A Comparison of Clinical Follow-Up of Different Total Temporomandibular Joint Replacement Prostheses: A Systematic Review and Meta-Analysis.

PURPOSE: There are different total temporomandibular joint (TMJ) prostheses on the market but no comparison of their efficacy. The purpose of this meta-analysis was to evaluate the effectiveness of different TMJ replacement (TJR) systems. MATERIALS AND METHODS: A systematic review and meta-analysis was performed using the PubMed, Embase, Medline, and Cochrane Library search engines in May 2017 to identify qualified studies. Outcome measurements were changes in maximal incisal opening (MIO), pain, dietary limitations, and functional deficiencies from before to after TJR. Analyses of heterogeneity, sensitivity, and publication bias were performed. A fixed-effects model was used for the meta-analysis of pooled weighted mean differences in pre- versus postoperative MIO, pain, diet, and function. RESULTS: Twenty studies with 1,262 patients were included in the meta-analysis. Comparison of the TJR systems showed no real difference for pre- versus postoperative MIO, pain, diet, and function. MIO and functional efficiency decreased gradually over time, but effective pain relief and improvements in dietary limitations were stable with no relevant differences during follow-up. Comparison of the custom and stock devices showed similar results for pre- and postoperative MIO, pain, function, and diet. CONCLUSION: This analysis showed no relevant difference in treatment outcomes among the TJR systems.