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General introduction and overview119treatment. Eleven patients and a total of sixteen joints were treated using the TMJR and its function was evaluated the analysis of the early in vivo results, with attention for the reported pain and dietary scores, as well as the measured movements. In chapter ten, the prosthetic system is further adapted to not only restore the function of the TMJ, but also to restore segmental mandibular defects with occlusal abnormalities. A total of five patients and six joints were treated using the extended TMJR (eTMJR) and evaluated for at least one year. The chapter also focusses on problems that can occur during the implantation of an eTMJR.Both chapters eleven and twelve focus on further improving the perand postoperative protocols for a total mandibular joint replacement. Through a systematic review, the first chapter discusses the usefulness of a periprosthetic autologous fat graft (AFG), to prevent postoperative heterotopic bone formation, leading to an ankylotic joint and necessity for a surgical revision. Besides per-operative measures to ensure proper joint function, post-operative physiotherapy is important as well to keep the joint mobile. By use of a systematic review, physiotherapeutic treatments are analyzed. This chapter seeks to develop a new postoperative physiotherapy protocol which is thorough yet comprehensible for practitioners and supported by scientific evidence.Discussion and summary In Chapter 13 we discuss the general findings of the previous chapters and provide insight into future studies to further improve and support the developed TMJ prosthesis. The final chapter contains both Dutch and English summaries of this thesis.Nikolas de Meurechy NW.indd 19 05-06-2024 10:14