Arthroscopy
Arthroscopy is often one of the first surgical techniques performed on the temporomandibular joint. It can be used both to help visualize the TMJ and to potentially remove and scar tissue that is present. With this type of procedure a small flexible camera called an arthroscope is inserted through an incision near the jaw. This camera can allow the doctors to determine the extent of the damage in the TMJ. The scope all has tools to remove any loose pieces of scar tissue, called loose bodies, which may help relieve pain and TMJ problems.
Arthroplasty
As the Mayo Clinic explains, arthroplasty describes virtually any kind of open surgery that is done on the TMJ. Arthroplasty is more invasive and can take longer to heal, but it also allows surgeons to perform more complex procedures. One form of arthoplasty is called disk repositioning. This kind of surgery works well for patients whose TMJ problems stem from slipping of the cartilage disc in the joint. This type of surgery usually takes approximately 2 hours, though it requires an overnight visit.
Discectomy
If the cartilage disc is badly damaged or if disk repositioning is not able to keep the cartilage in place, a discectomy may be indicated. With a discectomy, the cartilage disc is completely removed. The entire procedure takes about the same amount of time as disk repositioning, but it can take weeks or months for the joint to fill in with scar tissue. This type of surgery can be useful, however, for people with significant cartilage damage.
Articular Eminence Recontouring
Articular eminence recontouring is useful for patients whose TMJ problems stem from the bones, not the cartilage. Slight abnormalities can cause the socket portion of the joint to be too deep or too shallow. Articular eminence recontouring involves tweaking and altering the bones in the joint to allow for better function.
Jaw Replacement
If the jaw has irreparable damage, replacement of the joint may be necessary. Depending on the severity of the damage, a partial joint replacement can be done in which either the socket is replaced with a metal prosthetic or the ends of the bones are reformed using bone grafted from elsewhere in the body. More extensive joint damage can be repaired with a full joint replacement in which the entire joint is replaced with metal parts.
