Alloplastic temporomandibular joint replacement systems: a systematic review of their history

Total Temporomandibular Joint Replacement: Stick to Stock or Optimization by Customization?

“…Although several other PSIs are available on the market, these 2 systems are currently the only US Food and Drug Administration (FDA)-approved TJR systems available. 1,2…”

“…Prosthetic treatment of the temporomandibular joint (TMJ) is far from new, with the first alloplastic interpositioning dating back to the mid-19th century and total joint replacement (TJR) first reported in 1965. 1 Since then, TJR has seen significant changes, using different designs and materials, as well as the development of both stock and computer-assisted design/computer-assisted manufacturing (CAD-CAM) systems. Most well-known current systems are the stock and patient-fitted Zimmer Biomet Microfixation TMJ Replacement System (Jacksonville, Florida) and the TMJ Concepts Patient-Fitted Total TMJ Replacement System (Ventura, California).…”

Prospective study of five-year outcomes and postoperative complications after total temporomandibular joint replacement with two stock prosthetic systems

“…Although it has been widely used, the latter has not been available since 2015 when the Food and Drug Administration withdrew its approval and, currently, there is only one stock model approved: the Biomet ® System. [14][15][16] The main surgical indication for a TMJ prosthesis is a damaged TMJ with extensive destruction (when no joint components are salvageable) together with increasing disability and pain, which can be the consequence of different types of severe joint disease or previous failed interventions. Compared with other operations such as costochondral and sternoclavicular grafts, TMJ prostheses reduce the duration of the operation and the time spent in hospital, and provide immediate function after the operation without morbidity from a donor site.…”

“…This allergy may precipitate unfavourable outcomes (two patients in the CS group, and one in the BS group) who had no known history of allergies. 16,[17][18][19][20][21][22][26][27][28] Some studies have reported that patients with a CS prosthesis had significantly raised serum concentrations of cobalt and chromium that could be toxic to exposed tissues. The systemic effects are mainly caused by an immunological response to metal hypersensitivity, although high concentrations of cobalt and chromium are related to facial pain, headache, neuromuscular abnormalities, and haematological changes.…”

“…19 Some studies have shown that the use of appropriate biomaterials and design variables can decrease wear and increase the longevity of the device. 12,16,[19][20][21] Although the fit of the temporal and condylar components improves the stability of prostheses, there is no valid argument to support the fact that because a custom replacement is based on an exact adjustment to the bone it will likely offer greater durability. 13 Without doubt, one deficiency in planning a joint prosthesis is the inability to produce difficult profiles using commercially accessible stock devices.…”