ABSTRACT Temporomandibular disorders (TMD) are a significant public health and societal problem that manifests itself in pain, compromised joint and overall function, and affecting up to 10% of the population. Since pain frequently occurs with a plethora of mostly subjective symptoms, TMD are frequently misdiagnosed and treatments are frequently non-standardized and ineffective. While investments in TMD research have been made over the past several decades, there has been limited success in translating such research to the clinic. Likewise, the heterogeneity in symptoms and complexity of a disease that impacts the joint, muscle, and nervous systems, complicates the understanding of disease etiology and mechanisms, and impairs the development of evidence- based therapies. As a result, basic and clinical research on TMD are frequently divorced from one another, with insufficient linkages between basic discoveries and clinical needs. To advance basic, clinical, and translational TMD research in an integrated manner, we will establish an interactive, multi- disciplinary team at Michigan in partnership with the clinical practice community as a means of forming a patient-centered collaborative ecosystem. The goal of our IMPACT program is to transform the treatment of TMD patients through the translation of clinically-relevant innovations. Our vision is to integrate life science, engineering and health technologies to solve clinically-defined problems in a translational infrastructure environment. Herein, we will develop an organizational structure, ecosystem and operational procedures for establishing a consortium that integrates basic and clinical research in TMD and guides the most promising research toward translation in an evidence-based manner to improve clinical care. To achieve this vision, we leverage the experience and leadership of the NIDCR center program in regenerative medicine (DOCTRC) at Michigan to guide our planning of how to best catalyze basic research through the translational pipeline and into the clinic. In this R34, we will design the structure and develop an implementation strategy for the future TMD collaborative via the following aims: 1) Develop a multi-disciplinary organizational structure and processes to inform basic and patient-centered research that yield a mechanistic understanding of TMDs and development of diagnostics and therapies suitable for translation to clinical practice. 2) Integrate diverse teams that support the collaboration of basic and clinical research and processes for selecting research themes and projects that can be translated into clinical practice. 3) Formulate operating procedures to support the clinical translation of innovative TMD technologies and therapies. Upon completion of the aims, we will be uniquely positioned to advance basic and clinical TMD research, research training, and translation to evidence-based treatments leading to a transformation in TMD care.

PROJECT NARRATIVE Temporomandibular disorders (TMD) are a significant public health and societal problem that manifests itself in pain, compromised joint and overall function, and affects up to 10% of the population. We will establish an interactive, multi-disciplinary team at Michigan to form a patient-centered collaborative ecosystem to advance basic and clinical TMD research, research training, and translation to evidence-based treatments leading to a transformation in TMD care.