Future: Tissue Engineering (Regenerative Medicine); Condyle-Ramus Construct

Abstract

The temporomandibular joint proves to be one of the most difficult structures to reconstruct in the craniomaxillofacial skeleton. This owes to the complex 3-dimensional geometrical shape, intricate mechanical function and load bearing, and the presence of both osseous and cartilaginous tissues in close proximity to a fibrocartilagenous disc. Reconstruction is recommended for re-establishing function and occlusion, correcting facial asymmetry, and reducing suffering and disability. Although a number of options are currently available, each has its distinct disadvantages. Autogenous reconstruction regardless of vascularity places the patient at risk for significant donor site morbidity and deformity. Allogeneic grafts may induce an immunologic response or reduce the rate of reliable integration through removal of osteogenic cellular tissues. Alloplastic materials place the patient at risk for mechanical failure, foreign body reaction and increased risk of infection. Regardless of the reconstructive material, one must be cognizant of the need to recapitulate the joint without osseous tissue overgrowth which puts the patient at risk for restriction in mobility with loss of function and possible ankylosis.