Objective: Surgical application of zirconium oxide ceramic TMJ prosthesis for first time with outcomes showed acceptable improvements in terms of pain levels, jaw function and morphology.

Method : Two cases of total unilateral joint replacement for TMJ ankylosis and congenital dysmorphisim were reported and described the surgical and post-surgical phases of treatment in patients that treated at the Department of Maxillofacial Surgery, Ramadi Teaching Hospital, Anbar Province, Iraq.

Result : The postoperative course was uneventful. The patient with TMJ ankylosis showed a good improvement in mouth opening and had no pain on either side at the 1-year follow-up; while the second patient who was with congenital dysmorphisim showed a well demarcated improvement morphologically and functionally excellent mouth opening at 1.5-year follow-up.

Conclusion : In both patients, the total TMJ replacement was successful. A carefully tailored post-surgical rehabilitation protocol applied on both patients helped the patient to gain a clinically significant improvement in jaw function. Longer follow-up periods are needed to assess the long-term maintenance of results.