Alloplastic Total Temporomandibular Joint Replacement in Degenerative Joint Diseases: A Systematic Review and Meta-Analysis
In brief
TMJ joint replacement adds 8 mm of opening and markedly eases pain
In a meta-analysis of 366 patients with osteoarthritis, rheumatoid or idiopathic TMJ degeneration, alloplastic total joint replacement increased maximum mouth opening by roughly 8 mm and produced a large reduction in pain scores. Functional diet also improved, supporting the procedure as a definitive option after conservative therapy fails, though evidence comes only from observational studies.
- Journal
- Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (Q1)
- Published
- 22 July 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Sibgutulah Rashid, Rudra Deo Kumar, Shivendra Choudhary, Khan Sabera Kalimuddin, Devanshu Devanshu
- PMID
- 42556788
- DOI
- 10.1016/j.joms.2026.07.018
Why clinicians should know about it
- Picked for Rheumatology (top studies of the week, 9 August 2026).
Abstract
BACKGROUND: Degenerative temporomandibular joint (TMJ) disorders are a major cause of chronic pain and functional limitation. Evidence specific to alloplastic total temporomandibular joint replacement (TJR) in degenerative pathology remains heterogeneous and incompletely synthesized. PURPOSE: To evaluate the therapeutic effectiveness of alloplastic TJR in subjects with degenerative TMJ disease who failed conservative and joint-preserving treatments. DATA SOURCES: This systematic review was prospectively registered in PROSPERO (CRD420261280616). Electronic searches were conducted in PubMed, Embase, Scopus, and ScienceDirect, along with ClinicalTrials.gov and the Clinical Trials Registry of India, from inception through December 31, 2025. Manual journal searches were also performed. Only English-language human studies were included. STUDY SELECTION: Randomized and observational clinical studies reporting outcomes of unilateral or bilateral alloplastic TJR performed exclusively for degenerative TMJ disease were included. Degenerative TMJ disease was operationally defined a priori using a Population, Intervention, Comparator, Outcomes, Time and Study Design-based framework as structural joint degeneration due to osteoarthritis, idiopathic condylar resorption, or inflammatory arthropathies (eg, rheumatoid arthritis, juvenile idiopathic arthritis). Study selection was performed independently by 2 reviewers. DATA EXTRACTION AND SYNTHESIS: Data extraction and quality assessment followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Risk of bias was assessed using Risk Of Bias In Non-randomized Studies of Interventions. Random-effects meta-analysis with inverse-variance weighting was performed. MAIN OUTCOMES AND MEASURES: Primary outcomes were postoperative TMJ pain reduction and improvement in maximum mouth opening. Secondary outcomes included dietary function and postoperative complications. RESULTS: Eleven observational studies (n = 366 subjects) were included. Meta-analysis demonstrated statistically significant reductions in TMJ pain (standardized mean change = -3.67; 95% CI: -5.69 to -1.65; P < .001), improvement in maximum mouth opening (mean difference = 7.81 mm; 95% CI: 3.99 to 11.64 mm; P < .001), and dietary function (standardized mean change = -3.05; 95% CI: -3.61 to -2.49; P < .001). Subgroup analysis showed greater improvements among subjects with osteoarthritis. Despite substantial heterogeneity, sensitivity analyses confirmed the robustness of findings. CONCLUSIONS AND RELEVANCE: Alloplastic TJR is associated with statistically significant improvements in TMJ pain, mandibular function, and dietary capacity in subjects with degenerative TMJ disease refractory to conservative therapy. These findings support TJR as a definitive reconstructive option in appropriately selected subjects.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.