Design characteristics for temporomandibular joint disc tissue engineering: learning from tendon and articular cartilage

Tissue engineering of chondrocytic or fibroblastic musculoskeletal tissues has been relatively well studied compared with that of the temporomandibular joint (TMJ) disc. Early attempts at tissue engineering the disc have been misguided owing to a lack of understanding of the composition and function of the TMJ disc. The objective of this review is to compare the TMJ disc with a chondrocytic tissue (hyaline articular cartilage) and a fibroblastic tissue (tendon) to understand better the properties of this fibrocartilaginous tissue. The TMJ disc has 25 times more glycosaminoglycan (GAG) per dry weight than tendon but half that of articular cartilage. The disc's tensile modulus is six times more than cartilage but orders less than tendon. The GAG content and tensile modulus suggest that the TMJ disc is characterized as a tissue between hyaline cartilage and tendon, but the disc appears more tendon like when considering its collagen make-up and cell content. Like tendon, the TMJ disc contains primarily collagen type I at 85 per cent per dry weight, while articular cartilage has 30 per cent less collagen, which is type II. Knowledge of quantitative comparisons between joint tissues can give extensive insight into how to improve tissue engineering of the TMJ disc.