Clinical Analysis of TMJ Replacement Using a Customized Prosthesis

The TMJ prosthesis is a valuable and effective tool in different clinical conditions. This study aims to uncover the variables related to the success of the intervention. A retrospective study was conducted on patients who underwent joint replacement surgery utilizing a customized alloplastic system between 2018 and 2023, comprising subjects with complete records for both the planning and follow-up phases. The Student's t-test was applied with a significance threshold of p < 0.05. Forty-eight subjects were admitted for initial analysis, and 31 subjects were evaluated with a minimum follow-up of 1 year and a maximum of 7 years with a mean age of 36.37  15.53. The TMJ diagnosis was mainly with degenerative TMJ disease followed by ankylosis and craniofacial syndromes, and an average of 2.1  1.2 previous surgeries were noted. Degenerative joint disease correlated with increased pain (p=0.0001) and a higher prevalence of prior joint surgery (p=0.0001). Thirty-one subjects were followed up with 47 prostheses installed; 74.4% underwent complementary surgery with other facial osteotomies. Significant improvements (p<0.0001) were observed when comparing pain levels pre- and postoperatively, with a decrease from 5.5 ( 2.3) to 2.2 ( 0.4). Concerning the interincisal opening, there was a significant increase (p<0001) from 25.85 ( 10.2) mm to 35.93 (± 4.2) mm in mouth opening. TMJ replacement treatment is efficient and effective, demonstrating stability in follow-up assessments for up to 7 years. The indications for replacement are diverse and may benefit patients who have not yet progressed to end-stage TMJ disease.