Stem Cells for Temporomandibular Joint Repair and Regeneration

Abstract

Temporomandibular Disorders (TMD) represent a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles and/or associated structures. They are a major cause of non-dental orofacial pain. As a group, they are often multi-factorial in nature and have no common etiology or biological explanations. TMD can be broadly divided into masticatory muscle and TMJ disorders. TMJ disorders are characterized by intra-articular positional and/or structural abnormalities. The most common type of TMJ disorders involves displacement of the TMJ articular disc that precedes progressive degenerative changes of the joint leading to osteoarthritis (OA). In the past decade, progress made in the development of stem cell-based therapies and tissue engineering have provided alternative methods to attenuate the disease symptoms and even replace the diseased tissue in the treatment of TMJ disorders. Resident mesenchymal stem cells (MSCs) have been isolated from the synovia of TMJ, suggesting an important role in the repair and regeneration of TMJ. The seminal discovery of pluripotent stem cells including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have provided promising cell sources for drug discovery, transplantation as well as for tissue engineering of TMJ condylar cartilage and disc. This review discusses the most recent advances in development of stem cell-based treatments for TMJ disorders through innovative approaches of cell-based therapeutics, tissue engineering and drug discovery.

Histological and Immunohistochemical Analyses of Repair of the Disc in the Rabbit Temporomandibular Joint Using a Collagen Template

“…In our study, the reconstituted collagen template formed optimal 50~150-μm pores that were suited for cell ingrowth [17]. Attempts have been made to apply stem cells [18,19], cytokines [20][21][22], platelet-rich plasma [23] for TMJ regeneration, however, no predictable therapy is currently available in the clinic, thus our implants provide a method to regenerate TMJ discs. In the beginning of wound repair, reconstituted collagen matrix provided mechanical resistance to protect the cartilage.…”

Distribution of pericellular matrix molecules in the temporomandibular joint and their chondroprotective effects against inflammation

“…These findings of PCM molecules, particularly collagen VI, may aid in the discovery of early biomarkers for TMJ-OA and the elucidation of new measures and modalities focusing on the PCM for the effective prevention and/or treatment of TMJ-OA. 30, 31 …”

Terapias para regeneração do disco articular

“…Diversas metodologias para regeneração do tecido do disco da ATM estão sendo desenvolvidas com base na utilização de terapias baseadas em células--tronco 6,19 . Células-tronco apresentam-se com proliferação rápida e capacidade de regenerar uma ampla gama de tecidos quando corretamente diferenciadas, além da capacidade de secretar uma ampla quantidade de moduladores tróficos para o crescimento celular e imunomoduladores 6,15 .…”

“…A disfunção temporomandibular (DTM) é uma desordem de etiologia multifatorial que tem prevalência aumentada na população adulta 1,2 . Cerca de 20% a 25% da população são acometidos 3 , sendo mais prevalente na faixa etária de 20 a 50 anos 4 , principalmente, em indivíduos do sexo feminino 5,6 . Fatores fisiológicos e psicológicos como ansiedade e estresse podem predispor o desenvolvimento e influenciar a severidade dessa patologia, que frequentemente se manifesta por meio de dores ou crepitações na região articular 7,8 .…”