Surgery for TMJ disorder is rarely needed, however, there are a small percentage of patients who do not see improvement from conservative treatment and must consult an oral & maxillofacial surgeon.
TMJ surgery has not been very well researched yet, however there are several surgeries available. Please make sure your expectations are realistic, and ask your surgeon what his/her expectations are before consenting to any procedure. A lot of the time, surgeons are aiming for an improvement in function, while patients are only concerned with pain relief. This makes for an unhappy patient who is not satisfied with his or her results. Also make sure you are aware of the potential risks of the surgery.
The success of TMJ surgery depends on many variables. Please make sure you do sufficient research on your doctor, the facilities (the hospital or the doctor's office), the actual procedure you are having done, and the recovery. If possible, speak to someone who has had the particular procedure. Be wary of doctors/dentists who provide you with a list of patients who have been "happy" with the surgery. Remember that the people on these lists have been hand picked by the surgeon, and often they are the ones that received optimum results.
As with any surgery, it is important to know what to expect as far as recovery. Make sure to write down a list of questions to ask the doctor, and some patients also find it helpful to write a "to-do" list before their surgery to make sure that everything they need is at home.
Types of TMJ Surgeries
What is done: In office or outpatient procedure to flush the joints with saline.
A TMJ arthrocentesis is done to lubricate the joint, loosen scar tissue, reduce inflammation, and improve range of motion.
What is done: Outpatient procedure using a scope to visualize the joint and any abnormalities.
A TMJ arthroscopy is done to loosen scar tissue and to visualize the joint.
What is done: Most often an inpatient procedure (one night in the hospital). Incision is made along ear to see the joint space, and adhesions are removed, bone spurs are shaved, and discs may be sutured in place or removed. The patient's own tissue may be inserted in the place of a disc. There are many types of arthroplasties, such as disc repositioning, tissue grafts, and gap arthroplasty.
TMJ Total Joint Replacement
What is done: An inpatient procedure (2-5 nights in the hospital) where the patients natural temporomandibular joints are removed, and prostheses are placed. There is an incision along the ear, and another incision along the jaw line. Several types of joint replacements can be used. This is a "last resort" procedure and should only be used when other therapies/surgeries have failed.