Painful chewing, clicking feelings in the jaw, locking of the jaw, unpleasant and difficult dental visits all make patients look for treatment.
There are various causes for these issues, such as:
A form of treatment for these issues is Total TMJ Replacement.
Total TMJ Replacement is intended for patients who did not benefit from non-surgical treatments, nor surgical reconstructions of natural joints.
First, a patient comes to a doctor’s office with one or more of the issues mentioned above. Complaints and medical history are very important for the selection of the treatment. Then the patient is examined at the office but may need further imaging. The majority of patients who may have surgical treatment of TMJ will have a Panorex x-ray, MRI scan and CT scan. The CT scan is particularly important for the Total TMJ Replacement.
If the patient’s complaints, history, physical examination and CT scan demonstrate that he/she is eligible for Joint Replacement surgery, then a thorough discussion between patient and doctor regarding the procedure, post-operative days, diet and potential problems would occur. The operation is done usually electively. The main exclusion is an acute severe TMJ injury.
The patient comes to the hospital in the morning after fasting overnight. He/she is then anesthetized (“put under”). While asleep, a patch of hair in front of the ear gets shaved. One incision is made there and another is under the lower jaw angle. During the operation, both jaws get wired temporarily. The artificial joint consists of 2 components: a socket (fossa) and a lower jaw (mandibular component). They are put inside after the removal of the diseased joint. The implant is fixed to the patient’s bones with high-quality screws.
The procedure takes about 2 hours 15 minutes. The patient stays at Hospital for 1 or 2 nights. Most patients comment on having moderate levels of pain during the first day, but progressively disappearing day by day. Stitches are removed after one week.
After the surgery, the swelling of the side of the face settles down within 1-3 weeks. Numbness of the ear can last 3-6 months. Around the 6th week, the joints of the jaw will be stretching. Guidance by a physiotherapist is preferable but daily exercises can be done easily by a dedicated patient alone. The typical goal is the painless opening of the mouth 30-35 mm between the top and bottom front teeth. Diet is a very important factor in the healing process. During the first week, a non-chewing diet is recommended. For example soups and smoothies. Then for the next 5 weeks, it is recommended that the patient stays on a very soft diet. Following this period the patient can resume their usual diet.
There may be a rare weakness that is felt in the corner of the mouth and eyebrow, but it recovers within 3 months.
The success rate is high according to the 2013 study reporting a 71% improvement in pain and a 61% improvement in mouth opening.
Dr. Filatov provided me with everything I hoped for and more. I had an accident in 2005 and broke the right side of my face. This left me with a titanium eye plate, a titanium cheek and a fractured jaw in three places. After suffering for years with a loss of confidence about me scarring for years, and after enduring excruciating pain in my eye and cheek which often left me debilitated with massive headaches, who knew a simple procedure could eliminate so many of my concerns. My scarring is unnoticeable except upon a close inspection. And even better, my headaches have virtually disappeared! Thank you so much, Dr. Filatov. And I would be amiss to overlook his excellent assistant Julie, who warmly guided me along from my first enquiry to the post surgery follow-up. I highly recommend Dr. Filatov for his expertise.
My family doctor referred me to Dr.Filatov as I was unable to close my right eye. I had a gold plate eyelid implant done. Each time i have been to see him it has been great, and the receptionist has been awesome. Dr.Filatov has a very good bedside manner, and I highly recommend him for anyone who needs surgery. He took great care and explained what had to be done. I am going back for a check up this week and will certainly go back to him if I need anything else done. For a specialist in particular I had a good experience.
I was referred to dr filatov due to many years of sinus problems. I had ablarge hump and major deviation to the left. My nose was very crooked and it impaired my breathing, taste, and smell. I found dr filatov to be very professional, straight forward, and at times blunt. However, i appreciate honesty and forwardness from a surgeon. Dr filatov took the time to ask me many questions and i found him to be meticulous in his examinations. I need to be able to trust a surgeon, especially when operating on something so noticable (being self conscious to start). After a lot of research into cost, skill, education, knowledge, and results dr filatov's extensive education made me feel confident in his abilities (even when bedside manner is lacking). We are all human beings with good and bad days. I did not encounter bad bedside manner, his forwardness and blunt answers were anticipated most surgeons have people skills lacking...thats what you get when you have your nose in the books becoming a dr. His staff are empathetic, helpful, and easy to approach. I was terrified before surgery, so very happy i went for it. 2 weeks post op and i look amazing. Better than i anticipated. I was told by the nurse he took over 3 hours in the operating room with me. He anticipated an hour to hour and a half. That tells me he went above and beyond to ensure the reults were the best possible. What other surgeon operates out of the kindness of their heart? Thank you dr filatov for giving me confidence that i did not have before!
I recently had blepharoplasty surgery and my family doctor recommended Dr. Filatov. I received excellent care from Dr. Filatov and his staff. Dr. Filatov took the time to explain the procedure, showing me videos and answering all my questions both before and after the surgery. I am extremely pleased wit the results and would recommend Dr. Filatov to anyone who is considering this surgery.
I recently had eyelid reduction surgery with a brow lift. Dr. Filatov was very informative, took the time to explain the surgery and the desired out come. He was courteous and punctual. His staff was awesome! All my questions were answered with out unrealistic expectations. My surgery went well and he checked in on me about a half hour after the surgery to make sure he had the desired result. I can't believe the difference in my eyes! They look fantastic! I know many people who have had different types of surgery all concerning cranial and facial areas, I have not found who has not said he has done a excellent job on their surgeries! I highly recommend Dr. Filatov to anybody I know needing cosmetic or ENT surgeries. If I ever need any further surgery in the future I will definitely be seeing Dr.Filatov. My results from my surgery were awesome! Thanks again Dr. Filatov.
Very informed and forthcoming. His dedication an thoroughness are always apparent, a doctor who does not rest on his laurels. I have visited Dr. Filatov on three occasions and have always had a total confidence in his diagnostic protocols and medical procedure. Given the flow-through of patients is very high in any specialist's practice, Dr Filatov is cautious and thorough, never rushing me out the door. Wish this fellow could give lessons to various & numerous GP's about bedside manner, they would do well to follow his example.
In December 2012 Dr. Filatov changed my life for the good :) I had many ugly scars on my face and he just started doing laser treatments in his office, so he offered to do my face at NO COST. Not many surgeons out there will offer free service like that, but he did! He to HIS time and costs of this laser machine to help ME! He really truly is a kind hearted gentleman, and knowledgeable in the procedures and consults he does. I had two treatments done on my face and even though the scars are not totally gone there is a remarkable difference for the better. He made me feel very comfortable, and even took my email when he went away on holidays to make sure I was healing properly. He also called my home over the holidays to check in with me as well, now tell me is that a man that doesn't care about his patients? He is our ONLY ENT in Prince George and it can be very overwhelming as he has a family and a life as well.
I had my nose broken in school and I had a bump and needed my septum repaired. Being a 16 year old girl your face is pretty important. I was sent to Dr. Filatov and I am so grateful to have had him as a doctor. Not only was the staff amazing, but he made me feel so comfortable and he explained the whole surgery to me during the appointment and right before the surgery. He answered all of the questions that my parents and I had. He took great care of me before and after the surgery, great bedside manor. I not only can breathe through my nose again, but i have no visible scarring and I feel a lot better about myself. I highly suggest him as a doctor, especially a plastic surgeon. Thank you so much Dr. Filatov.
All surgical and non-surgical results are subject to the individualities of the patient and the normal variability of clinical procedure results. For more information, review our full disclaimer