Surgical management of temporomandibular joint dysfunction

Indications for the surgical treatment of temporomandibular joint (TMJ) disorders include: (a) a history of recurrent acute dislocation of the condyle,(b) osteoarthrosis with pain and serious functional disorder,(c) disc displacement without reduction, causing functional disorder. There are several surgical techniques that can be used when the above-mentioned conditions do not respond to conservative treatment. The aim of this study is to present and evaluate the most popular of these techniques by means of five representative cases. These cases are: (1) a case of recurrent dislocation treated by bilateral eminectomy, (2) a case of osteo -arthritis treated by discectomy, (3) a case of disc displacement and perforation corrected by discoplasty,(4) a case similar to the one mentioned before, treated by anchoring the disc to the condyle, and (5) a case of recent anterior disc displacement, also treated by anchoring the disc to the condyle. We present the findings of the long-term postoperative follow-up of these patients. The alternative solutions in each case are then discussed and a comparative evaluation of these solutions is attempted. Finally, we conclude that the aim of the surgical treatment should be to preserve the function of all the normal structures of the joint.