Our Summary

This research paper is an analysis of various studies on temporomandibular joint (TMJ) dysfunction, a condition where the hinge connecting the jaw to the skull causes pain, limited mouth opening, and joint noise. The study aims to understand the effectiveness of arthroscopy, a minimally invasive surgery, in treating TMJ dysfunction when conservative (non-surgical) treatments fail.

The researchers found that non-surgical treatment should always be the first option. If that doesn’t work, a less invasive surgery like arthroscopy can be considered. The severity of the condition, known as the Wilkes stage, doesn’t change this approach. If arthroscopy fails, a more invasive surgery called TMJ arthrotomy may be necessary.

The researchers also looked at whether the disc (a small cartilage in the joint) position can be improved after surgery and if it should be repositioned. They found that while it might be possible to improve disc position in the long term, it’s not easy and only one study reported this. There’s also no evidence suggesting that the disc needs to be repositioned.

FAQs

  1. What is the first line of treatment recommended for temporomandibular joint (TMJ) dysfunction?
  2. If non-surgical treatments fail, what surgical options are available for TMJ dysfunction?
  3. Is there any evidence suggesting the need to reposition the disc in the joint during or after surgery for TMJ dysfunction?

Doctor’s Tip

A helpful tip a doctor might tell a patient about arthroscopy for TMJ dysfunction is to follow the recommended non-surgical treatments first and to only consider arthroscopy if those treatments are not effective. It’s important to discuss the potential risks and benefits of arthroscopy with your doctor before making a decision. Additionally, patients should be aware that improving disc position may not always be possible and may not be necessary for symptom relief. Regular follow-up with your healthcare provider is important to monitor your progress and determine the best course of treatment.

Suitable For

Patients who are typically recommended arthroscopy for TMJ dysfunction are those who have not responded to conservative treatments such as medication, physical therapy, and lifestyle modifications. These patients may experience persistent pain, limited mouth opening, joint noise, and difficulty performing daily activities. Arthroscopy is considered when the symptoms significantly impact the patient’s quality of life and other treatment options have been exhausted.

It is important for patients to undergo a thorough evaluation by a healthcare provider specializing in TMJ disorders to determine if arthroscopy is the appropriate treatment option for their specific case. Factors such as the severity of symptoms, the presence of joint damage, and the individual’s overall health will be taken into consideration when making this recommendation. Ultimately, the decision to undergo arthroscopy should be made in collaboration with the patient’s healthcare team to ensure the best possible outcome.

Timeline

Before arthroscopy:

  1. Patient experiences symptoms of TMJ dysfunction such as pain, limited mouth opening, and joint noise.
  2. Patient undergoes conservative treatments such as medication, physical therapy, and mouth guards to manage symptoms.
  3. If conservative treatments fail to provide relief, patient may be considered for arthroscopy.

After arthroscopy:

  1. Patient undergoes minimally invasive arthroscopic surgery to treat TMJ dysfunction.
  2. Recovery period typically involves rest, pain management, and physical therapy to regain jaw function.
  3. Follow-up appointments are scheduled to monitor progress and address any lingering symptoms.
  4. If arthroscopy is successful, patient may experience reduced pain, improved jaw function, and overall better quality of life.
  5. If arthroscopy fails to provide relief, patient may need to consider more invasive surgical options such as TMJ arthrotomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with arthroscopy for treating TMJ dysfunction?
  2. How long is the recovery period after arthroscopy surgery?
  3. What are the expected outcomes and success rates of arthroscopy for TMJ dysfunction?
  4. Are there any alternative treatments or therapies that can be considered before opting for arthroscopy?
  5. Will I need to undergo physical therapy or follow any specific post-operative care instructions after arthroscopy?
  6. How many arthroscopy procedures have you performed for TMJ dysfunction, and what is your experience with this type of surgery?
  7. Are there any specific factors or conditions that may make me a better or worse candidate for arthroscopy surgery?
  8. How long do the effects of arthroscopy for TMJ dysfunction typically last?
  9. Will I need to have any follow-up appointments or additional treatments after the arthroscopy procedure?
  10. Are there any lifestyle changes or modifications I should consider to help improve the success of the arthroscopy surgery for TMJ dysfunction?

Reference

Authors: Foletti JM, Cheynet F, Graillon N, Guyot L, Chossegros C. Journal: Rev Stomatol Chir Maxillofac Chir Orale. 2016 Sep;117(4):273-9. doi: 10.1016/j.revsto.2016.07.010. Epub 2016 Aug 11. PMID: 27523442