Extended temporomandibular joint prostheses: a retrospective analysis of feasibility, outcomes, and complications

Abstract

Prostheses for extended total temporomandibular joint replacement (eTJR) include modifications to the traditional alloplastic fossa–condyle joint that extend to adjacent bone defects. The aim of this retrospective study was to assess the feasibility, postoperative complications, and functional and aesthetic outcomes after eTJR. Patients aged ≥18 years undergoing eTJR between 2013 and 2022 were included. Data recorded were age, sex, comorbidities, indication for eTJR, prosthesis brand, classification, concomitant surgical procedures, postoperative complications, maximum inter-incisal opening (MIO), pain, quality of life (QoL), and aesthetic outcome. Twenty-five patients (mean age 40 years), with a total of 30 joint prostheses, were included. Over a median follow-up of 42 months, there was a significant improvement in MIO in patients with reduced mouth opening at baseline (P = 0.003), as well as in pain (P = 0.007) and QoL (P = 0.004). Both patients and surgeons judged facial appearance as improved or unchanged in 88% of cases. Postoperative complications included permanent trigeminal nerve hypoesthesia (44%), permanent facial nerve dysfunction (35%), infection (8%), salivary leak (4%), and lingual nerve impairment (4%). The findings suggest that eTJR is a safe and effective treatment for temporomandibular joint deficits extending to adjacent structures, yielding satisfactory functional and aesthetic outcomes.