Matrix-associated chondrocyte transplantation for reconstruction of articulating surfaces in the temporomandibular joint: a pilot study covering medium- and long-term outcomes of 6 patients

Publication date: Available online 9 March 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Gerhard Undt, Michael Jahl, Sebastian Pohl, Stefan Marlovits, Doris Moser, Hyang-Hee Yoon, Jimmy Frank, Susanna Lang, Christian Czerny, Guenter Klima, Eileen Gentleman, Rolf Ewers
ObjectivesMatrix associated chondrocyte transplantation (MACT) is routinely used in joints of the extremities, but not in the temporomandibular joint (TMJ).Study designWe report the first case series in 7 patients of a tissue engineering approach to regenerate severely degraded articulating surfaces in the TMJ by simultaneously completely resurfacing both the mandibular condyle and the articular eminence/glenoid fossa with a commercially available collagen sponge seeded with autologous cells stabilised within a fibrin matrix. To facilitate healing, we temporarily employed a silicone membrane to protect the engineered tissues. The indications for surgery were post-traumatic fibro-osseous ankylosis, ankylosing osteoarthritis or late stage osteoarthritis.ResultsSix of the patients were recalled for follow-up after 3 years 6 months to 12 years 1 month. The maximum incisal opening was 18.2mm ± 9.2mm (min 9, max 33mm) before and 31.2mm ± 13.6mm (min 12, max 47mm) at the latest follow-up. Histological specimens taken at 4 months showed beginning differentiation of fibrocytes into chondrocytes, whereas at 3 and 11 years, mature hyaline cartilage – not typical for the TMJ - was present.ConclusionWe conclude that the reconstruction of TMJ surfaces by matrix associated chondrocyte transplantation may become a routine method for cartilage regeneration in the temporomandibular joint in the future.



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