AbstractBackground: Mandible reconstruction using vascularized free fibula flaps (FFF) is now considered the state of the art, however, those including disarticulation resections and hence reconstruction of the temporomandibular joint (TMJ) are still challenging for most maxillofacial surgeons as the available literature reports are scarce. Most reports focused on the clinical outcomes, and few focused on the spatial deviations of the neocondyle. Several modifications and methods have been reported to support the fibula and improve the functional outcomes of the TMJ.Objective: The aim of this systematic review is to investigate different functional and morphological outcomes following TMJ reconstruction with FFF after disarticulation resections and correlates with the different modification and factors. Materials and Methods: An online search will be done to check all articles reporting TMJ reconstruction using FFF and advocating different outcomes. prospective clinical study was to introduce three modified techniques simultaneously with mandible reconstruction of the TMJ with vascularized free fibula flap (FFF) for dynamic mandible reconstruction and evaluate the different outcomes of such modifications in comparison to the conventional technique.