TMJ or the temporomandibular joint connects the human jaw with the skull. It is present in both sides of the jaw. This joint along with the surrounding muscles help in the jaw movements. When such movements seem difficult and painful, it is called TMJ joint disorder. Patients with TMJ joint disorder may require some kinds of surgeries to get relief from the painful symptoms. The recovery depends on the surgical procedure performed by the surgeon.
Signs and Symptoms of TMJ Disorder
There may be moderate to severe pain in the jaws joints or in any one joint which is the most basic symptom of this problem. This pain may spread in the ear, neck, forehead, and eyes. Some other signs and symptoms are as follows:
- Ear pain or cracking sound in the ear
- Blurred vision may occur in some severe situations
- A headache or a migraine
- Stiffness in the jaw muscles
- Jaw joints locking
- Moderate to severe pain in the temple area.
When the condition is severe and the disorder is progressing to further damage the joint, the TMJ surgery is done to prevent the condition from worsening.
Types of TMJ Surgery
There are three kinds of surgical options for treating TMJ. All these methods are performed by the maxillofacial and oral surgeon. The types of TMJ surgery are as follows:
Arthrocentesis: This is a primary step. Arthrocentesis is a minor procedure that is performed using general anesthesia and it is performed when there is restricted jaw opening among the patients and they have no major earlier history of this problem.
Open-joint Surgery: In this procedure the patients are given a general anesthesia. The whole area around TMJ is opened and this way the doctor gets full view access. Many forms of the open-joint surgeries are available. When the bony structures that consist of the jaw joints are reducing, this treatment is useful. An open-joint surgery takes a longer healing time and therefore the chances of nerve injury and scarring are more.
TMJ Surgery: When arthroscopy procedure is diagnosed, patients go through surgery under general anesthesia. In comparison to the open-surgery method, this one leaves fewer scars, is less invasive, shorter recovery time, and very fewer complications.
Procedures for TMJ Surgery
Surgeons follow different procedures which depend on the present condition of the patients:
Arthroplasty: With an open joint surgery or arthroplasty, a larger incision may be required to expose the total joint for a good view. This helps in facilitating the replacement or repair of the disc and this can allow you to open as well as close your jaw. It may need realignment after the replacement of disc and removal of bone spurs and scar tissue. The recovery time is longer and may be more painful too. Patients may need to take a break of one week from work. You may be required to stay at a hospital for one or two nights. Till the time, i.e., one week, the stitches are removed you will not be able to eat anything solid. Bruising, tightness, swelling, and stiffness can last for one week. Bleeding may happen around the incision the next day after surgery; however, it stops after that day.
Arthroscopy as a TMJ Surgery: This is a least invasive and the most common TMJ procedure. In this technique, a very small incision is made at the ear’s front for inserting a small instrument. This technique helps a surgeon to explore the jaw and the joint pain causes, remove the inflamed tissue, and make the realignment when required. BAOMS or the British Association of Oral and Maxillofacial Surgeons noted that stiffness and swelling may be there for some days. The recovery takes lesser time as compared to arthroplasty.
Total Joint Replacement Surgery: Total joint replacement is done where there has been degeneration of joint from osteoarthritis, traumatic injury, or irreparable damage. Post-surgery you have to stay in the hospital for 3-5 days and it may take a month before you can resume your normal activities. Your surgeon may wire the jaw for a limited time period. Previously, surgery of total joint replacement used to be risky and was considered a last resort. However, according to a study that followed 300 patients for 10 years post operation showed great improvement. None of the patients reported severe pain after six months of operation.
Success Rate for TMJ Surgery
The intensity of TMJ pain reduces or recovers completely after surgery. In a survey, it is found that 36 out of 37 patients recovered from the problem completely and lead a normal life. These patients had difficulties in jaw opening and there was a severe pain but after the operation, it got reduced. The success rate is very high. As per the experts over 85% of patients recover and come to their normal life after surgery. However, misdiagnosis is also a problem in this disease.
Recovery Period for TMJ Surgery
TMJ surgery recovery period varies from one patient to another. There may be general complication such as bruising, pain, and infection and some specific complications, jaw stiffness, and tenderness. The recovery period is mainly subjected to the kind of surgery performed on a patient; however, discomfort and swelling rise after two days.
Experts ask the patients to avoid strenuous activity. They also ask to refrain from long conversations and smoking. Patients are given liquid and soft diet for some days. Maintaining a hygienic routine is mandatory. Later, some jaw exercises under the expert supervision and physical therapy may be required. The patients are asked to avoid brushing and using a mouthwash for some days.
Conclusion
TMJ disorder is widespread and it is linked with dysfunction and pain of the temporomandibular joint. A general dentist can always offer primary diagnosis during the early stage of this disorder. However, if the pathology is identified for a patient or the condition is refractory, TMJ surgery is advised. Irrespective of the surgical method performed whether immediate or aggressive, post-operative physiotherapy is the actual key.
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