At a Glance
Researchers in the Orthopaedic Biomedical Research Lab (OBRL) at Colorado State University have developed a patient specific molded polyvinyl alcohol (PVA) hydrogel with a microfiber mesh. These new hydrogel constructs are created using computed tomography (CT) images to mold to a patient’s anatomy. This combination represents a promising artificial replacement strategy for the temporomandibular joint disc.
The temporomandibular joint (TMJ) acts like a sliding hinge, connecting the jawbone to the skull. TMJ disorders, a type of temporomandibular disorder or TMD, can cause pain in the jaw joint and in the muscles that control jaw movement (1). State of the art treatments for temporomandibular joint disorders begin with palliative patient care such as rest and soft diet, or bite guards and physical therapy. If pain persists, the gold standard surgical technique is disc resection. A temporalis muscle flap or skin/fat autograft may be used in place of the resected disc, however this does not seem to improve outcomes over resection.
Currently, there are no available artificial TMJ disc replacements. TMJ degeneration typically accelerates post resection, leaving many patients unable to use their jaw fully and pain free.
The hydrogel construct described here would be an early intervention for preventing the advance of TMD. By replacing the disc with an artificial one, made of biocompatible PVA with exceptional mechanical toughness and a low coefficient of friction, surgeons may prevent the need for a total TMJ replacement and restore TMJ functionality for patients.
Figure 1 (below) illustrates the substantial similarities in mechanical properties of the hydrogel construct as compared to native TMJ disc.
Figure 1: Comparative mechanical properties of the ovine TMJ disc and a 20% weight PVA hydrogel from (A) friction at different applied pressures, (B) indentation in short and long term states, (C) unconfined compression, and (D) tensile testing aligned in the anterior-posterior (AP) and medio-lateral (ML) anatomic planes.
- Molded to patient imaging scans, giving an individualized fit
- Comparative mechanical properties to native TMJ disc (see additional figures)
- Tunable properties may allow for other cartilage constructs to be replaced (i.e. menisci)
- Can be modified to include drug release or tissue integration characteristics
- Disc replacement
- temporomandibular joint (TMJ)
- spinal disc
Last updated: April 2022