Mandibular reconstruction with custom-made extended total temporomandibular joint prosthesis after resection of ameloblastoma:A systematic review.

Objectives: Ameloblastoma (AB) are aggressive odontogenic tumors, often treated with wide marginal resection and concurrent reconstruction. Extended total temporomandibular joint replacement (eTMJR) prosthesis is a viable treatment option for reconstruction of large defects caused by resection of AB tumors. The objective of this study was to systematically review the utilization and effectiveness of eTMJR prosthesis in treating patients with AB tumors.

Methods: A detail search in Web of Science, Medline/PubMed, Google Scholar and Embase identified studies reporting AB patients who underwent implantation of eTMJR prosthesis. Studies reporting the use of eTMJR prosthesis in the management of AB tumors were eligible, with no restriction of the study type, language or year of publication and patient's demographics. Quality assessment of the selected case reports and case series was carried out with the 13 Domains (30 Items) of the CARE checklist, using a scoring scale of "0" (No/ non-adherence), "1" (Yes/ adherence) and "2" (unclear). The completeness of reporting (COR) score was determined as the ratio of "yes" responses to "total" (i.e., yes + no + unclear) responses.

Results: A total of 27 studies were selected for analysis, including 15 case reports, 06 case series and 06 retrospective cohort studies. These studies presented 41 patients of AB who received eTMJR prosthesis. The patients' mean age was 37.8 ± 14.9 (range: 14-72, median: 36) years, whereas the mean follow-up period was 19.7 ± 20.3 (range: 1-84, median 12) months. The majority of studies did not document all clinically relevant data regarding patient clinical presentation, surgical procedures, long-term follow-up and post-operative complications. The mean ± SD (range, median) COR score for all case reports/ series was 61.7 ± 23.5 (4.0-100, 64.0) %.

Conclusion: The use of eTMJR prosthesis in the management of AB tumors has demonstrated promising treatment outcome in case reports/ series. However, large cohort randomized controlled trials are essential to establish their therapeutic efficacy.