In the last years, several materials and design have been assessed in an attempt to improve the mechanical performance of temporomandibular joint total joint replacement (TMJ TJR) prostheses. However, the wear of the TMJ TJR condyle to the polymer-based fossa component during loading and sliding movements. That promotes the release of debris and risks of toxicity to the surrounding tissues. The purpose of this study was to perform a narrative literature review on the wear of TMJ TJR sliding contacts and potential toxicity of metallic debris to the patients. Previous studies reported a significant deterioration of the sliding contact surfaces of TMJ TJR prostheses. Material loss as a result of wear can cause a TMJ TJR condyle/fossa mismatch and the modification of the contact pressure and chewing loading. As a further consequence of wear, metal particles are released to the surrounding tissues with a high risk of local tissue and systemic toxicity through the bloodstream. The presence of particles induces the stimulation of inflammatory reactions depending on the concentration and size of debris. Thus, CoCr-based condyle release metallic ions and sub-micron particles that can be engulfed by macrophages or internalized by other tissue cells. The wear and material loss of TMJ TJR could be decreased by design optimization and novel materials with low friction and contact pressure. That consequently decrease the amount of metallic ions and particles to the surrounding tissues, preventing peri-prosthetic inflammatory reactions.

Bone grafting has increasingly been used in surgical procedures for enhanced bone augmentation. Tooth-derived graft material has received considerable attention due to its chemical composition and autogenous source that can improve bone tissue healing. The main aim of this study was to provide a short and comprehensive review on the chemical composition, morphological aspects, and clinical outcomes of bone grafting using tooth-derived matrix granules. Dentin tissue has a chemical composition similar to that on bone tissues regarding the presence of hydroxyapatite, type I collagen, and different growth factors. Dentin-matrix granules are often processed at well-controlled size ranging from approximately 300 up to 1300 µm, while maintaining porosity and organic content. In addition, a dense collagen fiber network is still present after the milling and chemical treatment of dentin granules. Thus, dentin-matrix granules can improve the bone healing process considering their chemical composition, porous structure, and adequate size. However, further in vivo and in vitro studies should be performed taking into consideration different demineralization procedures, remnant organic content, porosity, and granule size.