Engineered cartilage, bone, joints, and menisci - Potential for temporomandibular joint reconstruction

Reconstruction of many musculoskeletal structures can be accomplished by bo ne grafting and implantation of prostheses. Alternate approaches are needed , however, for repair of complex structures such as articular cartilage sur faces and the temporomandibular meniscus and joint. Tissue engineering, eit her cell-free or cell-based, offers promise because of recent advances in m aterials research and in our knowledge of the cellular and molecular mechan isms of tissue repair. There are th ree considerations in designing a const ruct for engineered tissue: the source of cells, if any; the nature of the carrier or scaffold; and use, if any, of genes, factors, or adjuvants. Auto genous cells, often expanded in vitro, have been useful for cartilage tissu e engineering. Precursor/progenitor cells are advantageous for bone tissue. There are many natural and synthetic resorbable materials with good biocom patibility and tissue compatibility that can be modified to have the porosi ty and mechanical properties needed for specific applications. The scaffold s can also be modified to provide biological signals to augment repair and integration. Copyright (C) 2001 S. Karger AG, Basel.