A Novel Fiber Embedded Hydrogel Temporomandibular Joint Disc Replacement

项目摘要 颞下颌关节（TMJ）疾病造成约5%至12%的人口。治疗晚期 关节颞下颌关节盘的疾病，通常不响应保守治疗，椎间盘切除术是 最常见的外科手术然而，颞下颌关节盘在分配机械力方面起着关键作用， 应力并防止关节的关节表面磨损。因此，移除椎间盘会进一步破坏 关节内稳态，驱动退化和骨关节炎的发展，这可能导致高度侵入性 以及具有挑战性的外科手术，例如重建和全关节置换。的现有尝试 用异体植入物替换椎间盘导致了与磨损相关的有害病理变化 碎片、植入物碎裂和不良炎症反应。因此，考虑磨损至关重要， 机械强度和生物相容性， 在颞下颌关节内加载。总的来说，迫切需要椎间盘置换术，可以恢复体内平衡， 在发生严重关节退变之前需要切除椎间盘时，因此 本建议的目的是创造一个人工颞下颌关节盘，取代天然的机械功能， 椎间盘，并防止随后的关节退化。为了实现这一目标，拟议的研究将 表征TMJ的机械负荷环境，以确定 需要进行TMJ椎间盘置换，以最大限度地减少关节内应力（具体目标1）。此外，非- 将制造可吸收的纤维包埋的水凝胶材料，优化以表现出仿生特性， 并开发成患者专用的人造颞下颌关节盘植入物。严格的机械评估将 确定材料作为TMJ椎间盘置换物的耐久性和适用性（具体目标2）。最后，一种大型动物 本研究将用于评估所开发的颞下颌关节盘置换术（特定目的）的安全性和有效性 3）。成功完成拟议的工作将代表一个范式转变的治疗颞下颌关节盘 这些疾病可以减轻进一步的关节退化，并防止更侵入性和复杂的手术。

Project Summary Temporomandibular joint (TMJ) disorders inflict approximately 5% to 12% of the population. For advanced disorders of the articular TMJ disc, which typically do not respond to conservative treatments, disc resection is the most common surgical intervention. However, the TMJ disc plays a critical role in distributing mechanical stresses and preventing wear to the articular surfaces of the joint. Thus, removing the disc can further disrupt joint homeostasis, driving degeneration and the development of osteoarthritis, which can lead to highly invasive and challenging surgical interventions such as reconstructions and total joint replacement. Prior attempts at replacing the disc with alloplastic implants have led to deleterious pathological changes related to wear debris, implant fragmentation, and adverse inflammatory responses. Therefore, it is crucial to consider wear, mechanical strength, and biocompatibility of disc replacement materials in the context of long-term cyclic loading in the TMJ. Overall, there is a critical need for disc replacements that can restore the homeostasis of the joint when disc resection is required prior to the development of severe joint degeneration. Accordingly, the objective of this proposal is to create an artificial TMJ disc that replaces the mechanical function of the native disc and prevents subsequent degeneration of the joint. Towards this goal, the proposed research will characterize the mechanical loading environment of the TMJ in order to determine the mechanical criteria of a TMJ disc replacement needed to minimize internal stresses in the joint (Specific Aim 1). Further, non- resorbable fiber-embedded hydrogel materials will be fabricated, optimized to exhibit biomimetic properties, and developed into a patient-specific synthetic TMJ disc implant. Rigorous mechanical evaluations will determine material durability and suitability as a TMJ disc replacement (Specific Aim 2). Finally, a large animal study will be utilized to evaluate the safety and efficacy of the developed TMJ disc replacement (Specific Aim 3). Successful completion of the proposed work would represent a paradigm shift in the treatment of TMJ disc disorders that can mitigate further joint degeneration and prevent more invasive and complicated surgeries.