Alloplastic temporomandibular joint replacement using patient-specific prostheses: a multicentre analysis of functional and aesthetic outcomes

Total alloplastic temporomandibular joint (TMJ) replacement with patient-specific prostheses is an established option for end-stage TMJ disease, but multicentre data integrating functional, pain, dietary, aesthetic and patient-reported outcomes are scarce. This retrospective multicentre cohort study assessed functional, pain, dietary, aesthetic and satisfaction outcomes after unilateral or bilateral patient-specific TMJ replacement in three tertiary units. Patients with ≥12 months' follow-up completed a postoperative questionnaire including the modified Helkimo index, diet score, numerical rating scale (NRS) for pain during function, modified Global Aesthetic Improvement Scale, and modified FACE-Q "Satisfaction with Outcome" module (0-100). Eighty-nine patients (125 joints; mean age 50.6 years; mean follow-up 3.4 years) were included. The mean modified Helkimo index decreased from 14.0 to 3.8 and the mean diet score improved from 5.1 to 8.6 (both p < 0.001). At follow-up, mean pain NRS was 2.4, 30.3% were pain free and 75.3% reported NRS ≤3. Approximately 25% reported aesthetic improvement and 10% some worsening; the mean FACE-Q satisfaction score was 88.2/100 and 75.3% scored ≥80. Patient-specific TMJ replacement yielded substantial functional and dietary improvement, low residual pain and high satisfaction; aesthetic change was modest in many patients.