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TMJ Replacement in Degenerative Disease: A Systematic Review
Víctor Ravelo1,2, Erick Vargas3,4, Henry García Guevara5,6
1Grupo de Investigación de Pregrado en Odontología (GIPO), Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco 4780000, Chile.
Journal of Clinical Medicine
|January 25, 2025
Summary
Total temporomandibular joint (TMJ) replacement significantly improves function and reduces pain in patients with degenerative or inflammatory joint diseases. Post-surgery, patients experience enhanced mouth opening and can consume solid foods, indicating favorable long-term outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Rheumatology
- Biomaterials Science
Background:
- Degenerative and inflammatory joint diseases significantly impair temporomandibular joint (TMJ) function, often leading to severe pain and limited mandibular mobility.
- Current treatment options for advanced TMJ conditions may not fully restore function or alleviate symptoms, necessitating advanced interventions.
Purpose of the Study:
- To systematically review and analyze the indications and clinical outcomes of total TMJ replacement in patients with degenerative and/or inflammatory joint diseases.
- To define patient profiles and intervention conditions associated with total TMJ replacement.
Main Methods:
- A comprehensive systematic review was conducted following Cochrane and PRISMA guidelines, searching major databases (PubMed, Embase, Scopus, Web of Science) and gray literature from 1997 to July 2024.
- Included studies involved patients over 15 years with degenerative/inflammatory TMJ conditions undergoing total joint prosthesis replacement, with a minimum 12-month postoperative follow-up.
- Risk of bias was assessed using ROBINS-I, and evidence quality was evaluated with GRADEpro.
Main Results:
- Osteoarthritis was the most common diagnosis among 579 participants with degenerative/inflammatory TMJ diseases.
- Pre-surgery, participants averaged 24.32 mm mouth opening, experienced moderate to severe pain (76.18%), and required soft/liquid diets.
- Total joint replacement indicated for system failure occurred in only 4.07% of cases.
Conclusions:
- Total TMJ replacement demonstrated favorable long-term results, with all participants reporting reduced or absent pain post-surgery.
- Patients experienced improved mandibular functionality, increased average mouth opening to 40.74 mm, and a diet shift to solid foods.
- Optimal timing for total joint replacement surgery remains unclear, irrespective of disease duration, non-surgical treatment history, or prior surgeries.
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