Surgery for Temporomandibular Joint Disorder

Surgery is a permanent choice and should only be used as a last resort. Make sure you have tried all the other alternatives before making this final move. Surgery for Temporomandibular Joint Disorder, or TMJ, is rarely used for a treatment because it does not guarantee a cure and could further damage the joint. Surgery may also decrease your jaw's range of movement as the jaw heals with scar tissue, which is harder and tighter than normal tissue. Surgery may become an option if you have tried everything and are still in constant, intense pain that is disrupting your ability to eat or work and is disabling your every day life. The other time that surgery may help is if a specific, severe structural problem has been definitely diagnosed.

Arthroscopy, arthrocentesis, and open-joint surgery are the three types of surgery for this disorder. What type to have depends on the type of problems or severity of the temporomandibular joint pain.

All the surgeries are done with general anesthesia. Make sure you do not have difficulties with using anesthesia. Also, make sure to check the qualifications of your surgeon and anesthesiologist..

Arthroscopy - First general anesthesia is given. Then a small incision is made by the surgeon in front of the ear. This incision allows a tiny, thin instrument with a lens and a light to be inserted. This device is hooked to a video screen where the surgeon examines the temporomandibular joint and areas around it. Removal of inflamed tissue or realignment of a disc or condyle is done by what the surgeon can see. The condyle is the part of your jaw consisting of the "ball" portion of the "ball and socket."

This choice is considered less invasive than open-joint surgery. Arthroscopic surgery leaves less scarring, usually has less complications and a shorter recovery period. The cause of the TMJ may rule out this option for you and open-joint surgery may become necessary.

Open-joint Surgery - For this option a general anesthesia is given. The incision is larger than with arthroscopy as the entire area around the temporomandibular joint needs to be opened for a full view by the surgeon. The larger incision is also to allow better access. The type of open-joint surgery needed depends on what is wrong. It can be that there is extreme scarring or chips of bone in the joint that need to be adjusted. The surgeon may find a tumor that will need to be removed,. The worst cases involve the deteriorating bony structures of the jaw and will need to be reconstructed. With the more intense problems and surgeries comes the longer healing times and chances of permanent scarring and nerve trauma.

Arthrocentesis - This is a minor procedure for sudden-onset problems when restricted jaw opening is diagnosed. It is performed under general anesthesia. This choice is for cases with no major history of temporomandibular joint disorders. The affected joints have a needle inserted and are washed out with sterile fluids. If necessary, insertion of another instrument to remove tissue adhesion or dislodge a stuck disc in the condyle is done at the same time. This is a common procedure for a painfully locked jaw and is successful in 94% of cases.