Question

What are the various approaches and incision for tmj surgery?

Answer 1

The initial diagnosis and treatment of facial pain and temporomandibular disorders (TMD) is becoming a routine part of practice for many general dentists. Some studies estimate the prevalence of clinically significant TMD to be as high as five percent of the general population with as many as two percent seeking some form of treatment for it (Dekanter 1992, Sep; Goulet 1995, Nov). Clinical experience and published literature suggests that conservative, non-surgical interventions, may account for as high as a 74 to 85 percent positive response rate in symptomatic TMD patients (Okeson 1986, Apr; Greene 1988, Sep). Likewise, other sources have even suggested that almost all patients with TMD will improve with time, regardless of the type of treatment they receive (Green 1982, Aug; Mejersjo 1983, Jun; Greene 1988, Sep; Nickerson 1989; Okeson 1989; McNeill 1993). Consequently, very few individuals with this disorder will ever require surgical intervention. The intent of this article is to provide the dental community with an overview of surgical treatment options that are available for those rare patients in whom conservative therapy has failed and surgery is indicated.

BACKGROUND

TMD is the general term used to describe pain and/or dysfunction of the masticatory apparatus including the temporomandibular joint, masticatory muscles, and supporting structures (Okeson 1997, Jan). Disorders of the Temporomandibular joints are one subset of TMD. For the purpose of this article, Temporomandibular Joint Dysfunction/ Disorders will be referred to as TMJD. The etiology of TMJD is multifactorial and signs and symptoms may be quite variable. Those presenting for treatment are more likely to be female (deBont 1997, Jan; Carlsson 1999, Fall). TMJD may be classified as articular (within the joint) or non-articular (outside the joint).