not statistically different in ultimate tensile strength from the TMJ disc in the mediolateral direction. However, the ovine TMJ disc tensile elastic moduli were 630 times larger in the anteroposterior direction and 53 times larger in the mediolateral direction than the stiffest PVA hydrogel. Ultimately, the 25% PVA hydrogel was the best candidate for TMJ disc replacement, demonstrating the most similarity to the ovine TMJ disc compressive properties; however, tensile reinforcement of the hydrogels would be necessary to approach the tensile modulus of the native TMJ disc.

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Knee orthopedics as a template for the temporomandibular joint

Cited by 22 publications

References 89 publications

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

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

A Review of Composition–Structure–Function Properties and Tissue Engineering Strategies of Articular Cartilage: Compare Condyle Process and Knee Joint

A mechanical evaluation of polyvinyl alcohol hydrogels for temporomandibular joint disc replacement

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