Assessment of Long-Term Functional Outcomes Following Total Temporomandibular Joint Replacement at Nigerian Tertiary Centres: A Multi-Site Study

Total temporomandibular joint replacement (TMJ replacement) represents the definitive surgical option for end-stage joint disease resulting from degenerative conditions, ankylosis, neoplastic involvement, or failed prior TMJ surgery. Given its high cost and technical demands, TMJ replacement is rare in Nigeria, and long-term functional outcome data from the Nigerian context are virtually absent. This multi-site retrospective study assesses functional outcomes at 12 and 24 months following total alloplastic TMJ replacement procedures performed at three specialist maxillofacial centers in Lagos, Ibadan, and Abuja, between 2016 and 2023. Eleven patients who underwent unilateral or bilateral TMJ replacement were included, representing the largest documented Nigerian case series. Outcome parameters include maximum mouth opening, pain-free jaw function, facial symmetry, device-related complications, patient satisfaction, and dietary tolerance. At 24-month follow-up, mean maximum interincisal opening improved from 15.2mm preoperatively to 32.7mm postoperatively. Pain-free function was reported in 8 of 11 patients. One patient experienced device loosening requiring revision at 18 months. Overall patient satisfaction was high, with 9 patients reporting a significant improvement in quality of life. The study demonstrates that acceptable functional outcomes can be achieved with TMJ replacement in Nigeria despite logistical challenges related to device procurement and multidisciplinary team assembly. Recommendations include the establishment of a national TMJ registry. Keywords: temporomandibular joint replacement, alloplastic, functional outcomes, Nigeria, TMJ ankylosis.