Background: The temporomandibular joint (TMJ) is a key component of the stomatognathic system, playing a major role in maintaining mandibular stability and function. Temporomandibular disorders (TMDs) are a prevalent disease in the world, with surgical treatment being reserved for complex cases or end-stage TMJ disease. A narrative review was conducted to describe the quantitative and qualitative factors that affect TMJ prosthesis stability. Methods: Studies with a sample size equal to or greater than 10 subjects who underwent surgical procedures for joint replacement using stock or customized ATM prostheses were included. This narrative review examined some variables that may influence in terms of the longevity of the TMJ prosthesis, highlighting issues to be considered in future research. Results: The current development of TMJ prostheses is benefiting from technological advances, offering a suitable adaptation to the patient’s anatomy and superior results in functionality and patient satisfaction. However, the biomechanical complexity of the TMJ shows unique challenges compared to other joints in the body, where anatomical, biomechanical, and functional requirements are high. The stability of the TMJ prosthesis is affected by multiple variables, including the selection of biocompatible materials that resist corrosion and wear, the design of the prosthesis, the diagnosis and indication for its use, and the surgeon’s experience. The success of TMJ replacement can be measured by improving the patient’s quality of life, reducing pain, restoring mandibular functionality, and recovering suitable facial morphology for the patient’s conditions. Conclusion: There is a need for training of maxillofacial surgeons in TMJ surgery and replacement, as well as a greater focus on the research and development of systems to simplify surgical design and procedures and to optimize the results of TMJ replacement.

Objectives: This study aims to describe and analyze the indications and clinical results of total TMJ replacement in participants with degenerative and/or inflammatory joint diseases, defining patient and intervention conditions. Methods: A systematic review was conducted according to the Cochrane Handbook for Systematic Reviews of Intervention and reported according to the PRISMA Items update. The search strategy was from 1997 to July 2024 in Pubmed, Embase, Scopus, and Web of Science. A search for gray literature was conducted in the databases Google Scholar and Open Access Theses and Dissertations (OATD), and there were no limitations on the language or study design. We incorporated studies involving human patients over 15 years of age with degenerative and/or inflammatory joint conditions who underwent joint prosthesis replacement, either concurrently or separately from orthognathic surgery, as an initial intervention or after prosthesis installation. Participants with a postoperative follow-up of 12 months or longer were included. A risk of bias analysis was performed for non-randomized studies using the ROBINS-I tool, and GRADE profiler (GRADEpro) software was used to assess the quality of evidence and synthesize the data. Results: All the selected studies performed postoperative follow-up with quantitative and qualitative parameters; 10 performed a follow-up of 2 to 5 years. The indication for joint prosthesis replacement due to system failure was only 4.07%. Concerning diagnoses, 579 presented degenerative and/or inflammatory joint diseases, with osteoarthritis being the most frequent, followed by osteoarthrosis, juvenile idiopathic arthritis, and rheumatoid arthritis. The maximum mouth opening of the participants with TMJ disease presented an average of 24.32 ± 5.8 mm with a range of 18 to 36.4 mm. Of the 579 participants, the studies mention that they presented a soft to liquid diet and pain associated with decreased mandibular functionality. Conclusions: A total of 76.18% of the participants presented a range of moderate to severe pain associated with a decrease in functionality and, after joint replacement, all participants mentioned a decrease in pain or absence of pain, a change in diet by incorporating solid foods, and an increase in opening with an average of 40.74 ± 3.1 mm. Total joint replacement shows favorable long-term results. It is not possible to identify the best time to perform joint replacement surgery, considering the time since diagnosis of the disease, the time since the start of non-surgical treatment, or the number of previous surgeries.

Orthognathic surgery is a successful surgical method for correcting facial deformities, and the piezoelectric system can be used in place of or in addition to traditional tools like the reciprocating saw to perform osteotomies. This study assesses how using a reciprocating saw or a piezoelectric device exclusively affects neurosensory impairment. A review was performed following the PRISMA-ScR recommendations. A search was conducted until December 2024 in PubMed, Embase, and Web of Science. Clinical trials and quasi-experimental studies in English and Spanish were included. A total of nine articles were obtained for full-text review using inclusion and exclusion criteria. The selected articles included a total of 731 subjects. The age range of the studies included was between 18 and 49 years. Three of the six analyzed state that piezoelectric surgery positively correlates with neurosensory recovery, showing less surgical time and a less painful and faster postoperative recovery than the use of a saw. However, only two reported no significant statistical difference in sensitivity recovery between the saw and piezoelectric instruments. Despite the methodological heterogeneity among the studies included, the sample size, and the variability of factors, using a piezoelectric system typically shows a better postoperative recovery of sensitivity compared to using a saw.