Abstract illustration of a jaw joint transitioning into a gear, symbolizing TMJ replacement options.

TMJ Replacement: Is One Type of Prosthesis Really Better?

Mira Elwood in Health & Wellness August 2025 • 4 min read.

"Exploring the nuances and similarities between different temporomandibular joint (TMJ) replacement options to help you make informed decisions about your health."

Dealing with temporomandibular joint (TMJ) disorders can significantly impact your quality of life, making everyday activities like eating and speaking painful. For those who have exhausted other treatment options, total TMJ replacement offers a ray of hope. However, the world of TMJ prostheses can seem complex, with various types and brands promising the best results. How do you navigate this landscape and determine the best option for your unique needs?

A recent meta-analysis published in the Journal of Oral and Maxillofacial Surgery sheds light on this very question. This comprehensive study pools data from multiple research papers to compare the clinical outcomes of different total TMJ replacement prostheses. The goal? To determine if one type consistently outperforms the others.

Before diving in, it's crucial to understand the basics. The TMJ is a complex joint that allows your jaw to move, and when it malfunctions due to arthritis, injury, or other conditions, it can lead to chronic pain and dysfunction. Total joint replacement involves replacing the damaged joint with an artificial prosthesis, aiming to restore proper function and alleviate pain.

The Meta-Analysis: Comparing Apples and Oranges?

Abstract illustration of a jaw joint transitioning into a gear, symbolizing TMJ replacement options.

The meta-analysis examined twenty studies encompassing data from 1262 patients. These studies focused on comparing various aspects of TMJ replacement, including the effectiveness of different brands (like Biomet, TMJ Concepts, and Nexus) and the outcomes of custom versus stock prostheses. The researchers looked at key outcome measures, such as changes in maximal incisal opening (MIO, or how wide you can open your mouth), pain levels, dietary restrictions, and overall jaw function.

One of the most striking findings was the lack of significant differences between the three major brands of TJR systems (Biomet, TMJ Concepts, and Nexus) in terms of MIO and pain, diet, function changes. While specific brands may have specific advantages or target certain applications, there was no strong evidence suggesting that one brand consistently outperforms the others in all outcome measures across the board.

Here’s what the study looked at:

The study also explored whether custom-made prostheses, designed to perfectly fit an individual's anatomy, offered superior results compared to stock (or off-the-shelf) prostheses. Again, the results indicated that both custom and stock devices performed similarly regarding MIO, pain relief, function, and dietary improvements. Custom prostheses allow fit to the patient's anatomy which can avoid reshaping, may reduce overload and the stock prostheses are usually chosen for cases with sufficient host bone or dramatically altering of the position of the mandible, which can make comparing two difficult. Does this mean one is not better? The results may leave you wondering whether the extra cost and time associated with custom prostheses are truly justified. The answer, as with many things in medicine, isn't always straightforward.

Making an Informed Decision: It's All About You

The meta-analysis provides valuable insights, but it's essential to remember that TMJ replacement is a highly individualized procedure. Factors like the underlying cause of your TMJ disorder, your specific anatomical considerations, and your surgeon's expertise all play a significant role in the outcome. This means that the 'best' prosthesis is ultimately the one that's best suited to your unique circumstances. You should consult your doctor to examine all your options.

About this Article -

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Everything You Need To Know

What was the primary objective of the TMJ replacement meta-analysis discussed?

A recent meta-analysis in the *Journal of Oral and Maxillofacial Surgery* compared different total TMJ replacement prostheses (like Biomet, TMJ Concepts, and Nexus) by pooling data from multiple studies with 1262 patients. The study looked at outcome measures like changes in maximal incisal opening (MIO), pain levels, dietary restrictions, and jaw function to see if one type consistently outperformed the others.

What specific brands and types of TMJ prostheses were compared in the meta-analysis?

The meta-analysis compared the effectiveness of different brands such as Biomet, TMJ Concepts, and Nexus, as well as custom versus stock prostheses. These outcomes were measured based on changes in maximal incisal opening (MIO), pain levels, dietary restrictions, and overall jaw function. The study aimed to find out whether custom prostheses, designed to fit an individual's anatomy, offered superior results compared to stock prostheses.

Did the meta-analysis determine that one brand of TMJ replacement consistently provides better outcomes than others?

The meta-analysis did not find significant differences between the three major TJR systems (Biomet, TMJ Concepts, and Nexus) regarding maximal incisal opening (MIO), pain reduction, dietary improvements, and functional outcomes. This suggests that while individual brands may have specific applications, no single brand consistently outperforms others across all measures. However, this does not account for other factors that contribute to a patient's individual needs.

How did custom-made prostheses compare to stock prostheses in terms of patient outcomes like pain relief and jaw function?

The meta-analysis indicated that both custom and stock prostheses performed similarly in terms of maximal incisal opening (MIO), pain relief, function, and dietary improvements. Custom prostheses allow fit to the patient's anatomy which can avoid reshaping, may reduce overload and the stock prostheses are usually chosen for cases with sufficient host bone or dramatically altering of the position of the mandible, which can make comparing two difficult. While custom prostheses can be tailored to an individual's anatomy, potentially reducing the need for reshaping and minimizing overload, stock prostheses are often suitable for cases with sufficient host bone or when significant mandibular repositioning is required.

How should one interpret the findings of the meta-analysis when deciding on the best TMJ replacement option?

While the meta-analysis offers valuable data, remember that TMJ replacement outcomes depend on factors like the cause of your TMJ disorder, anatomical considerations, and the surgeon's expertise. The "best" prosthesis for you is the one that fits your individual circumstances. Consulting with your doctor helps examining all your options. Also, factors such as the surgeon's experience with specific prostheses and your specific anatomical needs will play crucial roles. The decision-making process should involve a comprehensive evaluation and discussion with your healthcare provider to determine the most suitable approach for your situation.