Total prosthetic replacement of the temporomandibular joint is considered when alternative treatments have failed. It involves replacing both the skull base component (the fossa or socket) and the condyle with prostheses. The aims of the procedure are to re‑establish function of the temporomandibular joint and to relieve pain.
With the patient under general anaesthesia, an incision is made anterior to the ear for insertion of the fossa component, with a second incision behind or below the mandible for insertion of the mandibular condyle component. The coronoid process of the mandible is sometimes removed to allow more mobility after surgery.
A number of different prostheses are available for this procedure.