title: Total temporomandibular joint replacement prostheses: a systematic review and bias-adjusted meta-analysis.
abstract: The aim of the present study was to determine which prosthesis has resulted in the best outcomes after total temporomandibular joint replacement (TMJR). A comprehensive electronic search was undertaken in September 2015. Inclusion criteria encompassed studies that described one of the three current TMJR systems and that had pre- and postoperative data on at least two of the following TMJR indications: pain, diet, function, and maximum inter-incisal opening (MIO). Sixteen papers were included in the systematic review, reporting 10 retrospective studies and six prospective studies (no randomized controlled or case-controlled trials). A total 312 patients with 505 TMJ Concepts prostheses, 728 patients with 1048 Biomet prostheses, and 125 patients with 196 Nexus prostheses were included in the analysis. There was no real difference between the various TMJR systems in terms of pain or diet scores. Function scores improved with the TMJ Concepts, but this was the only prosthesis for which data were available. Biomet prostheses appeared to have a greater increase in MIO mean gain compared to TMJ Concepts and Nexus prostheses; however this was heavily biased by one study. Without this study, there was no real difference in MIO. It is concluded that the prostheses are similar, but most data are available for the TMJ Concepts prosthesis, with results being favourable.
authors.affiliation: Maxillofacial Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; School of Medicine, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: nigel.johnson1@uqconnect.edu.au.
authors.forename: N R
authors.initials: NR
authors.lastname: Johnson
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Roberts
authors.affiliation: Research School of Population Health, The Australian National University, Canberra, Australia; College of Medicine, Qatar University, Doha, Qatar.
authors.forename: S A
authors.initials: SA
authors.lastname: Doi
authors.affiliation: Maxillofacial Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: M D
authors.initials: MD
authors.lastname: Batstone
mesh_terms: D019643:Arthroplasty, Replacement / Q000379:methods*; D006801:Humans; D007595:Joint Prosthesis; D011474:Prosthesis Design; D013705:Temporomandibular Joint Disorders / Q000601:surgery*
keywords: Biomet; Christensen; Nexus; TMJ Concepts; joint replacement; prosthesis; surgery; systematic review; temporomandibular joint