Background: End-stage diseases of the temporomandibular joint (TMJ) represent a reconstructive challenge. The function and form of the TMJ is important for mastication, speech, deglutition, airway support, facial esthetics, psychological development, and quality of life. The surgeon presented with any of these scenarios currently has 2 replacement options, either autogenous or alloplastic. The purpose of this article is to report the University of Torino experience and to review the literature on the on the management of failed autogenous tissues using TMJ prostheses.