Alternative Total TMJ Arthroplasty: Metal-on-Metal for Longevity in Implant Survivorship and Patient Satisfaction

Use of biomaterials as an implant device for TMJ joint reconstruction in oral maxillofacial surgery has been an ever-increasing dilemma for the oral maxillofacial surgeon. The decision to choose the best procedure and device/material in providing longevity wirh satisfaction to the patient has become a demanding factor. Maxillofacial surgeons are faced with a "young age" patient population and are in a continual struggle to find the proper device to maintain long-term survivorship without recurrent multiple operations. This multiple operation(s) factor can cause a further complication in itself, and also reduce the survivorship of implant devices. There has been a steady decrease in recent years in the number of TMJ surgical procedures performed by accredited OMS residency training programs; this may be due to the many short-term survivorship failures with certain alloplastic devices (Proplast/Teflon and Silastic) as well as the short-term survivorship of autologous tissue implants (Fascia and Grafts) and the added factor of enhanced complications with multiple surgeries. So the question asked by many oral maxillofacial surgeons is: what other procedure or biomaterial/device, if any, is available to avert the ever-present TMJ disease process and disorder?