Temporomandibular Joint Regenerative Medicine

Int J Mol Sci. 2018 Feb 2;19(2):446. doi: 10.3390/ijms19020446.

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.

Keywords: drug delivery systems; functionalization; growth factors; nanotechnology; osteochondral regeneration; regenerative medicine; scaffolds; stem cells; temporomandibular joint.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / cytology
  • Adipose Tissue / drug effects
  • Adipose Tissue / metabolism
  • Animals
  • Bone Marrow Cells / cytology
  • Bone Marrow Cells / drug effects
  • Bone Marrow Cells / metabolism
  • Bone Regeneration / drug effects*
  • Cell Differentiation / drug effects
  • Fibroblast Growth Factor 2 / metabolism
  • Fibroblast Growth Factor 2 / pharmacology
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Insulin-Like Growth Factor I / pharmacology
  • Regenerative Medicine / methods*
  • Skin / cytology
  • Skin / drug effects
  • Skin / metabolism
  • Skull Fractures / pathology
  • Skull Fractures / surgery
  • Skull Fractures / therapy*
  • Stem Cell Transplantation*
  • Stem Cells / cytology*
  • Stem Cells / drug effects
  • Stem Cells / metabolism
  • Temporomandibular Joint / injuries
  • Temporomandibular Joint / surgery
  • Tissue Engineering / methods*
  • Tissue Scaffolds
  • Transforming Growth Factor beta1 / metabolism
  • Transforming Growth Factor beta1 / pharmacology

Substances

  • IGF1 protein, human
  • TGFB1 protein, human
  • Transforming Growth Factor beta1
  • Fibroblast Growth Factor 2
  • Insulin-Like Growth Factor I