Comparative clinical outcomes between stock vs custom temporomandibular total joint replacement systems

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Orthopedic Surgery

Background:

• Temporomandibular joint (TMJ) prosthetic total joint replacement techniques are evolving.
• Debate exists regarding the benefits of custom versus stock prostheses for TMJ replacement.

Purpose of the Study:

• To compare clinical outcomes between custom (OMX) and stock (Zimmer-Biomet) temporomandibular joint prostheses.
• To evaluate the efficacy of custom vs. stock TMJ implants in patients with end-stage joint osteoarthritis.

Main Methods:

• Retrospective analysis of clinical data from 139 prosthetic joints in 117 patients.
• Patients treated by a single surgeon with a minimum 2-year follow-up.
• Cohort divided into stock (n=60) and custom (n=79) prosthesis groups.

Main Results:

• No significant pre-operative differences in maximum interincisal opening (MIO) or pain scores between groups.
• Custom prostheses showed statistically significant improvement in post-operative MIO (+6.33 mm vs +2.53 mm, P=0.013).
• Custom prostheses were associated with fewer post-operative complications; pain scores and patient satisfaction were similar between groups.

Conclusions:

• Both stock and custom TMJ implants are effective in experienced hands.
• Custom prostheses offer advantages in MIO and complication rates.
• Digital technology advancements may lead to custom TMJ devices dominating the market.