Oral and Maxillofacial Surgery

Open Temporomandibular Joint (TMJ) Surgery

What is Open Temporomandibular Joint (TMJ) Surgery?

Open TMJ surgery is a procedure used to treat temporomandibular joint disorders (TMD). It includes both minor surgical options such as arthroplasty and arthroscopy, as well as major surgical options such as disc repositioning and joint replacement by removing the jaw joint condyle (condylectomy). In cases where the jaw joint has fused to the skull base (ankylosis), usually due to trauma at a young age, the separation of these two bones is also considered a major surgical procedure. These procedures are performed by an oral and maxillofacial surgeon.

Who Should Undergo Open Temporomandibular Joint Surgery?

If you experience persistent, severe pain or tenderness when opening or closing your mouth, difficulty closing your mouth completely, and difficulty eating or drinking due to jaw movement or inactivity, and these symptoms do not improve with conservative treatments and appear to be caused by issues with jaw attachments, surgical intervention may be recommended.

These procedures, both minor and major, are typically performed once jaw growth has stopped. In females, this typically occurs between the ages of 14 and 16, and in males, between the ages of 17 and 21.

The surgery typically begins with an incision made above and in front of the ear to access the affected temporomandibular joint (TMJ). The surgeon may then replace the disc or install artificial jaw attachments, depending on the specific procedure. During the surgery, the surgeon may also remove any bony growths, excess tissue, or diseased bone.

Corrective jaw surgery can improve a variety of functions such as breathing, speaking, swallowing, biting, and jaw movement, and can also reduce pain during these functions.

What are the Risks of Open Temporomandibular Joint Surgery?

Open joint surgery carries more risks than other procedures, and the decision to undergo the surgery should be made with great care after fully considering the potential risks and complications, as well as the potential benefits of the surgery.

Potential complications may include bleeding, infection, nerve damage (paralysis resulting from damage to certain branches of the facial motor nerve), unintended fractures that may occur during the procedure, deterioration of dental occlusion, and the need for repeated surgeries. Pain or pressure in and around the joint and earache after jaw surgery is normal and is typically caused by the new position of the jaw. This discomfort usually subsides within 2 to 3 weeks.

How is the Recovery After Open Temporomandibular Joint Surgery?

The recovery period after open jaw joint surgery is typically 2-6 weeks, but this can vary depending on the specific procedure and the patient. It is important to note that these estimates may not apply to every individual and recovery times may vary.

You may experience swelling, bruising, pain, and tenderness in and around the jaw after surgery. Applying cold compresses to the joint is recommended on the post-surgical first day. It is important to follow all post-surgical instructions, including avoiding hard or solid foods and eating a soft diet until allowed by the maxillofacial surgeon.

After the initial recovery period, your maxillofacial surgeon will recommend physical therapy exercises to prevent unwanted adhesions from forming between the jaw joint and skull base (ankylosis). It is crucial to follow the physical therapy regimen as directed.