When you move your jaw, TMJ issues produce discomfort and a limited range of motion. In addition, they may generate a painful clicking or grating noise in the jaw joint while opening or shutting the mouth. TMJ surgery aims to alleviate discomfort and restore normal jaw function.
There are a few recognized causes of TMJ, but the reason remains unexplained in most instances. Some examples are autoimmune disorders, injuries to the jaw, and having your mouth open for an extended period of time, such as during a dental operation or when a breathing tube is implanted before surgery.
After diagnosing TMJ with an examination of the head, neck, face, and jaw, a review of symptoms such as pain when chewing, and imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI), your healthcare provider or dentist will likely recommend non-surgical treatments first. TMJ jaw surgery is the last resort treatment.
What is TMJ Arthroplasty?
Temporomandibular joint arthroplasty is one of the surgical procedures performed in a hospital operating room by an oral and maxillofacial surgeon with specialized training. It is generally referred to as complete jaw joint replacement. It entails removing the diseased joint and replacing it with an artificial one.
An open-joint arthroplasty is used when arthroscopic surgery is not possible. It can relieve pain and improve jaw function with disc repositioning surgery.
Arthroplasty is an open TMJ procedure in which an incision is made over the joint region in front of the ear. Typically, the incision extends from within the sideburn region, then in front of the top of the ear, and finally into the ear itself. The portion that reaches into the ear is there to conceal the incision. This “skin flap” is then reflected forward, revealing the layers beneath.
The fascial layer is revealed and reflected, so revealing the TMJ capsule. The capsule is opened, and the disk is revealed (meniscus). Typically, this is the structure responsible for your problems. The disk is checked thoroughly, and its location, thickness, smoothness, and pliability are recorded. Special attention is paid to identifying rough surfaces, sharp edges, voids, and anatomical anomalies on the bone surfaces of the TMJ. If the disk is sufficiently healthy, it is repaired by pushing it into a more normal position and stitching it in place (sutures).
If the disk is unusually stretched, a wedge of tissue is removed from beneath the disk, and the edges are sutured together. If the disk is irreparably damaged, it must be removed. If the disk is not removed, it may continue to produce the same symptoms following surgery. The choice to repair or remove the disk is decided following a firsthand examination of the disk during surgery.
After the disk has been repaired or removed, the bony surfaces are inspected, and any abnormally rough areas are polished with surgical files. If the disc has been removed, the surgeon will decide whether not to replace it, implant a temporary disc, or replace it with a transplant of the patient’s own tissue.
What to Expect Days After Surgery
According to the TMJ Arthroscopy Post-Operative Instructions material from the University of Michigan Health System, here are some of the things you can expect after the TMJ arthroplasty procedure.
- You will spend a brief time in the recovery room after surgery. Once you have recovered from the anesthetic, you will be released with the necessary medicines and instructions for home care. You must be accompanied by a competent adult who will transport you home and care for you following surgery.
- It may take 5-7 days for the swelling to subside following surgery.
- You may temporarily feel a change in your bite. If so, this will often disappear within five to seven days.
- You may experience jaw joint clicking that was not previously present. This may be normal, and there is no need for an alarm.
- You may experience facial numbness and transient paralysis on the surgical side. This is often the result of a local anesthetic (numbing drug) supplied for your comfort, and it should only last a few hours.
Potential Risks
Open joint surgeries are more prone to complications than less invasive procedures. Before considering TMJ surgery, obtain various opinions from other healthcare professionals to assess the potential risks and benefits.
Potential complications related to TMJ surgery include:
- Deafness
- Loss of jaw movement
- Persistent pain or reduced mobility of TMJ that isn’t resolved by surgery
- Teeth misalignment
- Facial nerve damage, weakness, or paralysis
Joint replacement, the most invasive TMJ surgery, can have serious consequences for some patients. Some artificial implants may not operate well or disintegrate in the jaw over time. More long-term clinical trials are required to evaluate the safety of these frequently irreversible surgeries.
Frequently Asked Questions
Can you talk after TMJ arthroscopy?
It is important to minimize jaw movements for the first 24 hours, and patients are usually advised to take it easy on their mobility after surgery. You can resume your usual activities after that, although you may still experience some discomfort and stiffness for a while. It is also recommended that you avoid eating hard foods or crunching your teeth until the swelling and bruising have subsided.
You should report symptoms such as trouble breathing, severe pain, heavy bleeding, fever, or difficulty closing your eyes immediately to your doctor.
How long is recovery from TMJ arthroplasty?
Recovery time following TMJ arthroplasty will depend on the extent of surgery performed, but most people can go home within three to five days. Full recovery typically takes four to six weeks.
While at home, it is important to take things easy and avoid any strenuous activities.
It is possible to restore your jaw’s function and range of motion through physical therapy or jaw exercises. To maintain movement and prevent scar tissue formation, you should begin physical therapy within 48 hours. You may also need to continue wearing your mouthguard for a period of time after returning home. Be sure to follow all post-operative instructions closely to ensure a smooth and speedy recovery.
Read More: Why Does TMJ Pain Only Hurt on One Side?
Consult with Garza DDS to learn more about TMJ arthroplasty
If you are considering TMJ surgery, consulting with a qualified oral and maxillofacial surgeon like Dr. Garza is important. He will be able to assess your condition and recommend the best treatment for you. In many cases, TMJ arthroplasty can relieve pain and enable normal jaw function. Contact Garza DDS today to learn more about this procedure or schedule a consultation.