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RecruitingNCT03991728Updated Sep 16, 2026

Alloplastic Total Temporomandibular Joint (TMJ) Replacement Registry

An observational study in Temporomandibular Joint Disorders, sponsored by AO Innovation Translation Center. Recruiting at 23 sites in 15 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-16.

Sponsored by AO Innovation Translation Center · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
200
Ages
18 Years and older
Sex
All
01

Study summary

Prospective data will be collected in approximately 200 patients treated with an TMJ replacement. Patients will be followed up according to the standard (routine) for up to 5 years after the treatment. Data collection will include underlying disease, treatment details, functional and patient reported outcomes (PRO)s and anticipated or procedure-related adverse events (i.e. complications).

This registry is designed to be able to assess the number of patients who refuse alloplastic total TMJ replacement. Therefore, the participating sites are asked to register all cases of refused TMJ replacements too.

Read the detailed description

More in detail this registry has the following objectives:

  • To describe clinical indications for TMJ replacement, and treatment patterns (including differences among regions if feasible)
  • To describe the clinical evolution and outcomes of patients treated with a TMJ replacement
  • To explore the relationship(s) between treatment, outcome(s) and quality of life (QoL).
  • To identify predictive factors for favorable outcomes (pain reduction, range of motion (ROM), occlusal status, QoL) in patients treated with TMJ replacement.
  • To describe the reasons of patients who refused TMJ replacements
02

Conditions studied

  • Temporomandibular Joint Disorders

Keywords

  • Temporomandibular joint
  • TMJ replacement
  • Trauma
  • Ankylosis
  • Degenerative joint disease
  • Registry
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients requiring alloplastic total TMJ replacement

Inclusion criteria

  • Age 18 years and or older
  • Patients requiring alloplastic total TMJ replacement
  • Informed consent obtained, i.e.:

    • Ability to understand the content of the patient information/informed consent form (ICF)
    • Willingness and ability to participate in the registry according to the Registry Plan (RP)
    • Signed and dated ethics committee (EC) / Institutional review board (IRB) approved written informed consent

Exclusion criteria

Exclusion Criteria:

  • Recent history of substance abuse (i.e. recreational drugs, alcohol) that would preclude reliable assessment
  • Pregnancy or women planning to conceive within the study period
  • Participation in any other medical device or medicinal product study within the previous month that could influence the results of the present study
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
200 participants (estimated)
Target follow-up
5 Years
Patient registry
Yes

Groups and cohorts

  • Alloplastic total TMJ replacement

    All treatments will remain the standard (routine) care procedures based on individual clinician's judgment and the patient characteristics. The registry does not dictate any specific treatment.

05

What researchers measure

Primary outcomes

  1. The registry has no primary but several objectives.

    due to the study design, no primary objective has been defined and therefore no primary outcome measure either

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

Secondary outcomes

  1. Demographics

    Year of birth Gender Smoking

    Time frame: pre-operative

  2. Comorbidities

    Concomitant diseases will be assessed using the Charlson Comorbidity Index (CCI). This score assesses the comorbidity level by considering both the number and severity of pre-defined comorbid conditions. It provides a weighted score of a patient's comorbidities which can be used to predict mortality rates

    Time frame: pre-operative

  3. Refusal of alloplastic total TMJ replacement surgery

    For patients who require alloplastic total TMJ replacement but refuse surgery, the reason(s) for refusal will be collected.

    Time frame: pre-operative

  4. Clinical and functional outcomes - Mandibular movements

    Interincisial opening/maximal opening Lateral movements Protrusive movement

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  5. Clinical and functional outcomes - Occlusal status

    Occlusion will be assessed according to Angle's classification:

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  6. Clinical and functional outcomes - Dentition

    Dental status will be recorded as: * Edentulous * Complete dentition * Partial dentition In case of partial dentition, missing teeth will be recorded individually using the Fédération Dentaire Internationale (FDI) tooth numbering formula .

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  7. Clinical and functional outcomes - Helkimo Clinical dysfunction index

    The dysfunction of the mandible will be evaluated by means of the Helkimo index. The Helkimo index is based on the assessment of five different symptoms.

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  8. Patient Reported Outcomes - Pain numeric rating scale (NRS)

    The Pain NRS is an 11-point scale where the end points are the extremes of no pain (0 points), to worst imaginable pain (10 points). It measures subjective intensity of pain and the patient rates his/her overall or average daily pain. Will be assessed independently for each site.

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  9. Patient Reported Outcomes - Jaw function NRS

    The jaw function NRS is an 11-point scale where the end points are the extremes of normal jaw movement (0 points), to no jaw movement (10 points). It measures subjective jaw function.

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  10. Patient Reported Outcomes - Diet limitation NRS

    The diet limitation NRS is an 11-point scale where the end points are the extremes of no restrictions (0 points), to liquids only (10 points). It measures subjective diet limitations.

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  11. Patient Reported Outcomes - EuroQoL five dimension (EQ-5D-5L)

    The EQ-5D-5L descriptive system comprises the following five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results into a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months

  12. Patient Reported Outcomes - Oral Health Impact Profile (OHIP) - 14

    The OHIP is concerned with impairment and three functional status dimensions (social, psychological and physical) which represent four of the seven quality of life dimensions proposed by Patrick and Bergner. Hence, it excludes perceptions of satisfaction with oral health, changes in oral health, prognosis or self-reported diagnoses. Furthermore, the OHIP aims to capture impacts that are related to oral conditions in general, rather than impacts that may be attributed to specific oral disorders or syndromes. All impacts in the OHIP are conceptualized as adverse outcomes, and therefore the instrument does not measure any positive aspects of oral health. The OHIP consists of 14 items evaluated using a 5-point Likert from "Never" to "Very often " in which higher scores indicated worse outcomes. It has validated translations to Swedish, Spanish, German, Hindi and further more.

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months

  13. Anticipated treatment or condition-related adverse events (i.e. complications)

    In this registry, only anticipated condition, treatment-, or implant-related adverse events (i.e. complications) will be documented in the electronic case report form (eCRF) from the time of consent onwards. In the context of the registry, these events are considered as events of scientific interest, i.e. events that can clearly be connected to the treatment(s) or the medical condition under investigation. These events do not require immediate reporting unless they occur at a higher frequency and/or severity to that cited in the literature

    Time frame: from the pre-operative assessment until 60 months after surgery (10 days / 3 months / 6 months / 12 months / 24 months / 60 months)

  14. Survival

    Follow up (FU) visits will be scheduled and performed according to the local standard of care and at each scheduled visit the patient's survival will be documented. In case a patient misses a scheduled visit, it will be assessed if the patient is still alive, which can be done via phone call.

    Time frame: 10 days / 3 months / 6 months / 12 months / 24 months / 60 months

  15. Radiological parameters - Displacement of ramus component

    All images (preferably computed tomography (CT) / cone beam (CB) CT scan) taken as part of the standard (routine) will be collected and 'displacement of ramus component' evaluated by local investigator:

    Time frame: pre-operative / 10 days / 12 months / 24 months

  16. Radiological parameters - Fracture of ramus component

    All images (preferably computed tomography (CT) / cone beam (CB) CT scan) taken as part of the standard (routine) will be collected and evaluated by local investigator if a 'fracture of the ramus component' occurred

    Time frame: pre-operative / 10 days / 12 months / 24 months

  17. Radiological parameters - Screw loosening

    All images (preferably computed tomography (CT) / cone beam (CB) CT scan) taken as part of the standard (routine) will be collected and evaluated by local investigator if 'screw loosening' occurred

    Time frame: pre-operative / 10 days / 12 months / 24 months

  18. Radiological parameters - Resorption/ osteolysis of surrounding bone

    All images (preferably computed tomography (CT) / cone beam (CB) CT scan) taken as part of the standard (routine) will be collected and 'resorption/ osteolysis of surrounding bone' evaluated by local investigator

    Time frame: pre-operative / 10 days / 12 months / 24 months

  19. Radiological parameters - Status of bone grafts if used (displaced/ resorbed/ healed)

    All images (preferably computed tomography (CT) / cone beam (CB) CT scan) taken as part of the standard (routine) will be collected and 'status of bone grafts if used (displaced/ resorbed/ healed)' evaluated by local investigator

    Time frame: pre-operative / 10 days / 12 months / 24 months

  20. Radiological parameters - Presence of ectopic bone

    All images (preferably computed tomography (CT) / cone beam (CB) CT scan) taken as part of the standard (routine) will be collected and 'presence of ectopic bone' evaluated by local investigator

    Time frame: pre-operative / 10 days / 12 months / 24 months

06

Study locations

17 of 23 sites recruiting
  • Hospital BP - A Beneficência Portuguesa de São Paulo
    São Paulo, Brazil
    • Gabriel Pastore, MD · Contact
    Recruiting
  • Estetica Maxilofacial
    Bogotá, Colombia
    Suspended
  • Rigshospitalet
    Copenhagen, 2100, Denmark
    Recruiting
  • Hannover Medical School
    Hanover, 30625, Germany
    Recruiting
  • University Hospital Leipzig
    Leipzig, Germany
    Recruiting
  • Klinikum der Johannes Gutenberg Universität Mainz
    Mainz, 55131, Germany
    • Daniel Thiem · Contact
    Not yet recruiting
  • Klinikum der LMU München
    Munich, 80337, Germany
    • Wenko Smolka, MD · Contact
    Recruiting
  • Sri Shankara Cancer Hospital and Research Center
    Bangalore, India
    • Vinay V Kumar, MD · Contact
    Recruiting
  • All India Institute of Medical Sciences (AIIMS)
    New Delhi, 110029, India
    Terminated
  • Erasmus Medisch Centrum
    Rotterdam, 3075, Netherlands
    • Eppo Wolvius, MD · Contact
    Recruiting
  • Waikato DHB
    Christchurch, New Zealand
    Terminated
  • Hutt Hospital
    Lower Hutt, New Zealand
    Suspended
  • Mayo Hospital
    Lahore, Pakistan
    Terminated
  • Wojewódzki Specjalistyczny Szpital Dziecięcy
    Olsztyn, Poland
    Recruiting
  • National Medical and Surgical Center named after N.I. Pirogov" of the Ministry of Healthcare of the Russian Federation
    Moscow, Russia
    • Sergey Epifanov, MD · Contact
    Recruiting
  • Clinic for Maxillofacial Surgery, University of Belgrade
    Belgrade, Serbia
    Recruiting
  • King Edward VIII Hospital
    Durban, 4030, South Africa
    • Vivesh Rughubar, MD · Contact
    Recruiting
  • 12 de Octubre University Hospital
    Madrid, 28041, Spain
    • Ignacio Zubillaga, MD · Contact
    Recruiting
  • Falu Hospital
    Falun, 79182, Sweden
    • Jani Talvilahti, MD · Contact
    Recruiting
  • Skåne University Hospital
    Lund, Sweden
    • Martin Bengtsson, MD · Contact
    Recruiting
  • Karolinska University Hospital
    Stockholm, Sweden
    • Mattias Ulmner, MD · Contact
    Recruiting
  • Uppsala University Hospital
    Uppsala, SE-75185, Sweden
    Recruiting
  • Universitätsspital Basel
    Basel, Switzerland
    • Florian Thieringer, MD · Contact
    Recruiting
07

References and documents

Publications

  • Thor A, Bengtsson M, Dowgierd K, Epifanov S, Fichter AM, Jelovac D, Korn PN, Nilsson JL, Pastore G, Rughubar V, Smolka W, Talvilahti J, Thiem D, Thieringer F, Ulmner M, Wolvius EB, Zubillaga Rodriguez I, Kumar VV. Alloplastic total temporomandibular joint (TMJ) replacement registry: a protocol for a prospective global multicentre observational cohort study. BMJ Open. 2026 Mar 9;16(3):e113558. doi: 10.1136/bmjopen-2025-113558. PubMed 41802784 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03991728
Lead sponsor
AO Innovation Translation Center
Responsible party
Sponsor
First posted
Jun 19, 2019
Start date
Oct 15, 2019
Primary completion
Sep 2032 (estimated)
Completion
Dec 2033 (estimated)
Last update
Sep 16, 2026

Study contacts

Viola Grünenfelder
Contact
viola.gruenenfelder@aofoundation.org
+41 79 696 33 97
Alix Frischknecht
Contact
alix.frischknecht@aofoundation.org
Andreas Thor, MD
principal investigator · Oral and Maxillofacial surgery Uppsala University Hospital
Vinay V Kumar, MD
principal investigator · Oral and Maxillofacial surgery Uppsala University Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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