Review

Principles of cartilage tissue engineering in TMJ reconstruction

Christian Naujoks¹ , Ulrich Meyer¹ , Hans-Peter Wiesmann² , Janine Jäsche-Meyer³ , Ariane Hohoff³ , Rita Depprich¹ and Jörg Handschel¹

¹  Clinic for Maxillofacial and Plastic Facial Surgery, Westdeutsche Kieferklinik, University of Düsseldorf, Germany

²  Clinic for Cranio-Maxillofacial Surgery, University of Münster, Germany

³  Clinic for Orthodontics, University of Münster, Germany

author email corresponding author email

Head & Face Medicine 2008, 4:3doi:10.1186/1746-160X-4-3

Published:	25 February 2008

Abstract

Diseases and defects of the temporomandibular joint (TMJ), compromising the cartilaginous layer of the condyle, impose a significant treatment challenge. Different regeneration approaches, especially surgical interventions at the TMJ's cartilage surface, are established treatment methods in maxillofacial surgery but fail to induce a regeneration ad integrum. Cartilage tissue engineering, in contrast, is a newly introduced treatment option in cartilage reconstruction strategies aimed to heal cartilaginous defects. Because cartilage has a limited capacity for intrinsic repair, and even minor lesions or injuries may lead to progressive damage, biological oriented approaches have gained special interest in cartilage therapy. Cell based cartilage regeneration is suggested to improve cartilage repair or reconstruction therapies. Autologous cell implantation, for example, is the first step as a clinically used cell based regeneration option. More advanced or complex therapeutical options (extracorporeal cartilage engineering, genetic engineering, both under evaluation in pre-clinical investigations) have not reached the level of clinical trials but may be approached in the near future. In order to understand cartilage tissue engineering as a new treatment option, an overview of the biological, engineering, and clinical challenges as well as the inherent constraints of the different treatment modalities are given in this paper.