Evolving Horizons in Temporomandibular Joint Total Replacement: A Comprehensive Narrative Review

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Total temporomandibular joint (TMJ) replacement has become a vital solution for managing end-stage TMJ disorders and significantly enhancing mandibular function and patient quality of life. This narrative review explores the historical developments, clinical objectives, biomaterials, devices, surgical techniques, preoperative preparation, complications, management approaches, and recent innovations in TMJ total joint replacement (TJR). The review draws from a literature search conducted across PubMed, Scopus, Web of Science, and Google Scholar from database inception to August 10, 2025, using terms like "total temporomandibular joint replacement," "TMJ TJR," and "alloplastic TMJ prosthesis," focusing on English-language peer-reviewed articles, reviews, and clinical studies. Current practice leans toward alloplastic reconstruction, utilizing titanium alloys for osseointegration and ultra-high molecular weight polyethylene (UHMWPE) for low-friction surfaces, supported by custom designs via computer-aided design and manufacturing (CAD/CAM). Surgical approaches, including preauricular, retromandibular, and rhytidectomy techniques, have been refined to protect critical structures, such as the facial nerve and internal maxillary artery. Preoperative preparation involves patient education on risks, such as infection and nerve injury; advanced imaging with computed tomography (CT) and

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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