Arthroscopy for temporomandibular joint disorders

Arthroscopy for temporomandibular joint (TMJ) disorders, sometimes referred to as TMJ scope surgery or arthroscopic jaw surgery, is a minimally invasive surgical procedure used to diagnose and treat problems within the jaw joint. A small camera, called an arthroscope, and other instruments are inserted through tiny incisions, letting the surgeon see and treat inside the joint.

Penn Medicine is an experienced provider of specialized care for a wide range of temporomandibular joint disorders. Home to one of the largest TMJ treatment centers, we are a recognized leader in facial surgery, oral medicine, and oral rehabilitation.

Candidates for an arthroscopy of the temporomandibular joint usually include people with:

• Conditions like jaw joint disc displacement, arthritis, or joint inflammation
• Temporomandibular joint dysfunction causing jaw pain, stiffness, or limited movement
• No improvement in jaw pain or mobility after nonsurgical treatments

In a typical temporomandibular joint arthroscopy, the following steps are taken:

1. You will receive local anesthesia with sedation to keep you relaxed and pain free, or general anesthesia, which puts you in a sleep-like state.
2. The jawbone is gently moved to widen the joint space.
3. Small incisions are made near the TMJ to allow access for tools.
4. A thin camera (the arthroscope) is inserted to view the joint.
5. The surgeon inserts additional instruments to remove scar tissue, reposition the TMJ disc, or flush the jaw joint (arthrocentesis).
6. Steroids or anesthetics are injected if needed.
7. Incisions are sutured closed, then you will be monitored in a recovery area before being sent home, usually the same day.

After TMJ arthroscopy, you should gradually ease back into your regular activities and diet. Initially, you may experience mild discomfort, swelling, or bruising. Ice packs for the first 24 hours can help bring relief, and you may also be given prescription medication for pain. Physical therapy is often started within 48 hours to help you maintain jaw mobility.

While most people can return to normal activities within a few days, your jaw movement may be limited. A soft food diet—pasta, cottage cheese, or egg salad, for example—may be recommended for a set period, while chewy foods like steak or pizza are best avoided. Be sure to follow your care team’s guidance and attend all follow-up appointments.

Although TMJ arthroscopy procedures are generally safe, potential risks or side effects may include:

• Pain, swelling, and bruising in the joint area
• Difficulty opening the mouth or jaw stiffness
• Hearing changes
• Facial weakness or numbness
• Infection

Trusted specialists for TMJ pain

The oral and maxillofacial surgeons at the Penn Center for Temporomandibular Joint Disease are highly skilled in treating TMJ disorders and perform among the highest volumes of joint surgery in the country. Our physicians and researchers are actively involved in studies on TMJ disorder treatment, prognosis, and prevention.