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Open-Joint Arthroplasty for Temporomandibular Disorders

Open-joint arthroplasty is surgery to repair, reposition, replace, or remove parts in a joint. When used to treat temporomandibular disorder (TMD), this usually involves the articular disc that cushions the jaw joint.

During open-joint arthroplasty of the jaw, an incision is made in the skin to expose the jaw joint. The surgeon may repair, reposition, or replace the disc with your own tissue or an artificial disc. Scar tissue or bony growths in the jaw joint can also be removed.

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Open-joint arthroplasty is done under general anesthesia. You can normally expect to go home the same day.

When jaw joint movement cannot be regained because the disc has changed too much or the joint has broken down, the surgeon may need to remove the disc (discectomy) and replace it with an artificial disc.

What To Expect After Surgery

After surgery, medicines are prescribed to relieve pain and reduce swelling.

You can start physical therapy within 48 hours to maintain movement and prevent scar tissue from forming.

You may be given a mouthpiece (splint) to wear while rehabilitating your jaw.

Why It Is Done

Open-joint arthroplasty is used when:

  • There are bony growths within the jaw joint. Such growths are hard to reach with arthroscopic methods.
  • Complications from a previous surgery occur, such as the failure of an artificial joint replacement.
  • The joint is fused together by bony growth (ankylosis).
  • The joint is not accessible with arthroscopic surgery.

How Well It Works

Disc repositioning surgery can relieve pain and improve jaw function. This surgery has good results 80% to 95% of the time.1

Risks

Possible complications include:

  • Loss of jaw movement. Everyone has some decrease in jaw mobility after surgery, because the jaw heals with scar tissue, which is harder and tighter than normal tissue. But jaw exercises will help jaw movement.
  • Adverse reaction to the materials in an artificial disc. The risk of tissue rejection is higher if artificial materials, rather than your own tissue, are used.

What To Think About

When possible, a nonsurgical approach is preferred over surgery, because:

  • It is cheaper, safer, and noninvasive.
  • It can be stopped or reversed.
  • It involves less risk of permanent damage.

Current practice trends are to avoid altering disc position or structure. After disc replacement, an adverse reaction to an artificial disc is possible.

Repeat surgery is less likely to produce positive results.

Surgeries done using open-joint arthroplasty require more recovery time than do arthroscopic surgeries.

If your doctor recommends surgery, experts agree that it is best to get a second opinion.

Temporomandibular Disorder: Should I Have Surgery for Jaw Pain?

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

Citations

  1. Tucker MR, et al. (2008). Management of temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp. 629–649. St. Louis: Mosby Elsevier.

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Arden Christen, DDS, MSD, MA, FACD - Dentistry
Last Revised January 11, 2012

WebMD Medical Reference from Healthwise

Last Updated: January 11, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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Only 18.5% of Americans never floss. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Floss removes food trapped between the teeth and removes the film of bacteria that forms there before it turns to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Try flossing just one tooth to get started.

You are one of 31% of Americans who don't floss daily. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for 3 more days!

You are one of 31% of Americans who don't floss daily, but you're well on your way to making a positive impact on your teeth and gums. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for all 7 days!

Only 50.5% of Americans floss daily, and good for you that you are one of them! Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Congratulations on your good oral health habit!

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American Dental Association, Healthy People 2010

This tool is intended only for adults 18 and older.

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