Temporomandibular joint surgery: Results of a 14‐year joint implant study

This paper analyzes the surgical techniques that are now used in treating organic temporomandibular joint (TMJ) disease. The authors attempt to evaluate the high condylectomy procedure which has been recommended by one group as the only surgical approach. In particular, the authors describe their experiences in using metallic and/or metal and plastic prosthetic devices for repairing damaged joints. The procedure used most frequently is a form of joint resurfacing, although total TMJ replacement is also described. On January 9, 1978, 205 questionnaires were mailed to patients who had undergone TMJ implant surgery. The population surveyed, representing 314 TMJ procedures, were asked to make a subjective overall assessment of the surgical result, and to rate the improvement, elimination, or worsening of each of 22 surgical indications (whenever such indications were applicable to themselves). The survey was done by the Clinical Research Division of a major company in the orthopedic field. The authors did not see the results of the evaluation until they were computed and analyzed by this independent group. The overall group assessment results were: Excellent — 41.7%; Good — 28.8%; Fair — 14.1%; and Poor — 15.3%. The 5 most common symptoms of patients who had surgery were a grating sound in the joint, partial inability to open the mouth, pain in the joint, clicking in the joint, and headaches. A review of TMJ surgical procedures other than TMJ implants is also presented.