Has anyone ever known anyone who had successful TMJ surgery?

[Joyce2]

I've been dealing with TMJ since '97, but within the last 1-1/2 years, it has gotten so much worse. I know of two people, one a dentist, who has had successful surgery. The dentist went to an oral surgeon that I tried, who made me a new splint, I had been wearing a nite guard (1st oral surgeon I saw made this device for me) for 4 years to stop clinching at nite. When I attempted to wear the new splint, I was so miserable, it made me so much more worse,I just couldn't put it back in my mouth- I also had been on two meds at night - Elavil and a muscle relaxant - I attempted to stop the muscle relaxant, which a Pain Management doctor had prescribed)I told the Oral Surgeon that two things had changed (I tried wearing the new splint and stopped the muscle relaxant)and something had made me worse, he wouldn't hear of the splint making me worse, said he never would have put me on those meds, didn't know what they were, but never would have prescribed them,and then sent me packing saying that he couldn't do anything more for me. I then went to a new dentist, who studied TMJ alot in college, he advised me that the new splint was not working, and to try another med (Robaxin - for daytime use-won't make me sleepy) and try wearing my night guard during the day, again I started clenching so much more that I got worse. He told me to then only use the nite guard again at nite, and that it sounded like wearing a day time splint wasn't for me. Again, surgery was mentioned. I feel like I'm beyond just clicking and popping, I feel/hear bone on bone and have terrible head spasms to go along with the pain in my jaw/face. Lately, I have begun thinking that surgery seems to be the only relief in sight, but so many TMJ sufferers say 'no way'. I feel so helpless right now, so miserable, so scared that this will only get worse, with no relief in sight, for the rest of my life. Any comfort or hope you can give me would be so appreciated.

[bjo]

I would also like to know the answer to this. There must be successes out there. I can't believe that all TMD surgeries have ended in disaster. Are there certain types of TMJ in which surgery is more successful? What is the definition of succsessful in the view of the surgeon? Funtionality or freedom from pain, or both?

Are there any Drs. out there that can give us some answers?

[Elaine]

This is an example of a consent form. Be assured, if something goes wrong the doctor is not responsible.


The proposed surgery has been outlined for me in laymen's terms and possible complications and side effects have been discussed including ( but not limited to ):


___A.Objectionable scarring of the incision line, possibly requiring later revision.


___B.Postoperative swelling, discomfort, bruising of the area, bleeding, hematoma (blood clot) formation, and wound infection.


___C.Adverse or allergic reactions to medications oranesthesia causing multiple side effects, some of which may be serious.


___D.Foreign body reaction and (if used) rejection of implant materials.


___E.Malocclusion (change in bite) after surgery.


___F.Postoperative development of adhesions (scarring) within the joint space which may cause continued jaw dysfunction and decreased range of jaw movement or chewing difficulty.


___G.Facial muscle weakness, particularly of the forehead and eyelid, or inability to close the affected eye tightly, which is caused by injury to
motor nerves in the immediate surgical area. This weakness may be partial or total and is usually temporary, but may be permanent.


___H.Sensory nerve damage, numbness, or other sensory alterations which may be temporary or permanent.


___I.Ear problems, including infection of external, middle or inner ear, ringing in the ear, hearing loss or equilibrium problems.


___J.Freys Syndrome


___5.I understand that additional treatment may be necessary post operatively, including physical therapy, splint therapy, reconstructive dentistry,
orthodontics, jaw repositioning surgery, removal of certain fixation devices, or further TMJ surgery including total joint replacement, bone grafts, and
arthroscopy.


___6.I understand that this is complex surgery, and there can be no guarantee of complete resolution of my present symptoms or jaw dysfunction. Occasionally
there may be increased symptoms post operatively.


___7.I have been told of my option of a second opinion regarding this procedure from a qualified professional.
___8.Recognizing that during surgery some unforeseen condition may be discovered that might necessitate a change in approach or different procedure from those
explained above, I authorize Dr. ****o perform such
procedures as are necessary and advisable in the exercise of his professional
judgment.


___9.I understand that general anesthesia will be used for my surgery and that there is risk of serious bodily injury inherent in such anesthesia, including
death. I have been told not to have any food or drink for 8 hours prior to my anesthetic and that CONSUMING FOOD OR DRINK BEFORE INTRAVENOUS GENERAL ANESTHESIA MAY CAUSE SERIOUS COMPLICATIONS OR DEATH!


___10.I have discussed my past medical history with my doctor and have disclosed all diseases and medications, including alcohol and drug use (past or
present).


___11.I agree to cooperate with the recommendations of Dr. ****,
realizing that lack of cooperation may result in a less than optimal result. I have not been given any warranty or guarantee as to the result of the
proposed procedure.


___12.I certify that I have had an opportunity to read and fully understand the terms within the and that all the above blanks were filled in prior to my
signing this form. All my questions have been answered to my satisfaction and I am willing to undergo the proposed surgery.

[Elaine]

TMJ has acquired the name of "The Great Impostor," and has been described in the press as "A Medical Mess."
Although all surgeries have risks, TMJ surgeries are especially risky have proven mostly unwarranted or unsatisfactory. An initial surgery can often lead to more. Except in life-threatening emergency situations, it is strongly recommended that TMJ surgeries be avoided or conducted only after multiple independent opinions. Additionally, certain jaw joint implants have been reported by the Food & Drug Administration to cause serious long-term medical problems, and rules have been tightened on their usage/approval.

There is currently no universally recognized medical discipline or accredited medical specialty that addresses TMJ. Jaw joints, due to their location in the oral cavity, are the only joints in the body that are considered both medical and dental joints. They are commonly and mistakenly isolated from whole body health and "assigned" to the realm of dentistry. Temporomandibular joints must be perceived as part of the whole body system and treated as are all other joints in the body. It is urgent that the medical profession take an active role in the diagnosis and treatment of TMJ. A change in perception would have several important consequences:

Current treatments often focus narrowly on the jaw and neglect other physiological systems in need of care. The desired therapeutic outcome is often not achieved, and many patients are left in serious pain or with serious dysfunction.

[Charlene]

Hi BJO
You asked about successful treatments or surgeries for
TMJ.
I am a success story now for 12 1/2 years, I have the Christensen Fossa-Eminence Prosthesis implanted bilateral. I'm eating everything in sight without any pain, I'm able to chew any type of food and even hard candy at times.
There are no loose screws in my implants, as I have a CT Scan done every spring to keep an eye on my own condyles. As I have rheumatoid arthritis and need to make sure that my condyles are not deteriorating.

I can only speak of my success with these implants, and not for others!! Remember what works for some, may not work for others. Its like taking medications, we all can not take the same meds as we might have a different reaction to them. And of course the most important issue is, each patient's case history is so different, and the surgeon is also a big factor on his success rate with these implants!!

Best Wishes & Regards to All for pain free days!!!
Charlene