Temporomandibular (TM) Disorders - Surgery
Surgery is rarely used to treat
temporomandibular (TM) disorders. Surgical treatment
does not guarantee a cure and can further damage the temporomandibular joint.
Because most TM disorders can be treated nonsurgically, most doctors believe that surgery should be the last option tried and should
be avoided if possible.
Surgery may be a treatment option for you
if both of the following apply:
- Other treatments have failed, and chronic jaw
pain and dysfunction have become disabling.
- There are specific,
severe structural problems in the jaw joint. These include scar tissue in the
joint area, problems with bone alignment, broken or degenerated bones, and
disc displacement or perforation.
The goals of surgery for temporomandibular (TM) disorders
- Relieve pain in the jaw
- Correct any structural problems.
- Restore normal
TM disorder: Should I have surgery for jaw pain?
- Arthrocentesis. This is not a true
surgery, since there is no incision. But it is an invasive procedure performed
by an oral and maxillofacial surgeon. Arthrocentesis to wash out
the joint area (lavage) seems to work for people who have severe closed
lock of the temporomandibular joint.5
Surgery may include:
procedures, including washing out the joint area (lavage), cutting or removing
scar tissue that is blocking joint movement (lysis), cutting tissue that has
shortened and is impeding joint function, or shaving part of the
- Open joint arthroplasty, used for disabling joint
problems that aren't easily reached or viewed arthroscopically.
Another type of surgery, called total joint replacement,
is rarely done. It has sometimes resulted in permanent jaw damage. Total joint
replacement replaces the jaw joint with artificial parts. In some cases the
artificial parts have not worked correctly or have broken. The available
technology for this surgery is still considered to be experimental and
What To Think About
Further pain complications or
joint dysfunction can result from temporomandibular joint surgery.
Surgery is not necessary in most
cases of disc displacement.5 Splint therapy (a
dental treatment), jaw rest, and physical therapy, including moist heat and jaw
exercises followed by an ice pack, can work very well for treating this
condition. If this and other nonsurgical treatment to relax the muscles are not
successful, arthrocentesis may effectively treat your condition.
If you are thinking about surgery, get a second opinion on your condition