Changes in signs and symptoms following temporomandibular joint disc repositioning surgery.
Fifty-one subjects with documented intra-articular pathology refractory to non-surgical therapy underwent temporomandibular joint (TMJ) disc repositioning surgery. Following surgery, subjects were evaluated for 6 months to 6 years by clinical examinations and questionnaires at designated times, and by postsurgical joint imaging. Significant decreases were noted in pain (headache, TMJ pain, ear pain, and neck/shoulder pain), the incidence of joint sounds and locking, and the presence of dietary restrictions. However, 35% of the subjects continued to have residual TMJ pain, and a similar percentage continued to need periodic nonsteroidal anti-inflammatory drugs for analgesia. Some degree of dietary restriction remained in approximately 50% of the subjects, and joint sounds persisted in a similar percentage following surgery. Mean mouth opening was improved by 8 mm, although lateral movements were increased by less than 0.5 mm. Surgery did not decrease the occurrence of jaw deviation, and disc position was unchanged in 86% of the joints imaged at an average of 2 years following surgery. Although TMJ disc repositioning surgery significantly improved pain and dysfunction in TMJ surgery patients, the improvement in disc position was not maintained in most subjects following surgery.
Montgomery
M T
MT
Department of General Practice, Dental School, University of Texas Health Science Center, San Antonio 78284-7914.
Gordon
S M
SM
Van Sickels
J E
JE
Harms
S E
SE
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002358:Cartilage, Articular / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D004435:Eating; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011182:Postoperative Care; D016059:Range of Motion, Articular; D012008:Recurrence; D013016:Sound; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome