Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 11 4 2024 12 31 249 257 Masoud Fallahi Motlagh Department of Oral & Maxillofacial, Urmia University of Medical Sciences, Urima, Iran; Private Practitioner and Consultant in Maxillofacial Surgery, Azarbayjan Hospital, Urmia, Iran. Mohamad Taghi Kiani Private Practitioner, Head of Maxillofacial Department, Nikan Hospital, Tehran, Iran. Mir Mahdi Seyad Ashrafi Oral and Maxillofacial Surgery, Dental School, Urmia University of Medical Sciences, Urmia, Iran. Farbod Fallahi Motlagh Student Researcher, Dental School of Islamic Azad University of Tehran, Tehran, Iran. 2024 09 02 2025 03 14 Temporomandibular Joints (TMJ) is a bilateral fibrocartilage joint. This joint is unique in that it is a bilateral joint that functions as one unit. As with the other joints, many conditions affect TMJ causing It not to do its tasks. These conditions are ankylosis, arthritis, trauma, congenital abnormalities, pathologic diseases, and chronic dislocation. Although as a rule less is often best in treating Temporomandibular disorder (TMD) sometimes it is necessary to use invasive modalities. Total mandibular joint replacement (TMJR) is one of them that has been in use since 1963 and has been developed since. It is used in End-stage TMJ diseases resulting in anatomical architectural form distortion and physiological dysfunction dictates the need for reconstruction. Although nowadays the use of TMJ prosthesis is popular, sometimes it has catastrophic results due to its complications. If there is no indication, this method may cause legal issues. This article provides an overview of the clinical indications and contraindications associated with the TMJR and outcomes for our custom TMJ prosthesis cases are presented. Keywords: Temporomandibular joint replacement; Indication; Contraindication; Total joint, ankylosis; Degenerative joint disease. https://jcr.tums.ac.ir/index.php/jcr/article/view/513 https://jcr.tums.ac.ir/index.php/jcr/article/download/513/433