PURPOSE: New-generation total temporomandibular joint prostheses have demonstrated their efficacy and low morbidity. However, their implantation requires a dual external approach, which can result in significant aesthetic and functional sequelae. The authors have therefore developed an alternative technique that avoids the cervical route. MATERIALS AND METHODS: The authors describe their technique for implanting a temporomandibular joint prosthesis using a combination of pre-auricular and intraoral approaches. They share the outcomes from a series of 16 patients treated with this technique, reporting complications as well as improvements in range of motion (ROM) and patient-reported outcomes regarding pain, eating ability, and overall satisfaction. RESULTS: A total of 16 patients and 22 prostheses were included. The functional results demonstrated a significant average increase in ROM of 34.4mm (p<
0.001), a one-point reduction on the visual analogue scale (VAS) for pain (p=0.19), and a 1.1-point improvement in feeding ability on our scale of 1 to 4 (p<
0.001). Complications included one case of transient facial paralysis with complete recovery, and one case of implant-related infection requiring removal of the prosthesis. DISCUSSION: this technique appears to provide comparable functional outcomes, with less scarring, and avoids the risk of facial nerve injury associated with the traditional approach. However, a potential disadvantage that needs further evaluation on a larger scale is the risk of infection, which does not appear to be increased in this series.