TMJ Surgery

Surgical treatments for TMJ disorder are reserved for those who have generally failed more conservative therapies. If other TMJ therapies are found ineffective in relieving jaw pain or other TMJ complaints, then a more aggressive approach can be considered. For clarification, surgeries will be categorized into dental-type surgery and joint-type surgeries.

Dental surgeries for TMJ disorders included occlusal adjustment , orthodontic treatments , and occlusal restoration . In essence all of these procedures try to correct poor dental alignment of the teeth and/or jaw so that TMJ symptoms can improve. By creating a smooth bite and even tooth surface, less mechanical stress is felt in the temporo-mandibular joint area.

Occlusal adjustment refers to a smoothening of the teeth exhibiting irregularities that prevent an even fit between the teeth. Once bite markings identify areas of irregularity, a fine painless drill smoothes these areas allowing the bite to regain a perfect occlusive fit. Occlusal restoration on the other hand identifies areas where missing teeth, abnormal crowns, and other tooth deformities alter the bite more dramatically. In this setting, restructuring of crowns, tooth transplants, dental implants and restructuring of the bone may be required. In general, more significant interventions are performed with occlusal restoration in TMJ. By establishing an even bite with good alignment, the chances for TMJ to respond to conservative treatments dramatically improves.

In some cases, orthodontic treatments are required to better align the bite and jaw. These treatments result likewise in an even bite and jaw movement which in turns takes strain off the TMJ area. These also can be quite effective. Depending on your dental situation, different levels of dental surgery may be considered. Overall the rate of success is quite high.

Jaw surgeries on the other hand focus less on the dental areas and more on the temporo-mandibular joint. This could be something as simple as an arthocentesis where fluid is removed from the TMJ area similarly to a knee aspiration. Or the surgeries can be more involved restructuring the jaw joint itself. If joint surgery is required, options include disc repositioning, discectomy, or complete joint replacement.

The disc within the temporo-mandibular joint is similar to the discs in your spine. It is a hard cushioning material that buffers the strain between the mandible and temporal bone of the skull. In other words, it is like a shock-absorber. As the TMJ area becomes inflamed, deformed or deteriorated, the disc material can become dislodged, calcified, or herniated. Some surgeries simply reposition the disc back into place, where as others may remove the disc and replace it with other material. If the jaw joint is damaged seriously, the entire temporo-mandibular joint may need replacement.

Fortunately, most TMJ patients do not require this degree of surgical intervention. The dental surgeries for those that require aggressive treatments usually are effective.

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