The 3 Types of TMJ Surgery
by Dr. Scott Bolding
Table of Contents
01. TMJ Arthrocentesis
02. TMJ Arthroscopy
03. Open Joint Surgery for TMJ Disorders
What Are the Types of TMJ Surgery?
TMJ disorders can be frustrating, especially when non-surgical options aren’t working. If you’ve been trying to relieve your pain with mouth guards or pain medication but aren’t seeing any results, it may be time to consider TMJ surgery. There are several different types of TMJ surgery, and the right option will depend on your unique situation. You can use the information below to start this conversation with your doctor so you can make the right decision going forward.
TMJ Arthrocentesis
What is it?
TMJ is arthrocentesis is the least invasive type of TMJ surgery. TMJ arthrocentesis involves washing the jaw joint out using needles and a saline solution. This procedure washes out the chemicals caused by inflammation. Arthrocentesis can help improve joint mobility.
Recovery and What to Expect After Surgery
Arthrocentesis is the least invasive procedure for TMJ disorders. As an outpatient procedure, you should be able to go home the day of. The entire procedure won’t take more than 20 minutes for one joint. Since arthrocentesis doesn’t require an incision, recovery is mild. You should expect to be able to get back to your normal life within 24 hours.
You should start to notice improvements in your joint after several days. Most patients only need one procedure. However, you may need more depending on your unique case.
Am I a Candidate for TMJ Arthrocentesis?
Patients who are an ideal candidate for TMJ arthrocentesis include patients who:
- Have osteoarthritis
- Have an acute inability to open their mouth
- Experience TMJ clicks or other TMJ symptoms
TMJ arthrocentesis is the type of TMJ surgery for patients who have not seen success with non-surgical treatments. It can also be paired with other non-surgical treatments.
TMJ Arthroscopy
What is it?
Arthroscopy is another minimally invasive type of surgery for TMJ disorders. It involves inserting a tube (arthroscope) into the jaw joint through a small cut. Depending on the specific procedure, the surgeon will connect a camera. The camera will help them see what is going on inside your jaw joint. In some cases, the surgeon may also be able to use small tools that allow them to work directly on the joint.
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Arthroscopy is used to treat TMJ disorders as well. Your surgeon can use the following methods during this procedure:
- Washing out the joint
- Medication injection
- Scar tissue removal
Recovery and What to Expect After Surgery
Since arthroscopy only takes a small incision, the recovery time is often short. Even though this procedure is very successful, there are still some general complications to be aware of, as with any surgery. These complications might involve pain and swelling of the surgical site. You may also experience stiffness or tenderness in your jaw in the days after surgery. Numbness around the surgical site is also common due to temporary nerve damage.
It’s important to note that most of these complications are rare and usually resolve themselves over time.
At least 48 hours after your surgery, you will need to start physical therapy. This will help you maintain mobility in your jaw and prevent scar tissue from forming.
Am I a Candidate for TMJ Arthroscopy?
This type of TMJ surgery can be used to treat TMJ disorders where:
- Joint disease is causing a tissue or bone breakdown
- You have scar tissue
- The cartilage on the joint is too thick
- You have severe disc problems in the joint
- An injury has loosened the joint
You are not a good candidate if:
- There is swelling in the jaw that has not yet been diagnosed
- You have an infection
- You have a tumor
- You can only hear out of the ear on the same side as the joint that needs surgery
Obesity can also affect whether you are eligible for this type of TMJ surgery. Excess skin caused by obesity can make it difficult for the surgeon to access the jaw joint.
Open Joint Surgery
What is it?
Open joint surgery involves making an incision so your surgeon can access the joint directly. This incision is bigger than the one made for arthroscopy. This enables your surgeon to work on the joint itself. They are able to make repairs, reposition the disc, and even replace some parts of the joint. Open joint surgery is helpful when your joint is too difficult to reach with arthroscopy.
Recovery and What to Expect After Surgery
Since open joint surgery is more invasive than other types of TMJ surgery, recovery will be a little bit longer and will require an overnight hospital stay. If you are getting a total joint replacement, the hospital stay will be longer. The incision will require stitches that will need to come off after about a week.
You may experience some pain and swelling in front of your ear where the incision was made. Pain medication will be prescribed to help. You will also be given a splint that will help rehabilitate your jaw. Like with other types of TMJ surgery, you will need to start physical therapy 48 hours after surgery.
For the first week or so after surgery, you may find it difficult to open your mouth, so we recommend sticking to a soft food diet at first. As your face starts to heal, you will be able to eat regular food again.
Complications with this type of TMJ surgery are rare but can include:
- Bleeding and infection
- Facial nerve damage
- Reactions to artificial disc replacements
The success rate for open joint surgery is quite high. According to University of Michigan Health, this type of TMJ surgery has an 85 – 90% success rate. Since the surgeon is able to work directly on your joint, they are better able to solve the root of your TMJ pain. Most patients who get this type of surgery see an improvement in jaw function as well as reduced pain.
Am I a Candidate for Open Joint TMJ Surgery?
Since open joint surgery is more invasive than other types of TMJ surgery, it’s usually the last resort for treating TMJ disorders. It’s really only an option for patients who have problems with a joint that can’t be solved with any other methods. If you have bony growths or excess tissue, for example, open joint surgery can allow your surgeon to remove it. Open joint surgery is also the right type of TMJ surgery if the disc in your jaw joint has been damaged or displaced. Your surgeon will be able to repair it or reposition the disc, as needed. Depending on your situation, you may also need to have your joint completely replaced. As always, the benefits of open joint surgery will depend on your unique needs.
Explore Your Options
Talk to Your Doctor About the Types of TMJ Surgery
Deciding to go forward with TMJ surgery is a big step. In order to take that step with confidence, you need to know what you’re getting into. Learning about the different types of TMJ surgery can help make that decision a little easier. As with any medical procedure, the right choice depends on your specific case and your unique needs. It’s important to talk to a medical professional to make sure you understand all of your options.
If you’re ready to take that step toward a TMJ-free life, schedule a consultation with our PRECiDENT specialists. They will work with you and the rest of your medical team to figure out the right solution for you.