Temporomandibular Joint Disc Replacement: Biomechanical Characterization and Novel Implant Assessment

/Abstract 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 stress 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 joint reconstructions and total joint replacement. Therefore, there is a critical need for disc replacements that can restore the homeostasis of the joint when disc resection is required. 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. 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 stress in the joint (Specific Aim 1). Further, non-resorbable composite hydrogels will be fabricated using biocompatible materials, refined to exhibit biomimetic properties, and molded into a 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. Project Number: 1R01DE035875-01 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Dental and Craniofacial Research (NIDCR) | Principal Investigator: Kevin Labus | Institution: COLORADO STATE UNIVERSITY, FORT COLLINS, CO | Award Amount: $659,747 | Activity Code: R01 | Study Section: Musculoskeletal Tissue Engineering Study Section[MTE] View on NIH RePORTER: https://reporter.nih.gov/project-details/11347910