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Zhao Y, Li C, Hu S, Wang C, Bian X, Kang H, Zhou P, Bao G. In vitro differentiation of human induced pluripotent stem cells into temporomandibular joint disc like cells. Heliyon 2024; 10:e23937. [PMID: 38192844 PMCID: PMC10772246 DOI: 10.1016/j.heliyon.2023.e23937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
Temporomandibular joint discs (TMJ discs) are unable to repair themselves in disease states, while induced stem cell differentiation is a common method to repair tissue defects. Nowadays, kinds of stem cells are attempted for tissue regeneration of TMJ disc, but these methods have several downsides, which limit their wide application. The proliferation and differentiation ability of human induced pluripotent stem cells (hiPSC) provides a new research direction for TMJ disc tissue regeneration. In this study, we investigated the feasibility of induced differentiation of hiPSC into TMJ disc cells in vitro and the differentiation efficiency of different methods to clarify the possibility and conditions of hiPSC application in TMJ disc tissue engineering. We collected sheep TMJ disc cells cultures for adding in hiPSC culture environment and treated hiPSC by both direct induction and Transwell co-culture for 7 days, 14 days and 21 days. The secretion of extracellular matrix in TMJ disc cells was detected by Sirius Red and Safranin O staining. Collagen Ⅰ and Collagen Ⅱ were qualitatively detected by immunohistochemical staining. The expression of extracellular matrix genes (type I collagen (COL1A1), type II collagen(COL2), glycosaminoglycan (GAG)), chondrogenic differentiation gene SOX9 and pluripotency gene OCT4 were detected by RT-qPCR. Our results showed that hiPSC had the ability to differentiate to TMJ disc cells by direct induction in TMJ disc cell culture medium and by Transwell co-culture method. The highest degree of differentiation was observed after 14 days of direct induction, while Transwell co-culture showed significant differentiation at different times and with different major directions. Meanwhile, Transwell co-culture not only differentiates hiPSC but also promotes the growth and proliferation of TMJ disc cells. Our study is valuable to investigate the possibility of differentiation of hiPSC toward TMJ disc cells and to determine the time of differentiation. It provides new ideas for the selection of seed cells for TMJ disc tissue engineering.
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Affiliation(s)
- Yiqing Zhao
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Ce Li
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Siyang Hu
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Chunya Wang
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Xueru Bian
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Hong Kang
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Ping Zhou
- School of Stomatology, Lanzhou University, No.199 Donggang West Road,Chengguan District, Lanzhou, 730000, China
| | - Guangjie Bao
- Key Lab of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, No.1 Northwest Xin Cun, Chengguan District, Lanzhou, 7300030, China
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Gao W, Lu J, Gao X, Zhou J, Dai H, Sun M, Xu J. Biomechanical effects of joint disc perforation on the temporomandibular joint: a 3D finite element study. BMC Oral Health 2023; 23:943. [PMID: 38031042 PMCID: PMC10685656 DOI: 10.1186/s12903-023-03521-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Disc perforation (DP) is a severe type of Temporomandibular Disorder (TMD). DP may induce changes in the internal stresses of the temporomandibular joint (TMJ). Herein, this study attempts to investigate the biomechanical effects of different positions and sizes of DP on the TMJ using a biomechanical approach, to explore the mechanical pathogenesis of TMD. METHODS Eleven three-dimensional finite element (FE)models of the TMJ were constructed based on CBCT imaging files of a patient with DP on the left side. These models included the disc with anterior displacement and discs with different locations and sizes of perforations on the affected disc. FE methods were conducted on these models. RESULTS Anterior displacement of the disc leads to a significant increase in the maxim von Mises stress (MVMS) in both TMJs, with the affected side exhibiting a more pronounced effect. DP occurring at the posterior band and the junction between the disc and the bilaminar region has a greater impact on the MVMS of both TMJs compared to perforations at other locations. As the size of the perforation increases, both sides of the TMJs exhibit an increase in the magnitude of MVMS. CONCLUSIONS Unilateral disc anterior displacement results in an increased stress on both TMJs. Unilateral DP further affects the stress on both sides of the TMJs. TMD is a progressive condition, and timely intervention is necessary in the early stages to prevent the worsening of the condition.
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Affiliation(s)
- Wentong Gao
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Lu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiang Gao
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jianping Zhou
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hongwei Dai
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Min Sun
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan Province, China.
| | - Jie Xu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China.
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Wang D, Qi Y, Wang Z, Guo A, Xu Y, Zhang Y. Recent Advances in Animal Models, Diagnosis, and Treatment of Temporomandibular Joint Osteoarthritis. Tissue Eng Part B Rev 2023; 29:62-77. [PMID: 35994388 DOI: 10.1089/ten.teb.2022.0065] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Temporomandibular joint osteoarthritis (TMJOA) is a gradual degenerative jaw joint condition. Until recent years, TMJOA is still relatively unrecognized and ineffective to be treated. Appropriate animal models with reliable detection methods can help researchers understand the pathophysiology of TMJOA and find therapeutic options. In this study, we summarized common animal models of TMJOA created by chemical, surgical, mechanical, and genetical approaches. The relevant pathological symptoms and induction mechanisms were outlined. In addition, different pathological indicators, furthermore, emerging therapeutic regimens, such as intra-articular drug delivery and tissue engineering-based approaches to treat TMJOA based on these animal models, were summarized and updated. Understanding the physiology and pathogenesis of the TMJOA, together using various ways to diagnose the TMJOA, were elaborated, including imaging techniques, molecular techniques for detecting inflammatory cytokines, histochemical staining, and histomorphometry measures. A more reliable diagnosis will enable the development of new prevention and more effective treatment strategies and thereby improve the quality of life of TMJOA patients. Impact statement Temporomandibular joint osteoarthritis (TMJOA) affects 8 to 16 percent of the population worldwide. However, TMJOA is still relatively unrecognized and ineffective to be treated in the clinic. Appropriate animal models with reliable diagnostic methods can help researchers understand the pathophysiology of TMJOA and find therapeutic options. We herein summarized common animal models of TMJOA and various ways to diagnose the TMJOA. More importantly, emerging therapeutic regimens to treat TMJOA based on these animal models were summarized. With the aid of strategies listed, more effective treatment strategies will be developed and thereby improve the life quality of TMJOA patients.
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Affiliation(s)
- Dongyun Wang
- Stomatological Center of Peking University Shenzhen Hospital, Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, China
| | - Yajie Qi
- Stomatological Center of Peking University Shenzhen Hospital, Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, China.,Peking University Shenzhen Hospital, Clinical College of Anhui Medical University, Shenzhen, China
| | - Zhubing Wang
- School of Dentistry, Health Science Center, Shenzhen University, Shenzhen, China
| | - Anyun Guo
- Department of Joint Surgery, Southern University of Science and Technology Hospital, Shenzhen, China
| | - Yingxin Xu
- Stomatological Center of Peking University Shenzhen Hospital, Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, China
| | - Yang Zhang
- School of Dentistry, Health Science Center, Shenzhen University, Shenzhen, China
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Cardoneanu A, Macovei LA, Burlui AM, Mihai IR, Bratoiu I, Rezus II, Richter P, Tamba BI, Rezus E. Temporomandibular Joint Osteoarthritis: Pathogenic Mechanisms Involving the Cartilage and Subchondral Bone, and Potential Therapeutic Strategies for Joint Regeneration. Int J Mol Sci 2022; 24. [PMID: 36613615 DOI: 10.3390/ijms24010171] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/13/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
The temporomandibular joint (TMJ) is a specialized synovial joint that is crucial for the movement and function of the jaw. TMJ osteoarthritis (TMJ OA) is the result of disc dislocation, trauma, functional overburden, and developmental anomalies. TMJ OA affects all joint structures, including the articular cartilage, synovium, subchondral bone, capsule, ligaments, periarticular muscles, and sensory nerves that innervate the tissues. The present review aimed to illustrate the main pathomechanisms involving cartilage and bone changes in TMJ OA and some therapeutic options that have shown potential restorative properties regarding these joint structures in vivo. Chondrocyte loss, extracellular matrix (ECM) degradation, and subchondral bone remodeling are important factors in TMJ OA. The subchondral bone actively participates in TMJ OA through an abnormal bone remodeling initially characterized by a loss of bone mass, followed by reparative mechanisms that lead to stiffness and thickening of the condylar osteochondral interface. In recent years, such therapies as intraarticular platelet-rich plasma (PRP), hyaluronic acid (HA), and mesenchymal stem cell-based treatment (MSCs) have shown promising results with respect to the regeneration of joint structures or the protection against further damage in TMJ OA. Nevertheless, PRP and MSCs are more frequently associated with cartilage and/or bone repair than HA. According to recent findings, the latter could enhance the restorative potential of other therapies (PRP, MSCs) when used in combination, rather than repair TMJ structures by itself. TMJ OA is a complex disease in which degenerative changes in the cartilage and bone develop through intricate mechanisms. The regenerative potential of such therapies as PRP, MSCs, and HA regarding the cartilage and subchondral bone (alone or in various combinations) in TMJ OA remains a matter of further research, with studies sometimes obtaining discrepant results.
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5
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Matheus HR, Özdemir ŞD, Guastaldi FPS. Stem cell-based therapies for temporomandibular joint osteoarthritis and regeneration of cartilage/osteochondral defects: a systematic review of preclinical experiments. Osteoarthritis Cartilage 2022; 30:1174-1185. [PMID: 35597373 DOI: 10.1016/j.joca.2022.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The aim of this systematic review was to assess the effects of stem cell-based therapies on the treatment of Temporomandibular Joint Osteoarthritis (TMJ-OA) and the regeneration of cartilage/osteochondral defects. METHODS Data on preclinical studies evaluating the effectiveness of stem cell-based therapies for treating Temporomandibular Disorders (TMDs) were extracted from PubMed, Web of Science, and Cochrane Library and the grey literature by three independent reviewers. A manual search was performed in the databases, the reference list of review studies, and relevant journals in the field. Compliance with the ARRIVE guidelines was evaluated for quality assessment. SYRCLE's risk of bias tool for animal experimental studies was assessed to define internal validity. RESULTS After applying the inclusion and exclusion criteria, 10 studies were included in the qualitative synthesis. Regardless of cell origin, stem cell-based therapeutic approaches induced protective, anti-inflammatory, and chondroregenerative potential in the treatment of TMJ-OA. Regeneration of the cartilage layer on the surface of the condyle was achieved when stem cells were directly flushed into the defect or when delivered within a carrier. CONCLUSION Stem cell-based therapies may be considered a promising approach for the treatment of TMJ-OA and for the regeneration of full-thickness cartilage and osteochondral defects in the TMJ. Human studies shall be performed to validate these results found in animals.
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Affiliation(s)
- H R Matheus
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA; Department of Diagnosis and Surgery - Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil.
| | - Ş D Özdemir
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA; Istanbul Medipol University, School of Dentistry, İstanbul, Turkey.
| | - F P S Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
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Trindade D, Alves N, Moura C. From Animal to Human: (Re)using Acellular Extracellular Matrices for Temporomandibular Disc Substitution. J Funct Biomater 2022; 13:61. [PMID: 35645269 PMCID: PMC9149827 DOI: 10.3390/jfb13020061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022] Open
Abstract
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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7
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Gan Z, Zhao Y, Wu Y, Yang W, Zhao Z, Zhao L. Three-dimensional, biomimetic electrospun scaffolds reinforced with carbon nanotubes for temporomandibular joint disc regeneration. Acta Biomater 2022; 147:221-234. [PMID: 35562008 DOI: 10.1016/j.actbio.2022.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 02/05/2023]
Abstract
Temporomandibular disorder (TMD) remained a huge clinical challenge, with high prevalence but limited, unstable, and only palliative therapeutic methods available. As one of the most vulnerable sites implicated in TMD, the temporomandibular joint disc (TMJD) displayed a complicated microstructure, region-specific fibrocartilaginous distribution, and poor regenerative property, which all further hindered its functional regeneration. To address the problem, with versatile and relatively simple electrospinning (ELS) technique, our study successfully fabricated a biomimetic, three-dimensional poly (ϵ-caprolactone) (PCL)/polylactide (PLA)/carbon nanotubes (CNTs) disc scaffold, whose biconcave gross anatomy and regionally anisotropic microstructure recapitulating those of the native disc. As in vitro results validated the superior mechanical, bioactive, and regenerative properties of the biomimetic scaffolds with optimal CNTs reinforcement, we further performed in vivo experiments. After verifying its biocompatibility and ectopic fibrochondrogenicity in nude mice subcutaneous implantation models, the scaffolds guided disc regeneration and subchondral bone protection were also confirmed orthotopically in rabbits TMJD defected areas, implying the pivotal role of morphological cues in contact-guided tissue regeneration. In conclusion, our work represents a significant advancement in complex, inhomogeneous tissue engineering, providing promising clinical solutions to intractable TMD ailments. STATEMENT OF SIGNIFICANCE: Complex tissue regeneration remains a huge scientific and clinical challenge. Although frequently implicated in temporomandibular joint disorder (TMD), functional regeneration of injured temporomandibular joint disc (TMJD) is extremely hard to achieve, mainly because of the complex anatomy and microstructure with regionally variant, anisotropic fiber alignments in the native disc. In this study, we developed the biomimetic electrospun scaffold with optimal CNTs reinforcement and regionally anisotropic fiber orientations. The excellent mechanical and bioactive properties were confirmed both in vitro and in vivo, effectively promoting defected discs regeneration in rabbits. Besides demonstrating the crucial role of morphological biomimicry in tissue engineering, our work also presents a feasible clinical solution for complex tissue regeneration.
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Affiliation(s)
- Ziqi Gan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, China; Department of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
| | - Yifan Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, China.
| | - Yeke Wu
- Department of Stomatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Wei Yang
- College of Polymer Science and Engineering, Sichuan University, State Key Laboratory of Polymer Materials Engineering, Chengdu 610065, Sichuan, China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, China.
| | - Lixing Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, China.
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8
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Smojver I, Katalinić I, Bjelica R, Gabrić D, Matišić V, Molnar V, Primorac D. Mesenchymal Stem Cells Based Treatment in Dental Medicine: A Narrative Review. Int J Mol Sci 2022; 23:1662. [PMID: 35163584 DOI: 10.3390/ijms23031662] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/29/2022] [Accepted: 01/29/2022] [Indexed: 02/01/2023] Open
Abstract
Application of mesenchymal stem cells (MSC) in regenerative therapeutic procedures is becoming an increasingly important topic in medicine. Since the first isolation of dental tissue-derived MSC, there has been an intense investigation on the characteristics and potentials of these cells in regenerative dentistry. Their multidifferentiation potential, self-renewal capacity, and easy accessibility give them a key role in stem cell-based therapy. So far, several different dental stem cell types have been discovered and their potential usage is found in most of the major dental medicine branches. These cells are also researched in multiple fields of medicine for the treatment of degenerative and inflammatory diseases. In this review, we summarized dental MSC sources and analyzed their treatment modalities with particular emphasis on temporomandibular joint osteoarthritis (TMJ OA).
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Gologorsky CJ, Middendorf JM, Cohen I, Bonassar LJ. Depth-dependent patterns in shear modulus of temporomandibular joint cartilage correspond to tissue structure and anatomic location. J Biomech 2021; 129:110815. [PMID: 34706301 DOI: 10.1016/j.jbiomech.2021.110815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
To fully understand TMJ cartilage degeneration and appropriate repair mechanisms, it is critical to understand the native structure-mechanics relationships of TMJ cartilage and any local variation that may occur in the tissue. Here, we used confocal elastography and digital image correlation to measure the depth-dependent shear properties as well as the structural properties of TMJ cartilage at different anatomic locations on the condyle to identify depth-dependent changes in shear mechanics and structure. We found that samples at every anatomic location showed qualitatively similar shear modulus profiles as a function of depth. In every sample, four distinct zones of mechanical behavior were observed, with shear modulus values spanning 3-5 orders of magnitude across zones. However, quantitative characteristics of shear modulus profiles varied by anatomic location, particularly zone size and location, with the most significant variation in zonal width occurring in the fibrocartilage surface layer (zone 1). This anatomic variation suggests that different locations on the TMJ condyle may play unique mechanical roles in TMJ function. Furthermore, zones identified in the mechanical data corresponded on a sample-by-sample basis to zones identified in the structural data, indicating the known structural zones of TMJ cartilage may also play unique mechanical roles in TMJ function.
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Affiliation(s)
| | - Jill M Middendorf
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Itai Cohen
- Department of Physics, Cornell University, Clark Hall C7, Ithaca, NY 14853, USA
| | - Lawrence J Bonassar
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA.
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Yoshikawa Y, Izawa T, Hamada Y, Takenaga H, Wang Z, Ishimaru N, Kamioka H. Roles for B[a]P and FICZ in subchondral bone metabolism and experimental temporomandibular joint osteoarthritis via the AhR/Cyp1a1 signaling axis. Sci Rep 2021; 11:14927. [PMID: 34290363 PMCID: PMC8295293 DOI: 10.1038/s41598-021-94470-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/12/2021] [Indexed: 12/19/2022] Open
Abstract
Bone loss due to smoking represents a major risk factor for fractures and bone osteoporosis. Signaling through the aryl hydrocarbon receptor (AhR) and its ligands contributes to both bone homeostasis and inflammatory diseases. It remains unclear whether the same AhR signaling axis affects the temporomandibular joint (TMJ). The aim of this study was to investigate possible mechanisms which mediate bone loss in the TMJ due to smoking. In particular, whether benzo[a]pyrene (B[a]P), a carcinogen of tobacco smoke, induces expression of the AhR target gene, Cyp1a1, in mandibular condyles. Possible functions of an endogenous ligand of FICZ, were also investigated in a TMJ-osteoarthritis (OA) mouse model. B[a]P was administered orally to wild-type and AhR-/- mice and bone metabolism was subsequently examined. TMJ-OA was induced in wild-type mice with forceful opening of the mouth. Therapeutic functions of FICZ were detected with μCT and histology. Exposure to B[a]P accelerated bone loss in the mandibular subchondral bone. This bone loss manifested with osteoclastic bone resorption and upregulated expression of Cyp1a1 in an AhR-dependent manner. In a mouse model of TMJ-OA, FICZ exhibited a dose-dependent rescue of mandibular subchondral bone loss by repressing osteoclast activity. Meanwhile, in vitro, pre-treatment with FICZ reduced RANKL-mediated osteoclastogenesis. B[a]P regulates mandibular subchondral bone metabolism via the Cyp1a1. The AhR ligand, FICZ, can prevent TMJ-OA by regulating osteoclast differentiation.
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Affiliation(s)
- Yuri Yoshikawa
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Takashi Izawa
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan.
| | - Yusaku Hamada
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Hiroko Takenaga
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Ziyi Wang
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Naozumi Ishimaru
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Hiroshi Kamioka
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
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11
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Trindade D, Cordeiro R, José HC, Ângelo DF, Alves N, Moura C. Biological Treatments for Temporomandibular Joint Disc Disorders: Strategies in Tissue Engineering. Biomolecules 2021; 11:biom11070933. [PMID: 34201698 PMCID: PMC8301995 DOI: 10.3390/biom11070933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 01/22/2023] Open
Abstract
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.
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Affiliation(s)
- Daniela Trindade
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
| | - Rachel Cordeiro
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
| | | | - David Faustino Ângelo
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
- Instituto Português da Face, 1050-227 Lisboa, Portugal;
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Nuno Alves
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
- Correspondence: (N.A.); (C.M.); Tel.: +351-24-456-9441 (C.M.)
| | - Carla Moura
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
- Correspondence: (N.A.); (C.M.); Tel.: +351-24-456-9441 (C.M.)
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12
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Zhao Y, Xie L. An Update on Mesenchymal Stem Cell-Centered Therapies in Temporomandibular Joint Osteoarthritis. Stem Cells Int 2021; 2021:6619527. [PMID: 33868408 PMCID: PMC8035039 DOI: 10.1155/2021/6619527] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/20/2021] [Accepted: 03/19/2021] [Indexed: 02/05/2023] Open
Abstract
Temporomandibular joint osteoarthritis (TMJOA) is a degenerative disease characterized by cartilage degeneration, disrupted subchondral bone remodeling, and synovitis, seriously affecting the quality of life of patients with chronic pain and functional disabilities. Current treatments for TMJOA are mainly symptomatic therapies without reliable long-term efficacy, due to the limited self-renewal capability of the condyle and the poorly elucidated pathogenesis of TMJOA. Recently, there has been increased interest in cellular therapies for osteoarthritis and TMJ regeneration. Mesenchymal stem cells (MSCs), self-renewing and multipotent progenitor cells, play a promising role in TMJOA treatment. Derived from a variety of tissues, MSCs exert therapeutic effects through diverse mechanisms, including chondrogenic differentiation; fibrocartilage regeneration; and trophic, immunomodulatory, and anti-inflammatory effects. Here, we provide an overview of the therapeutic roles of various tissue-specific MSCs in osteoarthritic TMJ or TMJ regenerative tissue engineering, with an additional focus on joint-resident stem cells and other cellular therapies, such as exosomes and adipose-derived stromal vascular fraction (SVF). Additionally, we summarized the updated pathogenesis of TMJOA to provide a better understanding of the pathological mechanisms of cellular therapies. Although limitations exist, MSC-centered therapies still provide novel, innovative approaches for TMJOA treatment.
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Affiliation(s)
- Yifan Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Liang Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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13
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Wang H, Xu Y, Wang P, Ma J, Wang P, Han X, Fan Y, Bai D, Sun Y, Zhang X. Cell-mediated injectable blend hydrogel-BCP ceramic scaffold for in situ condylar osteochondral repair. Acta Biomater 2021; 123:364-378. [PMID: 33453407 DOI: 10.1016/j.actbio.2020.12.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 02/08/2023]
Abstract
The existing approaches for healing mandibular condylar osteochondral defects, which are prevalent in temporomandibular joint disorders (TMD), are sparse and not reparative. To address this, regenerative medicine in situ has transpired as a potential therapeutic solution as it can effectively regenerate composite tissues. Herein, injectable self-crosslinking thiolated hyaluronic acid (HA-SH)/type I collagen (Col I) blend hydrogel and BCP ceramics combined with rabbit bone mesenchymal stem cells (rBMSCs)/chondrocytes were used to fabricate a new bi-layer scaffold to simulate specific structure of rabbit condylar osteochondral defects. The in vitro results demonstrated that the blend hydrogel scaffold provided suitable microenvironment for simultaneously realizing proliferation and chondrogenic specific matrix secretion of both rBMSCs and chondrocytes, while BCP ceramics facilitated rBMSCs proliferation and osteogenic differentiation. The in vivo results confirmed that compared with cell-free implant, the rBMSCs/chondrocytes-loaded bi-layer scaffold could effectively promote the regeneration of both fibrocartilage and subchondral bone, suggesting that the bi-layer scaffold presented a promising option for cell-mediated mandibular condylar cartilage regeneration.
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14
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Wu M, Cai J, Yu Y, Hu S, Wang Y, Wu M. Therapeutic Agents for the Treatment of Temporomandibular Joint Disorders: Progress and Perspective. Front Pharmacol 2021; 11:596099. [PMID: 33584275 PMCID: PMC7878564 DOI: 10.3389/fphar.2020.596099] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/19/2020] [Indexed: 02/05/2023] Open
Abstract
Temporomandibular joint disorders (TMD) are a common health condition caused by the structural or functional disorders of masticatory muscles and the temporomandibular joint (TMJ). Abnormal mandibular movement in TMD patients may cause pain, chronic inflammation, and other discomfort, which could be relieved by a variety of drugs through various delivery systems. In this study, we summarized commonly used therapeutic agents in the management of TMD as well as novel bioactive molecules in preclinical stage and clinical trials. The emerging therapy strategies such as novel intra-TMJ delivery systems and implants based on tissue engineering are also discussed. This comprehensive review will strengthen our understanding of pharmacological approaches for TMD therapy.
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Affiliation(s)
- Mengjie Wu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Jingyi Cai
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomato-logy, Sichuan University, Chengdu, China
| | - Yeke Yu
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sihui Hu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Yingnan Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Mengrui Wu
- College of Life Sciences, Zhejiang University, Zhejiang, China
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15
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Bai B, Bai X, Wang C. Mapping research trends of temporomandibular disorders from 2010 to 2019: A bibliometric analysis. J Oral Rehabil 2021; 48:517-530. [PMID: 33386626 DOI: 10.1111/joor.13143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Because of various clinical manifestations and complicated courses, temporomandibular disorders (TMDs) are difficult to treat. Current knowledge about this disease remains insufficient for precise treatment after diagnosis. OBJECTIVES The objective of this study is to obtain and map the overall literature trends and most cited keywords in TMDs research. METHODS Many indicators, including annual number of publications, country distribution, global cooperations, author contributions, original journals, cited references and keywords, were calculated and evaluated using VOSviewer v.1.6.13, which visualised many results, from the WoSCC database. RESULTS A total of 3121 papers on TMDs research were retrieved from 2010 to 2019. The United States produced the most articles published, but the most productive institution was the University of Sao Paulo (Brazil). Researchers and institutions conducting TMDs research have shown a very widespread and close connection. TMDs have been studied worldwide by many research centres. Professor Svensson P was the most published researcher in TMDs research and the Journal of Oral Rehabilitation published the most TMDs research articles. The top cited references mainly presented diagnostic criteria of TMDs. The most cited keywords formed clusters: (a) Anatomical factor of TMDs, (b) Symptoms of TMDs and (c) RDC/TMD, the risk factors, biopsychosocial factors and epidemiology of TMDs. CONCLUSIONS The research results provide very valuable data for a thorough understanding of the research status of TMDs and demonstrated international cooperation.
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Affiliation(s)
- Bing Bai
- Department of Prosthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Xiaofeng Bai
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Chunxia Wang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, China
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16
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Labus KM, Kuiper JP, Rawlinson J, Puttlitz CM. Mechanical characterization and viscoelastic model of the ovine temporomandibular joint Disc in indentation, uniaxial tension, and biaxial tension. J Mech Behav Biomed Mater 2020; 116:104300. [PMID: 33454627 DOI: 10.1016/j.jmbbm.2020.104300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/10/2020] [Accepted: 12/26/2020] [Indexed: 11/17/2022]
Abstract
There have been recent investigations into developing disc replacements and regenerative medicine to treat internal derangements of the temporomandibular joint (TMJ) disc. Previous attempts at disc replacements have faced challenges related in part to a limited understanding of the TMJ's complex mechanical environment. The purpose of this study was to characterize the mechanical behavior of the ovine TMJ disc and to derive viscoelastic constitutive models from the experimental data. Fresh ovine TMJ discs were tested in indentation stress-relaxation tests on the inferior surface, uniaxial tension tests to failure, and dynamic biaxial tensile tests. Results showed an order of magnitude stiffer behavior in tension in the anteroposterior (primary fiber) direction compared to the mediolateral direction. The stiffness in tension was much greater than in compression. Regional comparisons showed greater elastic moduli in indentation in the posterior and anterior bands compared to the central region. A hyper-viscoelastic constitutive model captured the dynamic stress-stretch behavior in both indentation and biaxial tension with good agreement. These data will support ongoing and future computational modeling of local TMJ mechanics, aid in biomaterials identification, and ultimately enhance development of implant designs for TMJ disc replacement.
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Affiliation(s)
- Kevin M Labus
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA
| | - Jason P Kuiper
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA
| | - Jennifer Rawlinson
- Department of Clinical Sciences, Colorado State University, 1678 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA
| | - Christian M Puttlitz
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA; Department of Clinical Sciences, Colorado State University, 1678 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA; School of Biomedical Engineering, Colorado State University, 1376 Campus Delivery, 200 W. Lake St.Fort Collins, CO, 80523, USA.
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17
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Bielajew BJ, Hu JC, Athanasiou KA. Collagen: quantification, biomechanics, and role of minor subtypes in cartilage. Nat Rev Mater 2020; 5:730-747. [PMID: 33996147 PMCID: PMC8114887 DOI: 10.1038/s41578-020-0213-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 05/02/2023]
Abstract
Collagen is a ubiquitous biomaterial in vertebrate animals. Although each of its 28 subtypes contributes to the functions of many different tissues in the body, most studies on collagen or collagenous tissues have focussed on only one or two subtypes. With recent developments in analytical chemistry, especially mass spectrometry, significant advances have been made toward quantifying the different collagen subtypes in various tissues; however, high-throughput and low-cost methods for collagen subtype quantification do not yet exist. In this Review, we introduce the roles of collagen subtypes and crosslinks, and describe modern assays that enable a deep understanding of tissue physiology and disease states. Using cartilage as a model tissue, we describe the roles of major and minor collagen subtypes in detail; discuss known and unknown structure-function relationships; and show how tissue engineers may harness the functional characteristics of collagen to engineer robust neotissues.
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Affiliation(s)
- Benjamin J. Bielajew
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617, USA
| | - Jerry C. Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617, USA
| | - Kyriacos A. Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617, USA
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18
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Abbadessa A, Crecente-Campo J, Alonso MJ. Engineering Anisotropic Meniscus: Zonal Functionality and Spatiotemporal Drug Delivery. Tissue Eng Part B Rev 2020; 27:133-154. [PMID: 32723019 DOI: 10.1089/ten.teb.2020.0096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Human meniscus is a fibrocartilaginous structure that is crucial for an adequate performance of the human knee joint. Degeneration of the meniscus is often followed by partial or total meniscectomy, which enhances the risk of developing knee osteoarthritis. The lack of a satisfactory treatment for this condition has triggered a major interest in drug delivery (DD) and tissue engineering (TE) strategies intended to restore a bioactive and fully functional meniscal tissue. The aim of this review is to critically discuss the most relevant studies on spatiotemporal DD and TE, aiming for a multizonal meniscal reconstruction. Indeed, the development of meniscal tissue implants should involve a provision for adequate active molecules and scaffold features that take into account the anisotropic ultrastructure of human meniscus. This zonal differentiation is reflected in the meniscus biochemical composition, collagen fiber arrangement, and cell distribution. In this sense, it is expected that a proper combination of advanced DD and zonal TE strategies will play a key role in the future trends in meniscus regeneration. Impact statement Meniscus degeneration is one of the main causes of knee pain, inflammation, and reduced mobility. Currently used suturing procedures and meniscectomy are far from being ideal solutions to the loss of meniscal function. Therefore, drug delivery (DD) and tissue engineering (TE) strategies are currently under investigation. DD systems aim at an in situ controlled release of growth factors, whereas TE strategies aim at mimicking the anisotropy of native meniscus. The goal of this review is to discuss these two main approaches, as well as synergies between them that are expected to lead to a real breakthrough in the field.
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Affiliation(s)
- Anna Abbadessa
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), IDIS Research Institute, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Campus Vida, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - José Crecente-Campo
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), IDIS Research Institute, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Campus Vida, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - María José Alonso
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), IDIS Research Institute, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Campus Vida, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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19
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Karic V, Chandran R, Abrahamse H. Photobiomodulation and Stem Cell Therapy for Temporomandibular Joint Disc Disorders. Photobiomodul Photomed Laser Surg 2020; 38:398-408. [PMID: 32486898 DOI: 10.1089/photob.2019.4790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Temporomandibular disorder (TMD) refers to a group of disorders affecting the temporomandibular joint (TMJ) and its related muscles. The two commonly used treatment modalities for TMD are occlusal splint therapy and relaxation therapy. Neither comprises definitive treatment. Objective: The objective of this review was to report updated information on photobiomodulation and stem cells, as an alternative treatment for the degenerative TMJ disc as a part of TMJ disorders. Materials and methods: With only a few research studies reported till date, this review also proposes the mechanism of laser irradiation on inflammatory mediators to treat TMD. Results: Photobiomodulation of stem cells with and without scaffolds could be used indirectly or directly as modulation of degenerative changes of the TMJ disc. Conclusions: The need for a distinct shift of the research margin in this field of dentistry is evident, specifically regarding the application of photobiomodulation and stem cells for tissue engineering of the TMJ disc.
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Affiliation(s)
- Vesna Karic
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,Department of Prosthodontic and Oral Rehabilitation, and Laser Therapy in Dentistry Division, School of Oral Sciences, Health Sciences Faculty, WITS University, Johannesburg, South Africa
| | - Rahul Chandran
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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20
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Lee YH, Park HK, Auh QS, Nah H, Lee JS, Moon HJ, Heo DN, Kim IS, Kwon IK. Emerging Potential of Exosomes in Regenerative Medicine for Temporomandibular Joint Osteoarthritis. Int J Mol Sci 2020; 21:ijms21041541. [PMID: 32102392 PMCID: PMC7073204 DOI: 10.3390/ijms21041541] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 02/06/2023] Open
Abstract
Exosomes are nanosized vesicles (30–140 nm) of endocytic origin that play important roles in regenerative medicine. They are derived from cell membranes during endocytic internalization and stabilize in biological fluids such as blood and synovia. Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease, which, in addition to chronic pain, is characterized by progressive cartilage breakdown, condylar bone remodeling, and synovitis. However, traditional clinical treatments have limited symptom- and structure-modifying effects to restore damaged cartilage and other TMJ tissues. This is due to the limited self-healing capacity of condylar cartilage. Recently, stem-cell-derived exosomes have been studied as an alternative therapeutic approach to tissue repair and regeneration. It is known that trophic regulation of mesenchymal stem cells (MSCs) has anti-inflammatory and immunomodulatory effects under pathological conditions, and research on MSC-derived exosomes is rapidly accumulating. MSC-derived exosomes mimic the major therapeutic effects of MSCs. They affect the activity of immune effector cells and possess multilineage differentiation potential, including chondrogenic and osteogenic differentiation. Furthermore, exosomes are capable of regenerating cartilage or osseous compartments and restoring injured tissues and can treat dysfunction and pain caused by TMJ OA. In this review, we looked at the uniqueness of TMJ, the pathogenesis of TMJ OA, and the potential role of MSC-derived exosomes for TMJ cartilage and bone regeneration.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, #26 Kyunghee-daero, Dongdaemun-gu, Seoul 02447, Korea; (Y.-H.L.); (Q.-S.A.)
| | - Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, Dental Research Institute, Seoul National University School of Dentistry, Seoul 03080, Korea;
| | - Q-Schick Auh
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, #26 Kyunghee-daero, Dongdaemun-gu, Seoul 02447, Korea; (Y.-H.L.); (Q.-S.A.)
| | - Haram Nah
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul 02447, Korea; (H.N.); (J.S.L.)
| | - Jae Seo Lee
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul 02447, Korea; (H.N.); (J.S.L.)
| | - Ho-Jin Moon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (H.-J.M.); (D.N.H.)
| | - Dong Nyoung Heo
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (H.-J.M.); (D.N.H.)
| | - In San Kim
- Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea;
| | - Il Keun Kwon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (H.-J.M.); (D.N.H.)
- Correspondence: ; Tel.: +82-2-958-9409; Fax: +82-2-958-9454
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21
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Su X, Wang J, Kang H, Bao G, Liu L. Effects of dynamic radial tensile stress on fibrocartilage differentiation of bone marrow mesenchymal stem cells. Biomed Eng Online 2020; 19:8. [PMID: 32024525 PMCID: PMC7003351 DOI: 10.1186/s12938-020-0751-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/24/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Uniaxial/biaxial tensile stress has been employed to induce chondrocyte differentiation of mesenchymal stem cells. However, the effects of radial tensile stimuli on differentiation of MSCs into fibrocartilage remain unclear. RESULTS It was found that induced bone marrow mesenchymal stem cells (BMSCs) were not only similar to TMJ disc cells in morphology, but also could synthesize type I collagen (Col I), a small amount of type II collagen (Col II) and glycosaminoglycans (GAGs). The synthesis of Col I significantly increased while that of Col II gradually decreased with increasing tensile strength. The ratio of Col I to Col II was 1.8 to 1 and 2 to 1 in the 10% and 15% stretching groups, respectively. The gene expression of Col I and GAGs was significantly upregulated, whereas that of Col II was downregulated. However, the higher tensile stimulation (15%) promoted the synthesis of α-smooth muscle actin (α-SMA). Too much α-SMA is not conducive to constructing engineered tissue. CONCLUSION Therefore, the 10% radial tensile stimulus was the optimal strength for inducing the BMSCs to differentiate into fibrochondrocytes of the temporomandibular joint (TMJ) disc. This work provided a novel approach for inducing BMSCs to differentiate into fibrochondrocytes.
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Affiliation(s)
- Xuelian Su
- College of Civil Engineering and Mechanics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.,Key Lab of Oral Diseases of Gansu Province, Northwest Minzu University, Lanzhou, People's Republic of China.,Key Lab of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, People's Republic of China.,Key Laboratory of Mechanics on Disaster and Environment in Western China, The Ministry of Education of China, Lanzhou University, Lanzhou, People's Republic of China.,Department of Prosthodontics, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China
| | - Jizeng Wang
- College of Civil Engineering and Mechanics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China. .,Key Laboratory of Mechanics on Disaster and Environment in Western China, The Ministry of Education of China, Lanzhou University, Lanzhou, People's Republic of China.
| | - Hong Kang
- College of Civil Engineering and Mechanics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.,Key Laboratory of Mechanics on Disaster and Environment in Western China, The Ministry of Education of China, Lanzhou University, Lanzhou, People's Republic of China
| | - Guangjie Bao
- Key Lab of Oral Diseases of Gansu Province, Northwest Minzu University, Lanzhou, People's Republic of China.,Key Lab of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, People's Republic of China.,Department of Prosthodontics, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China
| | - Lin Liu
- Key Lab of Oral Diseases of Gansu Province, Northwest Minzu University, Lanzhou, People's Republic of China.,Key Lab of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, People's Republic of China.,Department of Prosthodontics, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China
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22
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Vapniarsky N, Huwe LW, Arzi B, Houghton MK, Wong ME, Wilson JW, Hatcher DC, Hu JC, Athanasiou KA. Tissue engineering toward temporomandibular joint disc regeneration. Sci Transl Med 2019; 10:10/446/eaaq1802. [PMID: 29925634 DOI: 10.1126/scitranslmed.aaq1802] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 05/25/2018] [Indexed: 12/11/2022]
Abstract
Treatments for temporomandibular joint (TMJ) disc thinning and perforation, conditions prevalent in TMJ pathologies, are palliative but not reparative. To address this, scaffold-free tissue-engineered implants were created using allogeneic, passaged costal chondrocytes. A combination of compressive and bioactive stimulation regimens produced implants with mechanical properties akin to those of the native disc. Efficacy in repairing disc thinning was examined in minipigs. Compared to empty controls, treatment with tissue-engineered implants restored disc integrity by inducing 4.4 times more complete defect closure, formed 3.4-fold stiffer repair tissue, and promoted 3.2-fold stiffer intralaminar fusion. The osteoarthritis score (indicative of degenerative changes) of the untreated group was 3.0-fold of the implant-treated group. This tissue engineering strategy paves the way for developing tissue-engineered implants as clinical treatments for TMJ disc thinning.
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Affiliation(s)
- Natalia Vapniarsky
- Department of Pathology, Microbiology, and Immunology, University of California, Davis, Davis, CA 95616, USA
| | - Le W Huwe
- Department of Biomedical Engineering, University of California, Davis, Davis, CA 95616, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Meghan K Houghton
- Directorate for Computer and Information Science and Engineering, National Science Foundation, Alexandria, VA 22314, USA
| | - Mark E Wong
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX 77054, USA
| | - James W Wilson
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX 77054, USA
| | - David C Hatcher
- Diagnostic Digital Imaging Center, Sacramento, CA 95825, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, USA.
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23
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Donahue RP, Hu JC, Athanasiou KA. Remaining Hurdles for Tissue-Engineering the Temporomandibular Joint Disc. Trends Mol Med 2019; 25:241-256. [PMID: 30678888 PMCID: PMC6436948 DOI: 10.1016/j.molmed.2018.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 12/29/2022]
Abstract
The temporomandibular joint (TMJ) disc, a fibrocartilaginous structure between the mandible and temporal bone, is implicated in temporomandibular disorders (TMDs). TMDs symptomatically affect approximately 25% of the population, of which 70% have internal derangement of the disc. Treatments lack efficiency, motivating novel therapies, including tissue-engineering toward TMJ disc regeneration. Recent developments in scaffold-based or scaffold-free approaches, cell sources, and biochemical and mechanical stimulation have resulted in constructs exhibiting native tissue mechanics. Safety and efficacy of tissue-engineered implants have shown promising results in orthotopic animal studies. However, many hurdles need to be overcome in tissue-engineering approaches, and clinical and regulatory pathways. Future studies present an opportunity for clinicians and researchers to work together toward safe and effective clinical trials.
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Affiliation(s)
- Ryan P Donahue
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA.
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24
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Acri TM, Shin K, Seol D, Laird NZ, Song I, Geary SM, Chakka JL, Martin JA, Salem AK. Tissue Engineering for the Temporomandibular Joint. Adv Healthc Mater 2019; 8:e1801236. [PMID: 30556348 DOI: 10.1002/adhm.201801236] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/17/2018] [Indexed: 12/24/2022]
Abstract
Tissue engineering potentially offers new treatments for disorders of the temporomandibular joint which frequently afflict patients. Damage or disease in this area adversely affects masticatory function and speaking, reducing patients' quality of life. Effective treatment options for patients suffering from severe temporomandibular joint disorders are in high demand because surgical options are restricted to removal of damaged tissue or complete replacement of the joint with prosthetics. Tissue engineering approaches for the temporomandibular joint are a promising alternative to the limited clinical treatment options. However, tissue engineering is still a developing field and only in its formative years for the temporomandibular joint. This review outlines the anatomical and physiological characteristics of the temporomandibular joint, clinical management of temporomandibular joint disorder, and current perspectives in the tissue engineering approach for the temporomandibular joint disorder. The tissue engineering perspectives have been categorized according to the primary structures of the temporomandibular joint: the disc, the mandibular condyle, and the glenoid fossa. In each section, contemporary approaches in cellularization, growth factor selection, and scaffold fabrication strategies are reviewed in detail along with their achievements and challenges.
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Affiliation(s)
- Timothy M. Acri
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - Kyungsup Shin
- Department of Orthodontics; College of Dentistry and Dental Clinics; University of Iowa; Iowa City, Iowa 52242 USA
| | - Dongrim Seol
- Department of Orthopedics and Rehabilitation; Carver College of Medicine; University of Iowa; Iowa City, Iowa 52242 USA
| | - Noah Z. Laird
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - Ino Song
- Department of Orthopedics and Rehabilitation; Carver College of Medicine; University of Iowa; Iowa City, Iowa 52242 USA
| | - Sean M. Geary
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - Jaidev L. Chakka
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - James A. Martin
- Department of Orthopedics and Rehabilitation; Carver College of Medicine; University of Iowa; Iowa City, Iowa 52242 USA
| | - Aliasger K. Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
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25
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Adams K, Schulz-Kornas E, Arzi B, Failing K, Vogelsberg J, Staszyk C. Functional anatomy of the equine temporomandibular joint: Histological characteristics of the articular surfaces and underlining tissues. Vet J 2018; 239:35-41. [PMID: 30197107 DOI: 10.1016/j.tvjl.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 05/29/2018] [Accepted: 08/09/2018] [Indexed: 12/01/2022]
Abstract
It has been assumed that dental conditions cause disorders of the equine temporomandibular joint (TMJ), due to biomechanical overload or aberrant loading. However, the incidence of published TMJ disorders in horses is low and this leads to the question whether the equine TMJ is adapted well to its biomechanical requirements or is able to remodel its articular surfaces in response to modified loading conditions. The aim of this study was to determine the histological characteristics of healthy equine TMJs. The tissue components of the articular surfaces of 10 TMJs obtained from horses without any clinical history of dental or TMJ disorders were analysed. Apart from the mandibular fossa of the temporal bone, the osseous aspects of the TMJ exhibited a uniform zoning pattern. The articular surfaces were composed of three tissue layers: (1) a superficial cell-rich dense connective tissue layer; (2) a middle fibrocartilage layer; and (3) a deep hyaline-like cartilage layer. The articular disc was composed of an inner core of fibrocartilage and hyaline-like cartilage meshwork covered with both cell-rich dense connective tissue and fibrocartilage at its dorsal and ventral aspects. In contrast, the mandibular fossa was only covered by a dense connective tissue, frequently supplemented by a synovial membrane, suggesting low biomechanical stress. Glycosaminoglycans, which are indicative of compressive loads, were predominantly present within the rostral part of the articular tubercle and the retroarticular process, the dorsal part of articular disc and the entire mandibular head, but were absent within the mandibular fossa. The results of this study suggest the presence of different biomechanical demands in the dorsal and ventral compartment of the equine TMJ.
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Affiliation(s)
- K Adams
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany
| | - E Schulz-Kornas
- Max Planck Weizmann Centre for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany
| | - B Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616, CA, USA
| | - K Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany
| | - J Vogelsberg
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany
| | - C Staszyk
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany.
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26
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Lin AW, Vapniarsky N, Cissell DD, Verstraete FJM, Lin CH, Hatcher DC, Arzi B. The Temporomandibular Joint of the Domestic Dog (Canis lupus familiaris) in Health and Disease. J Comp Pathol 2018; 161:55-67. [PMID: 30173858 DOI: 10.1016/j.jcpa.2018.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/02/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
This study aimed to characterize the histological, biomechanical and biochemical properties of the temporomandibular joint (TMJ) of the domestic dog in health and disease. In addition, we sought to identify structure-function relationships and to characterize TMJ degenerative lesions that may be found naturally in this species. TMJs (n = 20) from fresh cadaver heads (n = 10) of domestic dogs were examined macroscopically and microscopically and by cone-beam computed tomography. The TMJ discs were evaluated for their mechanical and biochemical properties. If TMJ arthritic changes were found, pathological characteristics were described and compared with healthy joints. Five (50%) dogs demonstrated macroscopically normal fibrocartilaginous articular surfaces and fibrous discs and five (50%) dogs exhibited degenerative changes that were observed either in the articular surfaces or the discs. In the articulating surfaces, these changes included erosions, conformational changes and osteophytes. In the discs, degenerative changes were represented by full-thickness perforations. Histologically, pathological specimens demonstrated fibrillations with or without erosions, subchondral bone defects and subchondral bone sclerosis. Significant anisotropy in the TMJ discs was evident on histology and tensile mechanical testing. Specifically, the discs were significantly stiffer and stronger in the rostrocaudal direction compared with the mediolateral direction. No significant differences were detected in compressive properties of different disc regions. Biochemical analyses showed high collagen content and low glycosaminoglycan (GAG) content. No significant differences in biochemical composition, apart from GAG, were detected among the disc regions. GAG concentration was significantly higher in the central region as compared with the caudal (posterior) region. The TMJ of the domestic dog exhibits similarities, but also differences, compared with other mammals with regards to structure-function relationships. The TMJ articular surfaces and the disc exhibit degenerative changes as seen in other species, including perforation of the disc as seen in man. The degenerative changes had greater effects on the mechanical properties compared with the biochemical properties of the TMJ components. Translational motion of the TMJ does occur in dogs, but is limited.
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Affiliation(s)
- A W Lin
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - N Vapniarsky
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, California, USA.
| | - D D Cissell
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - F J M Verstraete
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - C H Lin
- Department of Biomedical Engineering, University of California, Davis, California, USA
| | - D C Hatcher
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - B Arzi
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA.
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27
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Helgeland E, Shanbhag S, Pedersen TO, Mustafa K, Rosén A. Scaffold-Based Temporomandibular Joint Tissue Regeneration in Experimental Animal Models: A Systematic Review. Tissue Eng Part B Rev 2018; 24:300-316. [PMID: 29400140 DOI: 10.1089/ten.teb.2017.0429] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reconstruction of degenerated temporomandibular joint (TMJ) structures remains a clinical challenge. Tissue engineering (TE) is a promising alternative to current treatment options, where the TMJ is either left without functional components, or replaced with autogenous, allogeneic, or synthetic grafts. The objective of this systematic review was to answer the focused question: in experimental animal models, does the implantation of biomaterial scaffolds loaded with cells and/or growth factors (GFs) enhance regeneration of the discal or osteochondral TMJ tissues, compared with scaffolds alone, without cells, or GFs? Following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines, electronic databases were searched for relevant controlled preclinical in vivo studies. Thirty studies reporting TMJ TE strategies in both small (rodents, rabbits; n = 25) and large animals (dogs, sheep, goats; n = 5) reporting histological and/or radiographic outcomes were included. Twelve studies reported ectopic (subcutaneous) implantation models in rodents, whereas 18 studies reported orthotopic, surgically induced defect models in large animals. On average, studies presented with an unclear-to-high risk of bias. In most studies, mesenchymal stem cells or chondrocytes were used in combination with either natural or synthetic polymer scaffolds, aiming for either TMJ disc or condyle regeneration. In summary, the overall preclinical evidence (ectopic [n = 6] and orthotopic TMJ models [n = 6]) indicate that addition of chondrogenic and/or osteogenic cells to biomaterial scaffolds enhances the potential for TMJ tissue regeneration. Standardization of animal models and quantitative outcome evaluations (biomechanical, biochemical, histomorphometric, and radiographic) in future studies, would allow more reliable comparisons and increase the validity of the results.
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Affiliation(s)
- Espen Helgeland
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Siddharth Shanbhag
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Torbjørn Ostvik Pedersen
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway .,2 Department of Oral and Maxillofacial Surgery, University of Bergen and Haukeland University Hospital , Bergen, Norway
| | - Kamal Mustafa
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Annika Rosén
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway .,2 Department of Oral and Maxillofacial Surgery, University of Bergen and Haukeland University Hospital , Bergen, Norway
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28
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Van Bellinghen X, Idoux-Gillet Y, Pugliano M, Strub M, Bornert F, Clauss F, Schwinté P, Keller L, Benkirane-Jessel N, Kuchler-Bopp S, Lutz JC, Fioretti F. Temporomandibular Joint Regenerative Medicine. Int J Mol Sci 2018; 19:E446. [PMID: 29393880 PMCID: PMC5855668 DOI: 10.3390/ijms19020446] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 01/09/2023] Open
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.
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Affiliation(s)
- Xavier Van Bellinghen
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Ysia Idoux-Gillet
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Marion Pugliano
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Marion Strub
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Fabien Bornert
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Francois Clauss
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Pascale Schwinté
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Laetitia Keller
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
| | - Sabine Kuchler-Bopp
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
| | - Jean Christophe Lutz
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
- Faculté de Médecine, Université de Strasbourg, 11 rue Humann, 67000 Strasbourg, France.
| | - Florence Fioretti
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
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29
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Abstract
In orthopaedic surgery, the reconstruction of musculoskeletal defects is a constant challenge.
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Affiliation(s)
- Xiaolei Nie
- Division of Bioengineering
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore 637457
- Singapore
| | - Dong-An Wang
- Division of Bioengineering
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore 637457
- Singapore
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30
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Lowe J, Almarza AJ. A review of in-vitro fibrocartilage tissue engineered therapies with a focus on the temporomandibular joint. Arch Oral Biol 2017; 83:193-201. [PMID: 28787640 DOI: 10.1016/j.archoralbio.2017.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 12/11/2022]
Abstract
The inability of fibrocartilage, specifically the temporomandibular joint (TMJ) disc, to regenerate and remodel following injury presents a unique problem for clinicians. Tissue engineering then offers a potential regenerative therapy. In vitro testing provides a valuable screening tool for potential tissue engineered solutions. The conclusions drawn for TMJ in vitro research were compared against state of the art fibrocartilage studies in the knee meniscus, and annulus fibrosus of the intervertebral disc (IVD). For TMJ disc regeneration, in vitro tissue engineered approaches, focused on cellular therapies with fibrochondrocytes, have displayed an inability to produce enough collagen, as well as an inability to recapitulate native mechanical properties. Biomaterial approaches have recapitulated the native properties of the TMJ disc, but their in vivo efficacy has yet to be determined. By comparison, the knee meniscus field is the most progressive in the use of stem cells as a cell source. The knee meniscus field has moved away from measuring mechanical properties, and are instead more focused on biochemistry and gene expression. IVD studies mainly use electrospun scaffolds, and have produced the best success in mechanical properties. The TMJ field, in comparison to knee meniscus and IVD, needs to employ stem cell therapies, new biomaterials and manufacturing techniques, and cutting edge molecular assays, in future in vitro approaches to screen for viable technologies to move to in vivo studies.
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Affiliation(s)
- Jesse Lowe
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, United States; Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA 15260, United States.
| | - Alejandro J Almarza
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, PA 15260, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, United States; Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA 15260, United States; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, United States.
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31
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Vapniarsky N, Aryaei A, Arzi B, Hatcher DC, Hu JC, Athanasiou KA. The Yucatan Minipig Temporomandibular Joint Disc Structure-Function Relationships Support Its Suitability for Human Comparative Studies. Tissue Eng Part C Methods 2017; 23:700-709. [PMID: 28548559 DOI: 10.1089/ten.tec.2017.0149] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Frequent involvement of the disc in temporomandibular joint (TMJ) disorders warrants attempts to tissue engineer TMJ disc replacements. Physiologically, a great degree of similarity is seen between humans and farm pigs (FPs), but the pig's rapid growth confers a significant challenge for in vivo experiments. Minipigs have a slower growth rate and are smaller than FPs, but minipig TMJ discs have yet to be fully characterized. The objective of this study was to determine the suitability of the minipig for TMJ studies by extensive structural and functional characterization. The properties of minipig TMJ discs closely reproduced previously reported morphological, biochemical, and biomechanical values of human and FP discs. The width/length dimension ratio of the minipig TMJ disc was 1.95 (1.69 for human and 1.94 for FP). The biochemical evaluation revealed, on average per wet weight, 24.3% collagen (22.8% for human and 24.9% for FP); 0.8% glycosaminoglycan (GAG; 0.5% for human and 0.4% for FP); and 0.03% DNA (0.008% for human and 0.02% for FP). Biomechanical testing revealed, on average, compressive relaxation modulus of 50 kPa (37 kPa for human and 32 kPa for FP), compressive instantaneous modulus of 1121 kPa (1315 kPa for human and 1134 kPa for FP), and coefficient of viscosity of 13 MPa·s (9 MPa·s for human and 3 MPa·s for FP) at 20% strain. These properties also varied topographically in accordance to those of human and FP TMJ discs. Anisotropy, quantified by bidirectional tensile testing and histology, again was analogous among minipig, human, and FP TMJ discs. The minipig TMJ's ginglymoarthrodial nature was verified through cone beam computer tomography. Collectively, the similarities between minipig and human TMJ discs support the use of minipig as a relevant model for TMJ research; considering the practical advantages conferred by its growth rate and size, the minipig may be a preferred model over FP.
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Affiliation(s)
- Natalia Vapniarsky
- 1 Department of Biomedical Engineering, University of California , Davis, Davis, California
| | - Ashkan Aryaei
- 1 Department of Biomedical Engineering, University of California , Davis, Davis, California
| | - Boaz Arzi
- 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California , Davis, Davis, California
| | - David C Hatcher
- 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California , Davis, Davis, California.,3 Diagnostic Digital Imaging Center , Sacramento, California
| | - Jerry C Hu
- 1 Department of Biomedical Engineering, University of California , Davis, Davis, California
| | - Kyriacos A Athanasiou
- 1 Department of Biomedical Engineering, University of California , Davis, Davis, California.,4 Department of Orthopedic Surgery, School of Medicine, University of California, Davis , Davis, California
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