Temporomandibular joint surgery

This article reviews the spectrum of temporomandibular joint surgery. Indications for surgical treatment are discussed. Techniques are presented in an orderly fashion, from simple to complex. Preoperative and postoperative care are reviewed.     

Temporomandibular joint symptoms in orthognathic surgery

Pre and postoperative TMJ-symptoms were observed in the various dentofacial deformities of 480 patients operated on because of a dysgnathia. Preoperative TMJ-symptoms were seen in 16.2% of the 480 patients. After surgery 66% of the preoperatively symptomatic patients reported fewer or no TMJ-symptoms. On the other hand 11.5% of preoperatively asymptomatic patients developed TMJ-symptoms after surgery. Although not statistically proven, a tendency was seen to more TMJ-symptoms in low and normal angle patients in comparison with high angle patients. The chance is high, however, that TMJ-symptoms in low and normal angle mandibular retrognathism patients will improve after surgery. The chance of developing TMJ-symptoms in high angle, absolute mandibular retrognathism patients, operated on by means of bimaxillary surgery, is considerable.     

Temporomandibular joint surgery: patient-based assessment and evaluation

Surgery has been important in the treatment of internal derangement of the TMJ. Many patient series have been reported concerning surgeons' evaluation of the surgery but only a few articles regarding patient-based assessment can be found. This study presents responses of 83 patients to personal interviews and mail questionnaires. A high degree of patient acceptance of the surgery and satisfaction with the results are reported. Eighty percent consider their joint status better and would repeat the surgery if faced with the same problems, 70% are essentially pain-free, and 18% experience pain mainly during heavy chewing. Diligent preoperative patient preparation and postsurgical care are recommended for success.     

Temporomandibular joint status, occlusal attrition, cervical erosion and facial pain among substance abusers.

STATEMENT OF THE PROBLEM: Drug addiction or substance abuse is an endemic habit globally. At present there is no data available regarding the temporomandibular joint status, occlusal and cervical tooth wear and facial pain among substance abusers from the Saudi Arabia. PURPOSE: The aim of the study was to investigate the temporomandibular joint status, occlusal and cervical tooth wear and facial pain among the drug abusers from narcotics control prison, Riyadh, Saudi Arabia. MATERIALS AND METHODS: One hundred subjects were included in the study as a convenience sample. Male comprised of 56 and female 44. An interview and clinical examination were performed. RESULTS: The age ranged from 20-65 years with mean (31.4 +/- 8.9). Smoking, drinking and chewing habits were most common modes of drug used. 98.0% were smokers, 61.0% alcohol drinkers and 41.0% were cannabis user. The duration of drug abuse was more than 5 years among most of the candidates. TMJ status revealed that clicking was reported by 40.0%, tenderness by 9% and reduced jaw mobility 0.0%. Occlusal enamel wear (attrition) was reported by 16.1% of male and 18.1% of female. However, the occlusal dentine exposure was among female only (18.1%). Cervical erosion abrasion was common among 16.1% male and 54.5% female. Facial pain was experienced by 6.0% and facial numbness by only 1.0% of the subjects. CONCLUSION: Smoking, alcohol and cannabis were common among the studied population. Only 9.0% of the subjects had tenderness in TMJ, occlusal enamel wear was among 17.0% of subjects. Only female subjects had dentinal exposure. Facial pain was common among up to only 6.0% of the studied population. From public health point of view, smoking cessation programs and oral health education should be introduced to adolescents to prevent unhealthy illicit substance abusing habits in future. Further studies are needed to assess the oral mucosal changes, dietary pattern, oral hygiene behavior, quality of life and level of satisfaction among the substance abusers from Saudi Arabia.     

Temporomandibular joint internal derangements in an orthognathic surgery population.

Of a selected group of 39 patients referred for orthognathic surgery, 38 were found to have some stage of internal derangement of the temporomandibular joint prior to surgery, a much higher incidence than previously reported in either symptomatic patients or asymptomatic individuals. Fifteen of 30 patients with follow-up greater than 12 months developed a new arthrosis after orthognathic surgery. All arthroses occurred in previously deranged joints. None of these patients has required joint surgery, but three have experienced pain. Internal derangement may be a contributing factor in the development of dentofacial deformities, and new loading of deranged joints after orthognathic surgery may be a cause of a new arthrosis and skeletal relapse.     

Temporomandibular joint related painless symptoms,orofacial pain,neck pain,headache, and psychosocial factors among non-patients

The aims of this study were to assess the prevalence of temporomandibular joint related (TMJ) painless symptoms, orofacial pain, neck pain, and headache in a Finnish working population and to evaluate the association of the symptoms with psychosocial factors. A self-administered postal questionnaire concerning items on demographic background, employment details, perceived general state of health, medication, psychosocial status, and use of health-care services, was mailed to all employees with at least 5 years at their current job. The questionnaire was completed by 1339 subjects (75%). Frequent (often or continual) TMJ-related painless symptoms were found in 10%, orofacial pain in 7%, neck pain in 39%, and headache in 15% of subjects. Females reported all pain symptoms significantly more often than men (P < 0.001). Frequent pain and TMJ-related symptoms were significantly associated with self-reported stress, depression, and somatization (P < 0.001). Perceived poor general state of health (P < 0.001), health care visits (P < 0.001), overload at work (P < 0.001), life satisfaction (P < 0.05), and work satisfaction (P < 0.05) were also significantly associated with pain symptoms, but the work duty was not (P > 0.05). Our findings are in accordance with earlier studies and confirm the strong relationship between neck pain, headache, orofacial pain, TMJ-related painless symptoms, and psychosocial factors. Furthermore, TMJ-related symptoms and painful conditions seem to be more associated with work-related psychosocial factors than with type of work itself.     

Temporomandibular joint related painless symptoms, orofacial pain, neck pain, headache, and psychosocial factors among non-patients

The aims of this study were to assess the prevalence of temporomandibular joint related (TMJ) painless symptoms, orofacial pain, neck pain, and headache in a Finnish working population and to evaluate the association of the symptoms with psychosocial factors. A self-administered postal questionnaire concerning items on demographic background, employment details, perceived general state of health, medication, psychosocial status, and use of health-care services, was mailed to all employees with at least 5 years at their current job. The questionnaire was completed by 1339 subjects (75%). Frequent (often or continual) TMJ-related painless symptoms were found in 10%, orofacial pain in 7%, neck pain in 39%, and headache in 15% of subjects. Females reported all pain symptoms significantly more often than men (P < 0.001). Frequent pain and TMJ-related symptoms were significantly associated with self-reported stress, depression, and somatization (P < 0.001). Perceived poor general state of health (P < 0.001), health care visits (P < 0.001), overload at work (P < 0.001), life satisfaction (P < 0.05), and work satisfaction (P < 0.05) were also significantly associated with pain symptoms, but the work duty was not (P > 0.05). Our findings are in accordance with earlier studies and confirm the strong relationship between neck pain, headache, orofacial pain. TMJ-related painless symptoms, and psychosocial factors. Furthermore, TMJ-related symptoms and painful conditions seem to be more associated with work-related psychosocial factors than with type of work itself.     

Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients

The investigators report an association between tinnitus and TMD.