Michael S. Detamore PhD

Enhancing Bone Regeneration for a Patient-Fitted Temporomandibular Joint Prosthesis

Michael Detamore is the Founding Director, Professor, and Stephenson Chair #1 of the Stephenson School of Biomedical Engineering at the University of Oklahoma. He is the recipient of the NSF CAREER Award and the Coulter Foundation Translational Research Award, and was a Fulbright Scholar and Visiting Professor at NUI Galway in Ireland in 2011. His primary research interest is regenerative medicine, including biomaterials and stem cells. Regenerative medicine efforts include nerve regeneration, but focus primarily on bone and cartilage regeneration, including the temporomandibular joint (TMJ), knee, cranium, and trachea, with a particular focus on translational regenerative medicine.

Abstract:

The long-term goal is to deliver a biomaterial device to regenerate the mandibular condyle for patients with select TMJ disorders. The TMJ, or jaw joint, is the only joint in the body not under the orthopedic umbrella and has thus been left behind other joints in many regards. Patients suffering from TMJ disorders may find daily activities such as talking, laughing, yawning, or eating to be painful and difficult. In severe cases, a total joint replacement may be required, and a biomaterial joint replacement may be preferred over conventional alloplastic implants for indications including condylar fractures in pediatric patients.

A 3D-printed, custom mandibular condyle prosthesis was designed to be ‘plug and play’ for a surgeon to affix to the mandible, and allow the option for the TMJ disc to be preserved, with the goal of regenerating into a healthy condyle. In a previous OSF project, feasibility with survival and jaw function was demonstrated in a goat model, with the demonstrated possibility of a fibrocartilage layer on the condylar head and healthy TMJ disc after 6 months. However, there was a need to enhance bone regeneration within the condylar head of the prosthesis, which is the focus of the current project.

Our strategy is to ensure the design supports load transmission, revise the design to accommodate syringe addition of marrow with BMP-2-releasing microspheres, and replace hydroxyapatite (HAp) with demineralized bone matrix (DBM). We hypothesize that pre-loading our patient-fitted TMJ prosthesis with autologous bone marrow and BMP-2 microspheres, and ensuring some degree of load transmission to underlying bone, will lead to enhanced condylar bone regeneration. To test our hypothesis, we propose three Specific Aims: 1) Tune the degradation and stiffness of 3D-printed prosthesis biomaterials, 2) Determine loading of bone morphogenetic protein (BMP)-2 in microspheres, and 3) Characterize hard and soft tissue regeneration in a sheep TMJ model.