In cases where diagnosis indicates a specific problem with the TMJ or where several attempts at non-surgical intervention have failed, joint surgery may be an appropriate treatment. TMJ surgery is designed to treat and fix a specific problem including removal of scar tissue, repair and reposition of the disc, alter the anatomy of a joint, or remove degenerative tissue.
options you and Dr. Cohen at Park Smiles NYC may discuss and consider if a surgery is indicated:
An arthroscope is a miniature telescopic instrument, like that used for many years with knee joints, through which the contents of the jaw joint can be viewed. Using a special arthroscope small enough to enter the TMJ, this allows us to visualize the joint and perform minor surgical procedures such as treating cartilage damage. Once you’re asleep, the joint is flushed out with numbing medicine and fluids. The TMJ is then carefully entered with the arthroscope though a small incision in front of the ear. After the arthroscope has been placed, we can view the magnified anatomy of the joint on a screen. We can then perform the needed treatment through the scope using specialized instruments such a laser to remove scar tissue, reduce swollen, inflamed tissue, and reposition an out-of-place disc.
In some cases arthroscopic surgery may be incapable of correcting a TMJ problem and other surgical procedures need to be considered. For example, if a disc is displaced and cannot be moved back into proper position, then open surgery may be needed to expose the joint and allow more complex treatment procedures to be performed. Arthroplasty involves making an incision in front of the ear to expose the joint so Dr. Cohen can repair a disc or ligament. Dr. Cohen can also remove any diseased condyle (the rounded projection on a bone) as a result of degenerative joint disease. Any bone interferences can also be smoothed out or removed and the disc can be secured into its correct position with the help of stitches.
TMJ Prosthetic Joint Replacement
Using a computer-generated image of your CT scan, a three-dimensional model of your skull can be fabricated out of plastic. Using this model, a prosthetic joint of metal and plastic can be custom made to your model and surgically inserted by Dr. Cohen. This procedure would be performed under general anesthesia.
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