Functional Biomaterials and 3D Bioprinting Approaches for Temporomandibular Joint Reconstruction: A Narrative Review.

The temporomandibular joint (TMJ) is a highly specialized synovial joint responsible for essential functions such as mastication, speech, and swallowing. Owing to its unique anatomical organization, complex biomechanics, and heterogeneous tissue composition, regeneration of the TMJ remains one of the greatest challenges in craniofacial reconstructive surgery. Conventional treatment modalities, including autologous grafts, alloplastic prostheses, and total joint replacement, are associated with several limitations, including donor-site morbidity, prosthetic wear, limited biological integration, and the inability to restore native tissue architecture. Three-dimensional (3D) bioprinting has emerged as a promising regenerative strategy capable of fabricating patient-specific living constructs that closely mimic the structural and functional characteristics of the native joint. This review summarizes recent advances in TMJ bioprinting, with particular emphasis on the regeneration of the mandibular condylar fibrocartilage, subchondral bone, articular disc, and integrated osteochondral constructs. The literature search covered publications from January 2010 through March 2026, and it was conducted using major scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Current progress in cellular sources, including mesenchymal stem cells and induced pluripotent stem cells, biomaterials and bioinks, growth factor delivery, and multimaterial bioprinting technologies is discussed. Particular attention is given to the challenges associated with reproducing the complex osteochondral interface, achieving adequate vascularization, ensuring long-term mechanical stability, and directing tissue-specific cell differentiation. Emerging technologies, including four-dimensional (4D) bioprinting, decellularized extracellular matrix-based bioinks, artificial intelligence-assisted design, patient-specific computational modeling, and bioreactor-mediated tissue maturation, are highlighted as promising approaches to improve construct functionality and clinical translation. Although the clinical application of TMJ bioprinting remains in its early stages, rapid advances in regenerative medicine and biofabrication technologies indicate that personalized bioengineered joint reconstruction may become a viable therapeutic option for the treatment of severe temporomandibular joint disorders in the future.