Does preoperative antiresorptive medication affect total temporomandibular joint replacement outcomes?

Objective: To evaluate the clinical and radiographic outcomes of temporomandibular joint (TMJ) total joint replacement (TJR) in osteoporotic patients receiving preoperative antiresorptive therapy.

Study design: This retrospective chart review included osteoporotic patients who underwent TMJ TJR at a single institution. Data collected included demographics, medical history, type and duration of antiresorptive therapy, surgical details, and postoperative outcomes. Clinical parameters included range of motion (ROM), joint noise, and dietary limitations. Radiographic assessment evaluated periprosthetic bone changes and implant stability. Descriptive statistics summarized outcomes.

Results: Eight patients (62.5% female; mean age 61.5 ± 11.4 years) with osteoporosis and history of antiresorptive therapy were analyzed. The average therapy duration was 3.75 ± 3 years. Mean clinical and CBCT follow-up was 16 ± 9.6, and 6.5 ± 3.6 months respectively. No patients developed medication-related osteonecrosis of the jaw (MRONJ), prosthetic failure, hardware loosening, or periprosthetic osteolysis. Functional outcomes were favorable, with mean postoperative ROM of 35.1 ± 4.8 mm and no joint noise.

Conclusion: Preoperative antiresorptive therapy in osteoporotic patients does not appear to increase the risk of complications or impair functional outcomes following TMJ TJR. Larger sample sizes, possibly through multicenter investigations, are critical to establishing high-level evidence regarding its safety and efficacy.