Scaffolds and Stem Cells Show Promise for TMJ Regeneration: A Systematic Review

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Orthopedics

Background:

• Temporomandibular joint (TMJ) disorders are common chronic degenerative conditions lacking effective regenerative treatments.
• Current therapies offer limited efficacy, creating a need for biologically based regenerative approaches.
• Tissue engineering (TE) using scaffolds presents a promising strategy for TMJ regeneration.

Purpose of the Study:

• To systematically review preclinical in vivo studies on scaffold-based interventions for TMJ disc and osteochondral repair.
• To analyze scaffold composition, cellular/bioactive components, animal models, and outcomes.
• To identify limitations and future research directions for clinical translation.

Main Methods:

• Systematic literature search of PubMed and Scopus databases.
• Inclusion of 39 eligible preclinical in vivo studies.
• Data extraction on scaffold materials, biological additives, models, and reported outcomes (histological, radiological, functional).

Main Results:

• Natural scaffolds (e.g., decellularized ECM, collagen) promote biocompatibility and fibrocartilage regeneration.
• Synthetic scaffolds (e.g., PCL, PLGA) offer mechanical stability and tunable structures.
• Cellular incorporation (43% of studies) and bioactive molecules (e.g., TGF-β, PRP) enhanced regeneration, with emerging drug/gene delivery showing potential.

Conclusions:

• Scaffold-based TE demonstrates preclinical potential for TMJ regeneration.
• Substantial heterogeneity in study design, outcome measures, and animal models limits direct comparison and translation.
• Standardized methodologies, long-term functional evaluation, and large-animal models are crucial for future clinical application.