Temporomandibular Joint Regenerative Medicine

Abstract

The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often so painful during fundamental oral activities that patients have lower quality of life. Limitations of therapeutics for severe TMJ diseases have led to increased interest in regenerative strategies combining stem cells, implantable scaffolds and well-targeting bioactive molecules. To succeed in functional and structural regeneration of TMJ is very challenging. Innovative strategies and biomaterials are absolutely crucial because TMJ can be considered as one of the most difficult tissues to regenerate due to its limited healing capacity, its unique histological and structural properties and the necessity for long-term prevention of its ossified or fibrous adhesions. The ideal approach for TMJ regeneration is a unique scaffold functionalized with an osteochondral molecular gradient containing a single stem cell population able to undergo osteogenic and chondrogenic differentiation such as BMSCs, ADSCs or DPSCs. The key for this complex regeneration is the functionalization with active molecules such as IGF-1, TGF-β1 or bFGF. This regeneration can be optimized by nano/micro-assisted functionalization and by spatiotemporal drug delivery systems orchestrating the 3D formation of TMJ tissues.

Nanomaterials in Craniofacial Tissue Regeneration: A Review

“…Electrospun PLA nanofibers with surface carboxylate groups were created by Chen and Su and were found to enhance the viability, proliferation, and differentiation of rabbit articular chondrocytes [55]. Similarly, electrospun poly(ε-caprolactone) matrices with a nanofiber network also showed an increase in osteochondral regeneration [56].…”

Emerging Potential of Exosomes in Regenerative Medicine for Temporomandibular Joint Osteoarthritis

“…Uniquely, TMJ discs do not have direct nerve distribution or vascularization due to their complex anatomic features. Alternatively, retrodiscal tissue, which is a posterior attachment of TMJ disc, is characterized by many blood vessels and nerves that are crucial in pathophysiological processes [20].…”

Temporomandibular joint damage in K/BxN arthritic mice

“…X-ray μCT was performed with an isotropic pixel size of 8 μm and a field of view of approximately 24.6 mm × 19.2 mm. 2 For each measurement, the sample was irradiated by X-rays with an acceleration voltage of 70 kV and a beam current of 260 mA. At each rotation angle position, four images with an exposure time of 0.5 s were acquired and averaged to a projection.…”

“…In the case of severe condyle destruction, malocclusion (defined as an abnormal disposition of the teeth in the jaw, generating teeth and jaw pain), and sometimes vertebral damage may occur. 1,2 Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic articular inflammation (driving swelling, stiffness, and pain) and sometimes accompanied by extra-articular manifestations. Affecting nearly 1% of the population worldwide, RA is associated with comorbidities (such as cardiovascular disorders).…”