Distraction osteogenesis offers the potential for autogenous reconstruction of the temporomandibular joint using an in vivo tissue-engineering technique. A study conducted by Koslovsky, et al investigated the feasibility of TMJ reconstruction with distraction osteogenesis using an animal model (minipig). Os- teoarthritic changes were induced with injection of a sclerosing solution into the left TMJ, and at 6 weeks, left mandibular condylectomy and discectomy were performed to create a gap of 15 to 20 mm between the glenoid fossa and remaining mandible. A distraction device was fixed to the bone and activated 1 mm per day for 20 days after a 7-day latency period. The minipigs consumed a normal diet for 2 months, then the distraction devices were removed; a normal diet was consumed for an additional 3 months. Five months following the docking of the condylar transport segment into the glenoid fossa, block sections of the experimental left TMJ as well as the bone in the distraction gap were examined histologically. The experimental tissue was compared to the right (control) side. The study found a functional temporomandibular joint was formed in the animals with creation of a joint space, fibrous tissue surfaces, and synovial tissues. All animals gained weight throughout the 7 months of the study. The authors anticipate that further studies are likely to result in a new and improved technique of autogenous reconstruction of the TMJ using distraction osteogenesis. Additional human clinical trials are required.
(Source: Jarvie, Journal of the William Jarvie Society, Vol. 48, Spring, 2005. Note: This research was supported by the Dentistry Today Student Research Fellowship at the Columbia University School of Dental and Oral Surgery.)
