Total Joint Reconstruction of the Temporomandibular Joint: A Review on Current Concepts and Clinical Outcomes

The temporomandibular joint plays a vital role in mastication, speech, and airway function, and severe pathology can result in pain, restricted motion, and impaired quality of life. When conservative and autogenous grafting methods fail, total joint reconstruction with alloplastic prostheses provides a predictable and durable solution. This review summarizes current concepts in TMJ TJR, including anatomy, indications, evolution of techniques, prosthetic systems, outcomes, complications, and future perspectives. Modern CAD/CAM-based custom prostheses demonstrate high survival rates exceeding 90% at long-term follow-up, with substantial improvements in function and pain relief. Stock devices remain an alternative in selected cases, though custom systems provide superior adaptation. Complications such as infection, prosthesis loosening, and heterotopic ossification remain infrequent but clinically significant. Ongoing research in regenerative medicine, 3D bioprinting, advanced biomaterials, and artificial intelligence promises biologically adaptive reconstructions that may redefine the future of TMJ management.