Alloplastic Temporomandibular Total Joint Replacement

Abstract

Alloplastic temporomandibular total joint reconstruction provides an effective surgical treatment option for patients with end-stage temporomandibular joint disease. While temporomandibular disorders are often initially managed with non-surgical modalities, severe ankylosis, aberrant anatomic deformity, or loss of primary function necessitates surgical intervention in patients with late-stage disease. Modern advancements in the field of temporomandibular joint replacement, especially over the last three to four decades, have improved upon initial challenges of poor prosthetic design and improper material selection. Modern alloplastic prosthetic devices, including both stock and custom patient-fitted prostheses, have been shown to be both safe and effective in restoring temporomandibular form and function. Alloplastic temporomandibular total joint replacement now represents a successful surgical solution with advantages including improved accessibility, reduced operative time, earlier return to mobilization, and lower morbidity risks than autogenous methods. This chapter will provide an overview of the fundamental principles of temporomandibular joint replacement, indications for surgery, patient selection, stock versus custom prostheses, outcomes, and potential complications with reference to the current body of literature.