Multi-Material Implants for Temporomandibular Joint Disc Repair: Tailored Additive Manufacturing Production.

Carla Moura,Daniela Trindade,Milena Vieira,David Faustino Ângelo,Nuno Alves,Luís Francisco

doi:10.3389/fbioe.2020.00342

Abstract

Temporomandibular disorders (TMD) affect a substantial percentage of the population, and the resources spent on their treatment are considerable. Despite the worldwide efforts around Tissue Engineering of the temporomandibular joint (TMJ) disc, a proper implant offering a long-term solution for TMD was not yet developed. To contribute to these efforts, this work is focused on the research and development of implants for TMJ disc regeneration. Scaffolds and hydrogels mimicking the TMJ disc of black Merino sheep were produced using different materials, poly(ε-caprolactone) (PCL) and poly(ethylene glycol) diacrylate (PEGDA), and as a multi-material structure. Different parameters of the scaffold manufacturing were assessed: the influence of processing temperatures, filament diameter, and biological environment. Moreover, two multi-material approaches were also assessed, scaffold with a hydrogel shell and scaffold with a hydrogel core. It was found that increasing temperature, the scaffolds’ porosity decreases, increasing their compressive modulus. Decreasing the filament size (300 to 200 μm) decreases the compressive modulus to almost half of the initial value. Scaffolds with 200 μm filaments are the ones with a closer modulus to the native disc and their properties are maintained under hydrated conditions. The introduction of a hydrogel core in these scaffolds presented better mechanical properties to TMJ disc substitution.

Highlights

The temporomandibular joint (TMJ) is the articulation between the glenoid fossa and the articular eminence of the temporal bone and the mandibular condyle, with an interposed fibrocartilaginous disc
Tissue Engineering of the TMJ disc is a promising field that can lead to alternatives to the current treatments for Temporomandibular disorders (TMD)
Combining different materials to mimic the properties of the TMJ disc can help restore function due to the lack of capacity for regenerating and self-repairing the TMJ disc

Summary

Introduction

The temporomandibular joint (TMJ) is the articulation between the glenoid fossa and the articular eminence of the temporal bone and the mandibular condyle, with an interposed fibrocartilaginous disc. Several studies indicate that TMD symptoms are more common in females and in the young and middle-aged adult population (Manfredini et al, 2011; KÖhler et al, 2012; Minghelli et al, 2014b). For patients with TMD, the prevalence is estimated to be 45% for muscle disorders, 41% for disc displacement and 30% for other joint disorders (Manfredini et al, 2011). In Portugal, studies indicate that TMD symptoms are experienced by 42% of the adult population (31% in males and 48% in females) (Minghelli et al, 2014b) and 25% of the young population (Minghelli et al, 2014a)

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