Deformed Condyles? - TMJ Disorder -TemporoMandibular Joint Message Board

pipdog · 08-21-2008, 05:44 AM

I saw my TMJ x-rays yesterday. Both my condyles are deformed with the ends bent forward. Dentist called them my 'shepherd's crooks'.

I had braces as a teenager and it looks like the orthodontist set my bite with my mandible too far back and over the years the compression slowly caused the condyles to bend and then at some point the displacement of one of the discs.
I think the dentist said that the bone of the mandible is of a different type and has regeneration potential and that once the compression is eased off they will straighten out but I was washed over with info from him and my own questions that I forget the exact details. Can anybody relate to what I am talking about?

I've been wearing a repositioning appliance for 5 months now to try and recapture a 'medially displaced non-reducing disc'. I'm told its harder to correct non-surgically than anterior displacement and have been given only a 15% chance of success with the splint therapy.

Responses have been that the clicking/twanging noises stopped about a month into wearing the splint and the quality and location of the pain has changed, its gone more into the TMJ itself, before it was general masseter/temporalis pain so something is happening I'm just not sure if its for the good. Dentist says area is healing after years of microtrauma, I hope he's right but at least something is changing. Also I used to get periods of feeling 'spaced out' and all over achiness, I know this is not a very specific description but whatever these periods were, they have totally stopped since wearing the splint. Maybe it was that 'brain fog' fibromyalgia syndrome that many people on here have described.

They will have me get another MRI after 12 months to see if the disc has been recaptured if not then disc plication surgery in Virginia from a guy who does them all the time and got his training as a field surgeon in Vietnam. I don't know what to think about this detail - is it good or bad?

I met another patient who had it done and she was happy with the outcome but reading the messages on surgery here makes me very wary

Thelma-Louise · 08-21-2008, 09:30 AM

Gee your dentist seems to give you a lot of detailed info on your case and does a good job in explaining it as well. I am not as technical with all of this I should be - but I do not seem to have any disc or joint issues from what I have been told - but during my research I have read elsewhere that the condyle will change shape while undergoing tmj splint therapy and return to normal shape and positioning over time. One of my condyles was flattened and my tmj dr told me he was not too concerned about it b/c that was easy enough to correct - but I didn't question him further on how that would happen.

The fact that your symptoms are mostly responding in a positive way suggests to me you have made good progress so far - if not excellent (from where I sit I wish I was seeing them same progress with myself)- and while I understand it is only natural to dwell on the possibility you might need surgery one day - I have also read that in some cases not everything concerning the tmj's has to be 100% for one to live a relatively painfree and symptom free life.

Surgery is such a general term and although there are many valid points in terms of it being the final option or used as a last resort - there are so many variables associated with it in terms of what type of "surgery" is done, how extensive the damage was to begin with, the surgeon doing the procedure, your own body's ability to heal itself, etc. Not all surgicall procedures result in making things worse - generally though those are what tend to surface since there is seldom a reason to post success stories since one tends to then move on with their life. Even if success stories were posted more often - it still wouldn't mean your surgery would be as successful b/c again you would be using a different surgeon or your problem could be slightly different. But then again your surgery may be major success - I honestly don't think one can accurately assess or weigh the risks and benefits of any surgery based on other peopels experiences b/c the variables for each are unique and different.

nynavey · 08-21-2008, 10:53 AM

Hello. I've also got a deformed condyle on my right side and my dentist told me the same thing yours did - it can reform to a more normal shape after time. I was concerned when I saw how different it looked on the Xray (kind of flat on top, almost pointed on one side, but perfectly shaped into the 'socket' so it was obvious how it got so misshapen), and he said he has said many x-rays 10 years after therapy that have perfectly round condyles. He believes it will change as long as I continue the treatment for life (meaning always wearing some type of splint at night). He didn't say anything about the type of bone material (I didn't ask either), but I would imagine because that's such a high-movement area with the tension of opposing muscles and the added tension of the other TMJ that it might be more likely to reshape than other less-involved areas of the body. Just my guess.

Your report of improvements after 5 months is a positive thing for me - thank you for sharing that. Now that I'm in this, I want to speak with everyone who's ever had it done, but all I run across in real life are those who had their teeth wired shut for a month and it not working anyway. Not exactly what I want to hear! It sounds like you have a very thorough dentist too.

TiredOTired · 08-26-2008, 05:17 PM

I wonder what the dr.'s name is in the states that you were going to be referred to was---do you have that info? The surgeon?

I have a condyl that has slipped out of position entirely. (Actually, maybe both of mine are-one in particular is worse than the other.) It is really quite bad and I can't open my mouth all the way without at least 2 huge pops just to open all the way up. I haven't seen an Xray of them in years but the last one I did was really bad and that was years ago before the worsening of the joint. I can only imagine what they look like now.

nynavey · 08-27-2008, 09:41 AM

TiredoTired, not sure which of us you're addressing. I see Dr. Simmons in Nashville, TN, quite a ways from you. I don't know if I can post his information on this forum, but he is easy to find. He's affiliated with Vanderbilt.

Yes, your joints may look worse than before, but today they are probably better than they will be tomorrow. Please forgive if this has been asked already, but are you getting any treatment at present?

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