Assessment of oral health-related quality of life after total temporomandibular joint replacement

Background: The article addresses the impact of total temporomandibular joint replacement (TMJR) on oral health-related quality of life (OHRQoL) in patients with advanced temporomandibular joint (TMJ) disorder. TMJ disorder encompasses a variety of conditions causing pain and dysfunction in the jaw, peripheral nerves, and TMJ. TMJR is considered a last resort in the surgical treatment of advanced joint disorders when conservative treatments fail. Methods: The study followed 10 patients undergoing TMJR and assessed their oral health-related quality of life using the OHIP-14 (Oral Health Impact Profile-14) questionnaire at different postoperative time points. Results: The results showed a significant improvement in physical pain, psychological discomfort, and physical disability after six months, with a restoration of oral health-related quality of life after twelve months. Conclusions: The research concluded that TMJR treatment can significantly improve oral health-related quality of life in patients with advanced TMJ disorder. However, further studies are needed to analyze the long-term effectiveness of treatment and compare different surgical approaches.

Temporomandibular joint replacement; Oral health-related quality of life; Advanced temporomandibular joint disorder; OHIP-14 questionnaire

[1] Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. Journal of Dental Research. 2008; 87: 296–307.

[2] Alhammadi MS, Almashraqi AA, Thawaba AA, Fayed MMS, Aboalnaga AA. Dimensional and positional temporomandibular joint osseous characteristics in normodivergent facial patterns with and without temporomandibular disorders. Clinical Oral Investigations. 2023; 27: 5011–5020.

[3] Namvar MA, Afkari BF, Moslemkhani C, Mansoori K, Dadashi M. The relationship between depression and anxiety with temporomandibular disorder symptoms in dental students. Maedica. 2021; 16: 590–594.

[4] Ning R, Chen J, Lu Y, Guo J. Obstructive sleep apnea: a follow-up program in its relation to temporomandibular joint disorder, sleep bruxism and orofacial pain. BMC Oral Health. 2023; 23: 578.

[5] Peres Lima FGG, Rios LGC, Bianchi J, Gonçalves JR, Paranhos LR, Vieira WA, et al. Complications of total temporomandibular joint replacement: a systematic review and meta-analysis. International Journal of Oral and Maxillofacial Surgery. 2023; 52: 584–594.

[6] Santos SS, Marchon RNB. Relationship between temporomandibular dysfunction and anxiety. Cardenos de Odontologia do UNIFESO. 2023; 5: 173–182. (In Portuguese)

[7] Goker F, Russillo A, Baj A, Giannì AB, Beltramini G, Rossi DS, et al. Custom made/patient specific alloplastic total temporomandibular joint replacement in immature patient: a case report and short review of literature. European Review for Medical and Pharmacological Sciences. 2022; 26: 26–34.

[8] Poveda Roda R, Bagan JV, Díaz Fernández JM, Hernández Bazán S, Jiménez Soriano Y. Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors. Medicina Oral, Patología Oral y Cirugía Bucal. 2007; 12: E292–E298.

[9] Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al.; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium Network* and orofacial pain special interest group†. Journal of Oral & Facial Pain and Headache. 2014; 28: 6–27.

[10] Mercuri LG, Neto MQ, Pourzal R. Alloplastic temporomandibular joint replacement: present status and future perspectives of the elements of embodiment. International Journal of Oral and Maxillofacial Surgery. 2022; 51: 1573–1578.

[11] Lima FGGP, Rios LGC, Paranhos LR, Vieira WA, Zanetta-Barbosa D. Survival of temporomandibular total joint replacement: a systematic review and meta-analysis. Journal of Oral Rehabilitation. 2024; 51: 775–784.

[12] Hu Y, Zhang L, He D, Yang C, Chen M, Zhang S, et al. Simultaneous treatment of temporomandibular joint ankylosis with severe mandibular deficiency by standard TMJ prosthesis. Scientific Reports. 2017; 7: 45271.

[13] Warzocha J, Gadomska-Krasny J, Mrowiec J. Etiologic factors of temporomandibular disorders: a systematic review of literature containing diagnostic criteria for temporomandibular disorders (DC/TMD) and research diagnostic criteria for temporomandibular disorders (RDC/TMD) from 2018 to 2022. Healthcare. 2024; 12: 575.

[14] Balon P, Vesnaver A, Kansky A, Kočar M, Prodnik L. Treatment of end stage temporomandibular joint disorder using a temporomandibular joint total prosthesis: the Slovenian experience. Journal of Cranio-Maxillofacial Surgery. 2019; 47: 60–65.

[15] Massena P, Frassetto SS. Psychological aspects associated to temporomandibular dysfunction: a systematic review of the literature. 2015. Available at: https://pepsic.bvsalud.org/pdf/aletheia/n47-48/n47-48a14.pdf (Accessed: 02 March 2025).

[16] Rauniyar D, Upadhyaya C, Chaurasia N, Shakya M, Sharma S. Total temporomandibular joint replacement in recurrent temporomandibular joint ankylosis: a case report. Journal of Surgical Case Reports. 2023; 2023: rjad426.

[17] Torres KV, Pessoa LS, Luna AHB, Alves GÂ dos S. Quality of life after orthognathic surgery: a case report. Revista CEFAC. 2017; 19: 733–739.

[18] Neuprez A, Neuprez AH, Kaux JF, Kurth W, Daniel C, Thirion T, et al. Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years. Clinical Rheumatology. 2020; 39: 861–871.

[19] Chęciński M, Chęcińska K, Bliźniak F, Lubecka K, Turosz N, Rąpalska I, et al. Temporomandibular joint (TMJ) replacement affects quality of life: a systematic review and synthesis of clinical trials. Applied Sciences. 2024; 14: 2912.

[20] Gonzalez-Perez LM, Gonzalez-Perez-Somarriba B, Centeno G, Vallellano C, Montes-Carmona JF, Torres-Carranza E, et al. Prospective study of five-year outcomes and postoperative complications after total temporomandibular joint replacement with two stock prosthetic systems. British Journal of Oral and Maxillofacial Surgery. 2020; 58: 69–74.

[21] Singh JA, Lewallen DG. Ninety-day mortality in patients undergoing elective total hip or total knee arthroplasty. The Journal of Arthroplasty. 2012; 27: 1417–1422.e1.

[22] Mezey GA, Paulik E, Máté Z. Effect of osteoarthritis and its surgical treatment on patients' quality of life: a longitudinal study. BMC Musculoskeletal Disorders. 2023; 24: 537.

[23] Gao W, Lu J, Gao X, Zhou J, Dai H, Sun M, et al. Biomechanical effects of joint disc perforation on the temporomandibular joint: a 3D finite element study. BMC Oral Health. 2023; 23: 943.

[24] Zanin RF, Ommizolo G, Weber A, Heitz C, de Lima EMS. Oral health-related quality of life in women with temporomandibular joint disk anterior displacement before and after disk repositioning and anchoring surgery assessed with the Oral Health Impact Profile (OHIP-14). Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 2019; 128: 112–116.

[25] DeLaura TL, Williams RA, Granquist EJ, Quinn PD. Patient-reported outcomes following temporomandibular joint replacement surgery using OHIP-TMDs. Journal of Oral and Maxillofacial Surgery. 2023; 81: S47–S48.

[26] Monje Gil F, Martínez Artal P, Cuevas Queipo de Llano A, Muñoz Guerra M, González Ballester D, López Arcas JM, et al. Consensus report and recommendations on the management of late-stage internal derangement of the temporomandibular joint. Journal of Clinical Medicine. 2024; 13: 3319.