Patients opting for TMJ disc removal face issues due to the absence of FDA-approved replacements, leading to bone-to-bone contact and subsequent joint problems. Autografts, like dermis-fat grafts, typically resorb within a year. Our goal is a secure disc replacement alternative. Previous studies demonstrated rapid transformation of an acellular ECM scaffold into TMJ disc-like tissue in canine and porcine models. The canine model, chosen for its hinge- socket preventing implant migration, lacks human-like motions, and pig models have access issues. Introducing the goat model, with human-like access and motions, addresses these limitations. Proposed research focuses on the 12-month clinical endpoint, investigating the impact of a pathogenic TMJ environment on remodeling a porcine SIS scaffold into a neo-disc in goats. We aim to determine the long-term (6, 9, 12 months) functional remodeling of SIS scaffolds in the TMJ, hypothesizing higher tensile moduli than dermis-fat autografts, even in a pathological environment. Addressing a critical gap in understanding outcomes beyond 6 months is crucial for clinical translation. This work aims to provide a groundbreaking, safe TMJ disc treatment, preventing joint damage and revolutionizing surgical management for TMJ patients, with the potential to significantly improve outcomes.

This proposal describes work in which a biologic scaffold composed of mammalian extracellular matrix will be used as an inductive scaffold for the in vivo generation of the temporomandibular joint disc. This inductive template will stimulate the rapid endogenous formation of a fibrocartilaginous disc that closely mimics the structure, composition and function of native disc material. The proposal will provide the first safe treatment following disc removal, improving outcomes for patients by preventing joint damage from long term bone-on-bone articulation.