Etiology and basic research progress on temporomandibular joint disc destruction

Temporomandibular joint (TMJ) is the only synovial joint in the oral and maxillofacial region, with its disc being a critical fibrocartilaginous structure that distributes stress and maintains the stability of joint movement. Various factors can lead to TMJ disc destruction, resulting in TMJ dysfunction and facial deformities. In recent years, research on TMJ disc destruction has become a frontier in the field of oral and maxillofacial surgery. Previous research and literature reviews have mainly focused on diagnosis and treatment, with a lack of reviews on the progress of basic research related to disc destruction. This review summarizes current progress in the etiology, pathological features, molecular mechanisms, and tissue-engineered repair materials of TMJ disc destruction, providing reference for basic research and clinical prevention and treatment. Studies have shown that the causes of TMJ disc destruction include mechanical damage (e.g. anterior disc displacement, malocclusion, trauma), chronic inflammation (e.g. TMJ osteoarthritis, rheumatoid arthritis), and susceptibility factors such as age and sex, as well as psychosocial factors. Its main manifestations are alterations in the ultrastructure and mechanical properties of collagen fibers. Its molecular mechanisms include abnormal angiogenesis, imbalanced fibrocartilage cell homeostasis under mechanical or inflammatory stimulation, and abnormal stem cell differentiation. The present study focuses on the development and optimization of tissue engineered biomaterials through cell sources, scaffold materials, and growth factors. Future studies should focus on the molecular mechanisms of TMJ disc destruction, regulation of disc development during embryonic and postnatal stages, development and translation of novel biomaterials, as well as the application of artificial intelligence in material design, molecular target screening, and clinical decision-making.