Why Would Someone Require A TMJ Joint Replacement And Other Questions About The Surgery?

Total joint replacement systems are done via an artificial orthopedic device insertion and replace joints that are painful due to a compromised or non functioning joint. TMJ prosthetics are ball and socket joints comprised of 2 parts. The 2 parts they are comprised of are the fossa as well as the condyle.

The fossa is the socket portion of the joint. It sits nestled between the maxilla and the zygomatic process. It’s located next to the ear canal. To replace such joints the surgeon uses medical grade plastic to create the portion of the body.

The condyle is the ball portion of the joint that is protruding from the mandible structure that extends from the fossa to comprise the joint. In this portion hard metals are utilized to construct the implant and make it last.

total join replacement

1. Why Would Someone Require A TMJ Joint Replacement?

If you’ve had severe degenerative changes within your joint that have given you severe pain or loss of function, you may need to have your joint replaced. Replacing said joint is imperative to restore functional properties of the TMJ.

For a lot of people, this is the last resort to preserve the function. It’s not meant for pain relief although often that does help. There are three basic types of pain that the person is suffering from: Bone, muscle and nerve pain. Replacement is only replacing the bone that is afflicted by the condition.

For those who are considering total joint replacement, it’s vital to do the background work. It’s imperative to understand the role in the process. Statistically, the reason for such surgeries is due to loss via a trauma. It is also done for heterotopic bone growth and for diseases such as rheumatoid arthritis and traumatic arthritis or Lupus. Tumors and cancer round out the list of reasons for such replacements.

2. How Long Will It Take To Recover?

Typically a patient will remain in the hospital for 3 to five days.

The full recovery will vary greatly from one patient to another. Most of the doctors will suggest normal activity after four to six weeks of having the procedure done. This doesn’t however imply that the patient is fully recovered. There may be extended swelling as well as paralysis and forms of tingling. In fact, it can take several months for complete healing to occur.

3. Will I Require A Soft Foods Diet?

In most surgeries, a soft foods diet is required. Any surgical procedure can slow down the digestive system and create issues. In the beginning you’ll be on a liquid diet. This is due to the anesthesia required for surgery. If you’re being wired, you may have to have this liquid diet a while longer. As your body recovers you’ll work back into a normal diet. You will however need to avoid hard candies, sticky or crunchy foods and chewing gum as well as taffy and jaw breakers for the rest of your life.

4. Is The Surgery Painful?

A week prior to surgery you’ll have a meeting with your anesthesiologist. Tell them of all medications that you are currently on. Tell them also if you’re on any pain medications and why. This information will help them to plan your pain relief accordingly. Successful pain management requires full communication between you, the surgeon and your anesthesiologist. You should always inquire about pain relief when you speak to your surgeon. You may need a prescription to help ease your pain in the first few weeks. If you’re in a pain management program you’ll also need to get your pain management specialist on board so that you can maintain your pain free life.

5. Is There Any Reasons I Shouldn’t Undergo This Procedure?

Only you and your surgeon can truly decide this. You may wish to ask about specific prosthesis, allergies and bruxism prior to surgery. If you have any active infections you’ll also want to address this infection prior to surgery. What do you anticipate after surgery? Be sure to discuss this with your surgeon as well. How much pain are you in at present and what is your level of function? Will surgery help to alleviate this? It’s important to understand how total joint replacement will affect this in your body and if it will improve your quality of life. Discuss all of this with your surgeon. It’s always wise to write out your questions prior to meeting with your surgeon as it’s easy to forget the questions when you’re in the meeting. Remember that the surgeon has other patients so your time is limited in the meeting and you’ll want to make the most of your time.

Jaw Surgery-Orthognathic Surgery Types

Jaw surgery or orthognatic surgery is a surgical procedure for jaw repositioning to correct any eventual imbalance between the upper and the lower jaw. This kind of surgery might be needed when jaws don’t meet correctly causing teeth misaligned, difficulty chewing, biting, swallowing etc.
If the imbalance between jaws is small sometimes all you need are braces, this way the jaws misalignment is camouflaged with correct teeth alignment. While braces and orthodontics can correct teeth alignment problems, orthognatic surgery can solve more complex cases where jaw repositioning is needed.
Corrective jaw surgery may be done to the lower jaw, upper jaw or both of them in the same time depending on the problem. It is performed under general anesthesia and all incisions are performed inside the mouth leaving no visible scar. Pain after jaw surgery is easily controlled with painkillers, and the patient can go back to his normal life after one or two weeks.
Before any surgery the alignment of the teeth might be needed

jaw surgery

Upper jaw problems

  • The maxilla or upper jaw is bigger -Sometimes the maxilla or the upper jaw is not normally developed and tends to grow forward. In these cases the maxilla appears to be longer or bigger, creating an excessive exposure of the gums, the so called gummy smile. This problem can be solved with an orthognatic sugery, where the upper jaw is separated from the rest of the skull and it is positioned superiorly and backwards. It is fixed with plates and screws which osteointegrate in the jaw so another surgery for their removal will not be needed. After the rehabilitation only he the teeth will be visible when the patient smiles.
  • The Maxilla or upper jaw is smaller– In this case the inverse surgery might be needed. The maxilla is divided from the skull and brought forward.
  • Transverse Maxillary Deficiency-When this condition it’s present another kind of jaw surgery could be performed. In these cases the maxilla is tighter than normal. Generally these patient breathe with their mouth since early age, so the nasal pavement it’s not fully developed. In other cases they have sucked their thumb for too long when were little or because they had other abnormal habits that interfere with the normal development of the orthognatic system. If the patient is still young these discrepancy can be solved with the positioning of a rapid palatal expansor. In more severe situation and when the patient it’s not so young a surgery is needed. The maxillary bone is divided surgically in half exactly where the median palatine suture (the suture that connects the left and right part of the maxilla during growth) used to be. The two parts are divided with an orthognatic appliance and the empty space will fill with bone in a short period of time. After this process the maxilla will be larger and will match the lower jaw in the correct way.

Lower jaw problems

  • Mandibular retrognathia- Is a condition where the lower jaw appears weak and a receding chin is present. The procedure needed is called mandibular advancement. During the surgery the lower jaw is separated and it’s brought forward to accompany the position of the upper jaw. The new position of the lower jaw is fixed with plates and screws that osteointegrate and don’t need to be removed after.
  • Mandibular prognathia– The condition where the lower jaw appears too large in confront with the upper jaw. In these cases the surgery needed is the inverse process of what we explained for the mandibular retrognathia. The procedure is called mandibular setback. The mandible is separated and it’s positioned backwards, the excessive parts of the bone are removed and the jaw is fixed again with plates and screws.

Genioplasty

Is a surgery performed when there is no discrepancy between the jaws and there are no bite problems between lower and upper teeth. There is only a chin problem which needs to be reshaped advanced or setback. Part of the chin bone is separated and repositioned forward, backward, rotated etc and it is fixed in the new position with plates and screws. It is not an important procedure as the other one mentioned and the discomfort after is smaller.

Both Jaws are Problematic

Sometimes the problem it’s not located in one of the jaws but in both of them in the same time. This kind of surgery is called bimaxillary surgery. Each jaw can be moved in any direction needed to fully correct the problems