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Evolving Horizons in Temporomandibular Joint Total Replacement: A Comprehensive Narrative Review
Yellanti Doondi Dinesh Nag1, Ravada Kinneresh2, Morthala Bala Venkateswara Reddy2
1Department of Oral and Maxillofacial Surgery, Clove Dental Clinic, Hyderabad, IND.
Cureus
|December 2, 2025
Summary
Total temporomandibular joint (TMJ) replacement offers a vital solution for end-stage TMJ disorders, improving function and quality of life. This review covers TMJ total joint replacement (TJR) history, techniques, materials, and innovations.
Area of Science:
- Maxillofacial Surgery
- Biomaterials Science
- Orthopedic Engineering
Background:
- End-stage temporomandibular joint (TMJ) disorders significantly impair mandibular function and patient quality of life.
- Total TMJ replacement (TJR) has emerged as a critical treatment option for these debilitating conditions.
- Alloplastic reconstruction is the current standard, utilizing advanced materials and techniques.
Purpose of the Study:
- To provide a comprehensive narrative review of total temporomandibular joint replacement (TJR).
- To explore historical developments, clinical objectives, biomaterials, surgical techniques, and recent innovations in TMJ TJR.
- To discuss complications, management strategies, and future directions in the field.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar.
- Search terms included "total temporomandibular joint replacement," "TMJ TJR," and "alloplastic TMJ prosthesis."
- Focus was on English-language peer-reviewed articles, reviews, and clinical studies from database inception to August 10, 2025.
Main Results:
- Current TMJ TJR predominantly uses titanium alloys and ultra-high molecular weight polyethylene (UHMWPE) with CAD/CAM customization.
- Refined surgical approaches aim to protect vital structures, while preoperative planning includes advanced imaging and patient education.
- Common complications include heterotopic bone formation and dislocations, managed surgically; nerve injuries and synovial issues require specific interventions.
Conclusions:
- TMJ TJR is a cornerstone in maxillofacial surgery, offering improved outcomes and reduced donor morbidity.
- Bioengineered solutions and nanomaterials show promise for enhanced alloplastic benefits.
- Ongoing research is crucial to address persistent challenges like infection rates and material hypersensitivity, driving continued refinement.
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