Read the Latest News

Wear Face Masks with No Metal During MRI Exams: FDA Safety Communication

The FDA recently received a report that a patient’s face was burned from the metal in a face mask worn during an MRI. The FDA reminds patients and providers that patients should not wear any metal during an MRI. TOPIC: Wear Face Masks with No Metal During MRI Exams: FDA Safety Communication  

A Tribute to William “Bill” Maixner, Ph.D., D.D.S

All of us at The TMJ Association are deeply saddened by the loss of a treasured friend, an accomplished and highly respected scientist, empathic clinician and one of temporomandibular disorder's (TMJ) greatest champions – Dr. William “Bill” Maixner. Bill passed away on Monday, November 2, 2020, at the age of 68.

New Report on Temporomandibular Disorders: Priorities for Research and Care

Over a year and half ago, the National Academy of Medicine (NAM) began the most comprehensive study ever undertaken on Temporomandibular Disorders (TMD). The study assessed the current state of TMD research, education and training, the safety and efficacy of clinical treatments, and associated burden and costs.

Statement by NIDCR Acting Director on the National Academies of Sciences, Engineering, and Medicine Report on Temporomandibular Joint Disorders

I am pleased to announce the release of the National Academies of Sciences, Engineering, and Medicine (NASEM) report, Temporomandibular Disorders: Priorities for Research and Care. As underscored by the comprehensive report, temporomandibular joint disorders (TMJDs) are a diverse and still poorly understood set of complex, painful conditions affecting the jaw muscles and tissues, temporomandibular joints, and associated nerves. Clearly, there is much more to be understood, and these conditions continue to confound medical and dental health care providers and researchers.

Have you seen the film Dark Waters?

The Film. Dark Waters is about attorney Robert Billott's real-life 20 year legal battle against DuPont chemical for releasing toxic waste - perfluorooctanoic acid, or PFOA - into Parkersburg, West Virginia's water supply, with devastating health effects on the townspeople and livestock. PFOA, also known as C8, is a man-made chemical. It is used in the process of making Teflon and similar chemicals known as fluorotelomers.

ARTHROSCOPY

  • Dec 6, 2019

TMJ arthroscopy is a procedure that is a little more involved and invasive than an arthrocentesis done with two hypodermic needles. This procedure is almost always done in an outpatient facility in the hospital. An arthroscope is used to look inside your joint to see what is causing your problems. Some surgeons will not only look inside and wash out the joint, but also perform surgical procedures like removing scar tissue, smoothing the bone and even attempt repositioning the disc.

You will be checked in prior to your surgery time and an IV will be started. The anesthesiologist will visit and take a look at your mouth opening and discuss the anesthetic procedure. Usually, before the surgery, the surgeon will visit you to discuss what he will be doing and what it will be like when you wake up. You should have had a pre-operative appointment to discuss all of this information, so this is just to make sure you have no additional questions. Don’t hesitate to ask any questions you may have. No question is a dumb question.

After this, the anesthesiologist or nurse will probably give you some medicine to help you relax, and then, you are off to the operating room. You might remember this or you might not. If you do, you will notice that the room is very cold and that there are a lot of people buzzing around getting ready for your surgery. Take a deep breath and close your eyes- try not to let it bother you. After all, they are all there to make sure you are okay. If at any point you aren’t, speak up!

When you wake up, you will be in the recovery room. You might feel pain in your jaw joint from the surgery. Please let the nurses know if you are in pain, because they are there to give you medication and make sure you are comfortable.

Recovery time from this surgery is several days to a week. You will probably want to take off from work for three days or so, but make sure the time off is flexible in case you need extra time. Your surgeon may tell you to maintain your soft diet for a few weeks. After several days, you will probably start jaw exercises or physical therapy.

As with all surgeries, there are advantages and disadvantages to this procedure. It does allow the surgeon to look into the joint and remove any adhesions or any other pathologic tissue. The recovery is shorter and easier than with an open joint procedure and the scar is smaller (virtually undetectable). However, this surgery takes longer than an arthrocentesis done with only hypodermic needles and requires general anesthesia. Also, many studies have reported that arthrocentesis with hypodermic needles can be equally successful as arthroscopy. Because of this, and the fact that arthrocentesis with needles is so much easier to perform, many surgeons may advise doing that first.

As with all invasive procedures, we recommend exhausting all conservative options first and getting independent opinions before submitting to any surgery.

Latest in TMJ Science for Arthroscopy

  • Temporomandibular lavage versus nonsurgical treatments for temporomandibular disorders: A systematic review and meta-analysis. Bouchard C, Goulet JP, El-ouazzani M, Turgeon AF. J Oral Maxillofac Surg. 2017 Jul;75(7):1352-1362. doi: 10.1016/j.joms.2016.12.027.
    PURPOSE: To investigate the efficacy of temporomandibular joint (TMJ) lavage (arthrocentesis or arthroscopy) for the treatment of temporomandibular disorders in reducing pain and improving jaw motion. PATIENTS AND METHODS: We performed a systematic review of the literature and meta-analysis of randomized controlled trials (RCTs) comparing TMJ lavage with conservative measures. The data sources were MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, Web of Science, and reference lists of relevant articles. Two independent reviewers identified RCTs by using controlled vocabulary (MeSH, Emtree) and free text terms. Data extracted from the selected studies included population characteristics, interventions, outcomes, and funding sources. Risk of bias was assessed with the Cochrane Collaboration risk assessment tool for RCTs. RESULTS: Five studies met the inclusion criteria, for a total of 308 patients. Of these studies, 3 were categorized as having a high risk of bias and 2 had a low risk. The summary effect of the 5 studies showed a reduction in pain in the intervention group at 6 months (-0.63; 95% confidence interval [CI], -0.90 to -0.37; P < .00001; I2 = 88%) and 3 months (-0.47; 95% CI, -0.75 to -0.19; P = .001; I2 = 85%). This was not the case at 1 month. No difference in mouth opening was observed at 6 months (-0.21; 95% CI, -1.82 to 1.40; P < .80; I2 = 74%), 3 months (0.20; 95% CI, -1.81 to 2.20; P = .85; I2 = 68%), and 1 month (-1.18; 95% CI, -2.90 to 0.55; P = .18; I2 = 0%). CONCLUSIONS: Given the relatively small number of patients included in this meta-analysis, the high risk of bias in 3 studies, and the statistical and clinical heterogeneity of the included studies, the use of TMJ lavage for the treatment of temporomandibular disorders should be recommended with caution because of the lack of strong evidence to support its use.
     
  • Open versus arthroscopic surgery for the management of internal derangement of the temporomandibular joint: a meta-analysis of the literature.
    Al-Moraissi EA. Int J Oral Maxillofac Surg. 2015 Jun;44(6):763-70. doi: 10.1016/j.ijom.2015.01.024. The objective of this study was to assess the clinical outcomes of the following three surgical methods for the management of internal derangement (ID) of the temporomandibular joint (TMJ): arthroscopic lysis and lavage (ALL), arthroscopic surgery (AS), and open surgery (OS). A systematic and electronic search of several databases with specific key words was performed from their inception through November 2014. Clinical human studies, including randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies, with the aim of comparing the three surgical methods for the management of ID of the TMJ were included. Seven publications were identified: three RCTs, two CCTs, and two retrospective studies. A significant difference was found between OS and AS in pain reduction (P=0.05), but no significant difference with regard to maximal inter-incisal opening (MIO>35mm), mandibular function impairment, and clinical findings (clicking, joint tenderness, and crepitation) (P=0.52, P=0.34, and P=0.19, respectively). The results of the meta-analysis showed that the use of OS is superior to AS in pain reduction, with comparable MIO, jaw function, and clinical findings. In addition, the results of the present study showed that ALL provides greater improvement in MIO and comparable pain reduction when compared to AS.

Back to Surgery