Temporomandibular Joint Prosthesis Revision and/or Replacement Survey and Review of the Literature

Purpose: The purpose of the present study was to report the temporomandibular joint (TMJ) alloplastic reconstruction (TMJR) revision and/or replacement rates and associated complication outcomes data gathered from experienced TMJ surgeons and to review the recent relevant data. Materials and Methods: A 21-question anonymous on-line survey was sent to all Commission on Dental Accreditation–approved oral and maxillofacial surgery program directors and to members of the European Society of TMJ Surgeons and the American Society of Temporomandibular Joint Surgeons. Results: Of the surgeons sent the survey, 22% completed the full questionnaire. Most responses were from surgeons who routinely perform TMJR surgery (93.5%). Of the respondents, 28.3% had more than 30 years of experience and 73.9% were full-time academic faculty. A total of 4638 TMJR procedures were recorded and analyzed. The incidence of TMJR revision (keeping the same device) was 3% and that of replacement (placing a new device) was 4.9%. The most common reason for revision was heterotopic ossification (27.5%). The most common reason for replacement was infection (21.1%). Revision was successful in 86.7% and replacement in 94.6% of the patients at the longest follow-up reported. Conclusions: The data from the present study have shown that the incidence is low and the success rate is high for TMJR revision and replacement.