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Looking for Relief from TMJ Pain A lot of us have a trick knee or a bad hip or shoulder, but one of the most grating and painful joint problems is in the temporomandibular joint, or TMJ, where the jawbone connects to the skull.
MOBster on a Creative High Note Thanks to Scholarship Support Jeff Morrow ’06 exemplifies what it means to be a member of the MOB. Over the past three years, he’s played the clarinet, written show scripts, and quietly completed other behind–the–scenes work. With such dedication to the MOB, it is fitting that Jeff has been named the first recipient of the Rebecca Margaret Pollard-Grayson Scholarship for an outstanding MOB member. The award was created by Brian Grayson ’94 and his wife, Elizabeth, in memory of their infant daughter, Rebecca, so that they could make a mark in the world for her. Even though Rebecca will never get the chance to wear Lewis, a stuffed moose, on her fedora as her father did when he was in the Marching Owl Band, the scholarship in her honor will enable more students like Jeff to have a Rice and MOB experience they’ll always treasure. Jeff says he’s touched that a family in their time of loss would reach out to help students like him. “I’m proud to carry on the memory of Rebecca, and I’m pleased that the MOB can recognize future members with this award.”
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Symptoms can range from minor and occasional pain due to clenching the jaw or grinding the teeth to severe, debilitating pain that requires hospitalization or surgery. Because the TMJ is essential for basic functions like speaking, chewing, and swallowing, TMJ disorders can seriously degrade a person’s quality of life and lead to severe depression. According to the National Institute of Dental and Craniofacial Research, nearly 11 million Americans suffer from TMJ disorders. Though the precise causes remain unknown, approximately 70 percent of all TMJ disorders involve displacement of the TMJ disc, a thin sheet of cartilage the size of a postage stamp that sits between the lower jaw and the skull. This sliver of cartilage cannot heal itself if it is injured or damaged, and there are no synthetic materials that can replace a damaged or injured TMJ disc. But help may be on the way. Rice bioengineers have received a five-year, $1.5 million grant from the National Institutes of Health (NIH) to develop new methods of using a person’s own cells to grow replacement cartilage for surgical implantation in patients suffering from TMJ disorders. “Our project marks the first time that a research group has tried to engineer the entire TMJ disc in vitro in the laboratory,” says Kyriacos Athanasiou, the Karl F. Hasselmann Professor of Bioengineering at Rice and the principal investigator on the NIH grant. “This is a tall order because there is scant information about what the TMJ disc is, what it is made of, what its functions are, what its pathologies are, and how its pathologies develop.” Athanasiou’s Musculoskeletal Bioengineering Laboratory specializes in growing cartilage tissues. There are projects under way to grow articular cartilage—which accounts for about half of all cartilage in the body—as well as more specialized types, such as the knee meniscus, a disc of cartilage that separates bones in the knee. Both the TMJ disc and the knee meniscus are unique, with properties different from any other cartilage in the body, but unlike the meniscus, the properties of the
TMJ disc—its compressive and tensile stiffness, for example, or the proportion and types of collagen it contains—are largely unknown. Athanasiou and colleagues have been laying the groundwork for the TMJ tissue-engineering program for four years. Earlier this year, he and his students published a review of the complex biochemical, biomechanical, and cellular properties of the joint disc and the challenges these properties pose for tissue-engineering approaches to reconstruction.
“Our project marks the first time that a research group has tried to engineer the entire TMJ disc in vitro in the laboratory.” —Kyriacos Athanasiou
In the early stages of the tissueengineering program, Athanasiou’s team will continue to characterize and compare tissues grown from adult animal cells. In growing the samples, the team will sort out the complex regime of biomechanical cues and growth factors that are needed to coax cells into producing TMJ cartilage. The researchers expect that a combination of mechanical stimuli and biochemical signals will be needed to make the tissue grow properly. Following a systematic experimental design, the team will try various combinations of stimuli and growth factors to determine the best regime for growing TMJ discs that are suitable for surgical implantation. “I have served as a scientific advisor to an advocacy group called the TMJ Association for several years,” Athanasiou says, “and I’ve gotten a glimpse of the pain and suffering that TMJ patients endure on a daily basis. It is my fervent hope that our work can help some of these people live normal and pain-free lives.” —Jade Boyd