PURPOSE: Alloplastic total temporomandibular joint replacement (TMJR) is now considered to be a standard procedure for temporomandibular joint (TMJ) reconstruction. TMJR can improve mandibular mobility, restore the dental occlusion and improve facial aesthetics. The purpose was to assess the presence of intraoperative and post-operative complications, including the presence of post-operative chronic pain. METHODS: This retrospective study evaluated the use of 62 stock TMJR devices implanted in 45 patients who underwent surgery between the years 2006 and 2015 by the same surgeon at the Department of Oral and Maxillofacial Surgery, Stomatology Clinic, General Teaching Hospital (VFN) Charles University, Prague, Czech Republic. RESULTS: Intraoperative and post-operative complications recorded were facial nerve dysfunction (14-22%), open bite/malocclusion (2-3.2%), condylar component dislocation (1-1.6%), infection requiring revision surgery (1-1.6%) and (27-43%) reported chronic pain 24 months after surgery. CONCLUSIONS: As with any surgical procedure, TMJR can have complications. The results of this study demonstrate that the most common post-operative complication was continued pain. Chronic pain after TMJR was more common in patients with a preoperative diagnosis of degenerative joint disease. Also, the incidence of post-operative TMJR pain increased with the duration of symptoms prior to TMJR, leading to a question of the best timing for TMJR.

Department of Oral and Maxillofacial Surgery Stomatology Clinic 1st Medical Faculty of Charles University and General Teaching Hospital Prague U Nemocnice 2 str 12000 Prague Czech Republic

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