Quality of Life After Total Temporomandibular Joint Prothesis Surgery

Total temporomandibular joint (TMJ) prostheses are increasingly used in patients with joint destruction presenting significant pain and mouth opening limitation. This surgery can be considered as the last resort solution whose goal is to restore the mandible function. The aim of this study was to evaluate the patient quality of life (QoL) before and after TMJ replacement surgery with a total TMJ prosthesis, using a modified QoL scale.

All patients with a total uni or bilateral TMJ prosthesis who could be contacted were included. All patients completed 2 retrospective questionnaires: once relative to the preoperative QoL and another for the post-operative QoL, including the assessment of mouth opening limitation, daily eating difficulties and also a QoL score, adapted from the TMJ-QoL questionnaire.

A total of 17 patients were included: 13 temporomandibular ankylosis, 3 condylar resorptions and 1 congenital malformation. Mouth opening limitation and daily eating difficulties were significantly reduced after surgery ( P < 0.001). Nine of the 11 QoL questions showed a significant decrease in score and thus an improvement of the QoL after surgery: having a conversation ( P = 0.006), eating ( P < 0.001), yawning ( P < 0.001), sleeping ( P = 0.043), recreational activities ( P = 0.005), relaxing ( P = 0.021), feeling depressed because of TMJ problems ( P = 0.032), daily activities ( P = 0.008) and patient self-assessment of QoL ( P = 0.003). Two showed no significant difference: taking analgesics, and social life. Total score of QoL showed a significant improvement ( P = 0.003).

Quality of life, mouth opening, and daily eating were significantly improved after total TMJ prosthesis, in agreement with the litterature. The TMJ prosthesis could be considered ealier in the management of end-stage temporomandibular disease.