Alloplastic temporomandibular joint replacement in skeletally immature population: a systematic review.

OBJECTIVE

To systematically evaluate the functional outcomes, complications, implant performance, and growth-related considerations of total temporomandibular joint replacement (TMJR) in skeletally immature population.

STUDY

DESIGN

A PRISMA 2020-compliant systematic review (CRD420261307254) was conducted through searches of PubMed, Embase, Scopus, ScienceDirect, and the Cochrane Library up to January 2026. Studies evaluating alloplastic TMJR in patients younger than 18 years were included. Methodological quality and certainty of evidence were assessed using the Joanna Briggs Institute tools and GRADE framework, respectively.

RESULTS

Nineteen studies involving 48 skeletally immature patients were included. Common indications were TMJ ankylosis, syndromic craniofacial deformities, juvenile idiopathic arthritis, trauma, and pathological lesions. Mouth opening improved markedly (0-15 mm to 25-50 mm), with consistent reductions in pain and improved mandibular function. Complications included infection, transient facial nerve weakness, heterotopic ossification, growth asymmetry, and occlusal changes. Prosthetic failure and ankylosis recurrence were rare. Overall evidence certainty was low to very low.

CONCLUSION

Alloplastic TMJR appears to be a safe and effective reconstructive option for carefully selected skeletally immature patients, providing meaningful functional improvement and symptom relief. However, evidence remains limited, and prospective multicentre studies with long-term follow-up are needed to determine growth outcomes, implant longevity, and revision rates.