The exact course of treatment for your TMJ disease will depend on the diagnosis given to you by your physician and/or dentist.
For the two most common diseases affecting the TMJ (myofascial TMD and osteoarthritis), your initial treatment will include medication (typically NSAIDS or Tylenol), physical therapy and a night guard/occlusal splint to wear at night. Most doctors recommend a trial of these therapies for a minimum of two months before considering other interventions.
The second line of treatment will depend on the exact diagnosis of TMJ disease given to you by your doctor. Most conditions can be managed with minimally invasive or reversible interventions. These therapies should be fully exhausted before surgery is considered.
Patients with TMJ disease involving the muscle may benefit from injections of medication (botox or steroids) into the affected muscle or the addition of stronger medications. These options should be discussed with your treating doctor or a Penn oral and maxillofacial surgeon.
Those with an advanced disease affecting the TMJ bone or cartilage may benefit from one of the following surgical procedures:
Arthroscopy - Arthroscopy is a minimally invasive surgical procedure, which involves introducing a camera into the joint via a small “nick” incision in front of the ear. This procedure allows for improved diagnosis, surgical manipulation of the disk, removal of scarring in the joint, as well as the introduction of medication into the joint via direct visualization.
Arthroplasty - Arthroplasty involves opening of the joint for surgical reconstruction. This is typically performed with an incision within or in front of the ear. This procedure allows your surgeon to repair or remove the disk in the TMJ. This procedure may also be performed to repair the bone to prevent jaw dislocation.
Total Joint Replacement - Patients with severe arthritis, bony fusion (ankylosis), tumors, or trauma (broken bone) may benefit from complete replacement of the joint with an alloplastic or total joint replacement. An incision is placed in front of the ear and underneath the jaw line to allow for replacement of the ball and socket component of the joint.
Any surgical procedure has the potential for complications. Your physician will review the risks and benefits as well as the treatment options with you.