Complications of temporomandibular joint replacement surgery in adult patients: A systematic review and meta-analysis.

The objective of this study was to assess the prevalence of different complications of temporomandibular joint replacement surgery in adult patients. An electronic search of PubMed, Embase, Web of Science Core Collection and Google Scholars was performed. Clinical studies with at least 10 patients aged 18 years or older undergoing total alloplastic temporomandibular joint replacement surgery were included. A random-effects meta-analysis of proportions to synthesize the complication rates across studies was used. Thirty-five studies met the inclusion criteria and were analyzed. The overall complication rate was 38.9 % (95 % CI 27.4-51.0 %, I(2) = 72 %). The most prevalent complication was transient facial nerve injury (24.1 %; 95 % CI 15.9-33.3 %, I(2) = 82 %) followed by permanent sensory changes (17.4 %; 95 % CI 0.6-45.7 %, I(2) = 95 %) and persistent postoperative pain (11.5 %; 95 % CI 5.4-19.4 %, I(2) = 78 %). The meta-analysis reports a moderate prevalence of neurogenic complications and a low prevalence of other complications which shows that it's a safe procedure. Future studies should collect the various complications in more detail in order to minimize reporting bias due to inconsistent reporting of complications in the studies.