title: Autologous temporomandibular joint reconstruction independent of exogenous additives: a proof-of-concept study for guided self-generation.
abstract: Joint defects are complex and difficult to reconstruct. By exploiting the body's own regenerative capacity, we aimed to individually generate anatomically precise neo-tissue constructs for autologous joint reconstruction without using any exogenous additives. In a goat model, CT scans of the mandibular condyle including articular surface and a large portion of the ascending ramus were processed using computer-aided design and manufacturing. A corresponding hydroxylapatite negative mold was printed in 3D and temporarily embedded into the transition zone of costal periosteum and perichondrium. A demineralized bone matrix scaffold implanted on the contralateral side served as control. Neo-tissue constructs obtained by guided self-generation exhibited accurate configuration, robust vascularization, biomechanical stability, and function. After autologous replacement surgery, the constructs showed stable results with similar anatomical, histological, and functional findings compared to native controls. Further studies are required to assess long-term outcome and possible extensions to other further applications. The absence of exogenous cells, growth factors, and scaffolds may facilitate clinical translation of this approach.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Wei
authors.affiliation: Plastic Surgery and Burn Center, Trauma Center Murnau, Munich, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Herrler
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Rulin
authors.initials: R
authors.lastname: Huang
authors.affiliation: Klinik für Allgemeine, Viszeral-, Transplantations-, Gefäß- und Thoraxchirurgie, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Guba
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Chuanchang
authors.initials: C
authors.lastname: Dai
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Li
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D001696:Biomechanical Phenomena; D002358:Cartilage, Articular / Q000502:physiology; D017886:Durapatite / Q000737:chemistry; D005260:Female; D006041:Goats; D008297:Male; D063175:Mandibular Reconstruction / Q000379:methods*; D010012:Osteogenesis / Q000502:physiology; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D014057:Tomography, X-Ray Computed
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite