Indications for the Use of TMJ Prostheses in South America

Abstract

Since the 1960s, various surgical procedures have been developed to treat the temporomandibular joint (TMJ) disease, including stock or customized prostheses for severe TMJ diseases. Understanding the appropriate indications and timing for joint replacement is crucial for evaluating the prognosis of the treatment. This study sought to identify the indications for joint replacement surgery in three countries in Latin America and to determine characteristics associated with its surgical planning. The study was conducted by interviewing surgeons who performed surgery on patients using customized TMJ prostheses between 2022 and 2024 and who had surgical planning under the same protocol. Only preoperative information related to the indication and complementary procedures related to the customized prosthesis was used, comprising 133 subjects, 41 male subjects (30.82%) and 92 female subjects (69.17%), with significant differences. Degenerative TMJ disease presented the highest indication for replacement with 47 (35.33%) cases, followed by malformations with 26 (19.54%), ankylosis with 22 (16.54%), TMJ deformity by trauma sequelae with 20 (15.03%) and replacement by another joint prosthesis 18 (13.53%). We found a significant correlation between indications and the use of orthognathic surgery in some diseases (P<0.001). In 72.34% of subjects with degenerative disease, orthognathic surgery with bilateral prosthesis was indicated. In subjects with facial malformation, orthognathic surgery with unilateral prosthesis was indicated in 76.92%. We can conclude that female subjects are more common than male subjects in the treatment with TMJ replacement. TMJ prostheses presented the highest indication in degenerative TMJ disease, and they were significantly related to orthognathic surgery.