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Chapter 116Aims and overview of the thesisIn 2019 Elledge et al.(26) reported on 27 different TMJ TJR being produced in over fifteen countries with only 2 of them being approved by the United States Food and Drug Administration (FDA). Twenty-two of these TJR applied a similar design to these 2 approved systems, yet still varied in the prosthetic materials that were used. Also, only 12 systems performed preclinical laboratory tests, yet none underwent in vivo testing before being implanted in human patients. The authors concluded that ‘Not all systems are equal in terms of design, material composition, preclinical laboratory testing, manufacturing methods, regulatory status, and reports of clinical outcomes.’ Thus, this doctoral thesis set out to develop and properly investigate a personalized TMJ prosthesis. The hypothesis is that it would be possible to develop a prosthesis that meets orthopedic standards in both wear properties and adverse tissue reactions. We also hypothesized that is possible to reinsert the LPM onto the prothesis, allowing for lateral condylar movement. Also, we aimed to further improve the per-operative and post-operative protocols that are currently in place, by evaluating the available literature and developing new guidelines or protocols.General introductionThe first chapter provides a general introduction on the anatomy of the joint, its surgical indications, and approaches. The outline of the thesis is presented as well.Part 1 Literature analysis and developmentBy better understanding the historic development of temporomandibular joint prosthetic systems with attention for the different materials and designs that were used, significant insights can be obtained in developing a new TMJR. By analyzing the challenges and complications that were encountered not only by engineers, but also by surgeons, the design of a new TMJR can also be influenced from a clinical point of view. This second chapter provides an extensive systematic review of the historical evolution Nikolas de Meurechy NW.indd 16 05-06-2024 10:14