Biomaterials in temporomandibular joint replacement: current status and future perspectives—a narrative review

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

“…Our findings correlate well with results from other studies on total joint prostheses. 13,14,[19][20][21] The strength and biocompatibility of the metal-on-ultrahigh-molecular-weight polyethylene prosthesis (BS), with its excellent wear characteristics, make it the current standard for articular surfaces of devices for total TMJ replacement. The BS implant had a lower long-term failure rate than the metalon-metal CS implant, which is not available at the present time because it is associated with several complications, including metallosis, wear of the condyle and fossa (lead-ing to fracture of the fossa), articulating wear debris-induced osteolysis, and loosening of joint replacement.…”

“…The BS implant had a lower long-term failure rate than the metalon-metal CS implant, which is not available at the present time because it is associated with several complications, including metallosis, wear of the condyle and fossa (lead-ing to fracture of the fossa), articulating wear debris-induced osteolysis, and loosening of joint replacement. 7,14,[19][20][21] TMJ prostheses can generate new complications that can also occur after long follow-up periods. Our results showed that two of 14 CS prostheses failed, with severe hypersensitivity to the Co-Cr alloy not detected preoperatively, one of them four years after the original operation.…”

“…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.…”

“…The relative novelty of the modern prosthesis, as those analysed, limits the availability of longterm results regarding material wear, stability, and failure of the implant. 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.…”

“…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.…”