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.
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