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

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.

Temporomandibular Joint Pathology of Wild Carnivores in the Western USA

Skull specimens from: southern sea otter (Enhydra lutris nereis), Eastern Pacific harbor seal (Phoca vitulina), California sea lion (Zalophus californianus), northern fur seal (Callorhinus ursinus), walrus (Odobenus rosmarus), polar bear (Ursus maritimus), North American brown bear (Ursus arctos), American black bear (Ursus americanus), California mountain lion (Puma concolor couguar), California bobcat (Lynx rufus californicus), gray fox (Urocyon cinereoargenteus), kit fox (Vulpes macrotis), and gray wolf (Canis lupus) (n = 5,011) were macroscopically examined for dental and temporomandibular joint (TMJ) pathology. The presence of temporomandibular joint osteoarthritis (TMJ-OA) varied across species: 4.1% of southern sea otter, 34.5% of harbor seal, 85.5% of California sea lion, 20% of northern fur seal, 60.5% of walrus, 9.2% of polar bear, 13.2% of North American brown bear, 50% of American black bear, 20.9% of California mountain lion, 0% of California bobcat and gray fox, 6.3% of kit fox, and 11.6% of gray wolf specimens had lesions consistent with TMJ-OA. TMJ-OA was significantly more prevalent in males than females in walrus, North American brown bear, polar bear, American black bear, and California mountain lion (p < 0.001, p = 0.005, p = 0.005, p = 0.002, and p = 0.004, respectively). No other species showed a sex predilection. Adult specimens were significantly more affected with TMJ-OA than young adults in the harbor seal, fur seal, walrus (all p < 0.001), and kit fox (p = 0.001). Gray wolf and American black bear young adults were significantly (p = 0.047 and p < 0.001) more affected by TMJ-OA than adults. Of the 13 species analyzed, only three species, namely the harbor seal, northern fur seal, and polar bear, had a significant increase in the prevalence of TMJ-OA if their teeth had attrition and abrasion (p < 0.001, p < 0.001, and p = 0.033, respectively). TMJ-OA can lead to morbidity and mortality in wild animals, but its etiology is not yet fully understood.

Transplantation of Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells Improves Cartilage Repair in a Rabbit Model

The aim of this study was to investigate the therapeutic efficacy and safety of transplanting human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in the treatment of cartilage injury. First, the articular cartilage defect model in rabbits was constructed. Then, the identified hUCB-MSCs and rabbit bone marrow stem cells (rBM-MSCs) were transplanted into the bone defect, respectively, and the cartilage repair effect was observed by hematoxylin-eosin (HE) staining and immunohistochemistry. Besides, the glycosaminoglycan (GAG) content and biomechanics of the restoration area were also evaluated. In our study, hUCB-MSCs and rBM-MSCs exhibited typical MSC characteristics, with positive expressions of CD73, CD105, and CD90 and negative for CD45, CD34, CD14, and HLA-DR. After the transplantation of hUCB-MSCs and rBM-MSCs, the overall quality of cartilage tissue was significantly improved, and the recipients did not show significant side effects in general. However, the expression of matrix metalloproteinase-13 (MMP-13) in the de novo tissues of the hUCB-MSCs and rBM-MSCs groups was both increased, indicating that the novel tissues may have some potential osteoarthritic changes. In conclusion, our results suggest the therapeutic effect of hUCB-MSCs transplantation in cartilage regeneration, providing a promising future in the clinical treatment of cartilage injury.

Shear mechanics of the TMJ disc: relationship to common clinical observations

The temporomandibular joint (TMJ) is a complex hinge and gliding joint that induces significant shear loads onto the fibrocartilage TMJ disc during jaw motion. The purpose of this study was to assess regional variation in the disc's shear loading characteristics under physiologically relevant loads and to associate those mechanical findings with common clinical observations of disc fatigue and damage. Porcine TMJ discs were compressed between an axially translating bottom platen and a 2.5-cm-diameter indenter within a hydrated testing chamber. Discs were cyclically sheared at 0.5, 1, or 5 Hz to 1, 3, or 5% shear strain. Within the anterior and intermediate regions of the disc when sheared in the anteroposterior direction, both shear and compressive moduli experienced a significant decrease from instantaneous to steady state, while the posterior region's compressive modulus decreased approximately 5%, and no significant loss of shear modulus was noted. All regions retained their shear modulus within 0.5% of instantaneous values when shear was applied in the mediolateral direction. The results of the disc's regional shear mechanics suggest an observable and predictable link with the common clinical observation that the posterior region of the disc is most often the zone in which fatigue occurs, which may lead to disc damage and perforation.