Artificial replacement of the human TMJ is used as the last possibility in severe TMJ destruction. But history of the TMJ replacement was shaped by multiple failures based on unsufficient design or inadequate biomechanical properties especially regarding the anatomically correct rotation and translation of the condyle. Based on a 13-years experience with different TMJ prosthesis, an adequate requirement profile for mechanical and biological aspects was established. Then, a TMJ prosthesis being composed of joint head and socket was developed to overcome the disadvantages of the former systems. The stability could be improved that the implanted could be miniaturized and could be inserted minimal-invasively without visible scar formation. This clinically efficient TMJ endoprosthesis was successfully inserted in 36 patients with highgrade arthrosis deformans. All operations went according plan, mean operation time was 82 min and there have been no complications. All patients have been absolutely satisfied and showed excellent mouth opening, long-time satisfaction at least 2 years after surgery was 8 points (scale 1–10). Functional follow-up by axiography and manual function analysis proved sufficient restoration of the TMJ function. All in all, the novel prosthesis meets all the high biomechanical, tribological and osseointegrative demands for a total TMJ replacement.