Different surgical options for temporomandibular disorder (TMD)

Temporomandibular disorder (TMD) affects the jaw joint (temporomandibular joint or TMJ) and the surrounding muscles, leading to pain, difficulty in moving the jaw, and headaches. While many cases of TMD can be treated with non-surgical methods like physical therapy, medication, or mouth guards, some patients may require surgical intervention when symptoms become severe and conservative treatments fail. Here’s an overview of different surgical options available for TMD.

Arthrocentesis

Arthrocentesis is a minimally invasive surgical option often considered as a first step when non-invasive methods don’t work. The procedure involves inserting small needles into the TMJ to flush out inflammatory debris and excess fluid that may be causing pain and restricted movement. 

It is performed under local or general anesthesia and is often followed by jaw stretching exercises to improve mobility. Arthrocentesis can offer quick pain relief and has a shorter recovery time compared to other surgical options.

Arthroscopy

TMJ arthroscopy is another minimally invasive procedure that allows the surgeon to visualise the joint with the help of a small camera. Using this method, the surgeon can remove scar tissue, reposition the disc within the joint, or perform other necessary repairs. Arthroscopy typically has a faster recovery time compared to open surgery, and it is useful for addressing internal derangements of the joint, such as displaced discs.

Open-joint surgery (arthrotomy)

Open-joint surgery, or arthrotomy, is reserved for severe cases of TMD where minimally invasive options are not sufficient. This procedure involves making an incision near the ear to directly access the joint, allowing for more extensive repairs, such as disc repositioning, joint restructuring, or even joint replacement.

Although it can be more invasive and requires a longer recovery period, open-joint surgery is sometimes the only solution for chronic pain and significant joint damage.

Joint replacement surgery

In cases of extreme joint damage due to arthritis, trauma, or other conditions, TMJ replacement surgery may be necessary. This involves replacing the damaged joint with an artificial implant. Although rare, this is typically the final option when other surgeries have failed to relieve symptoms.

Choosing the appropriate surgical option depends on the severity of TMD, the patient's overall health, and their specific condition. Consulting with a specialist is essential to determine the best course of action.