How risky is a TMJ arthroplasty

one the best UK surgeons

How risky is a TMJ arthroplasty where the slipped disc is stitched back into position, with pre and post surgical splints and finish orthodontics. I am told this is 80% successful with one the best UK surgeons. But, I wonder about long term results, does anyone have any information regarding this type of surgery? Thank you


Discussion


Keren Purchase What is this surgery exactly? Are they attaching the disc to the condyle so it can no longer move at all from the position which it’s attached? Surely if that’s the case it’s not normal to have discs attached like that.
Or are they just shortening the over stretched posterior ligament which is attached to the disc?

Amit Alok Pandey What is the cause of disc displacement ? Is it trauma or is it bad occlusion ?

Cath Shannon Naturalhoofbalance no answers??????
is this because this group is mostly dentists with an interest in TMJ????
Where are the surgeons???

Keren Purchase Sam Burton, why do you need the surgery, has it been explained to you, and have you tried more conservative treatments first?

Darick Nordstrom Properly administered prolotherapy (new way) has resulted in a high success rate of comfortable, functional, stable TMJoints, in concert with correcting biomechanics. Arthroplasty by a master can be a rapid (often durable) solution in a some cases, but the stakes are high and the odds OK (for a master).

Amit Alok Pandey The diagnosis has to be precise. If occlusion is off, just correction of occlusion is required. Yoga is a must too.

Rob Stubbs Not many seem to want to use prolotherapy on the jaw joints, perhaps I should find someone in the UK who can administer this after the surgery to aid healing. It’s worth a thought as it is basically just speeding up the supply of healing materials through inflammation due to the solution. Here is my bite for anyone interested:
I added the red lines to show the lengths of condyle and rotation of jaw

Rob Stubbs Darick Nordstrom, what risks should we worry about, scar tissue? possible nerve damage or long term failures? I have to put my trust in someone my plan is to then use ALF’s to develop the arches, especially the upper jaw due to two pre-molar extractions

Rob Stubbs Slowly reversing the damage done created by traditional extraction orthodontics and trauma

Darick Nordstrom Sorry, my comment got lost in space. Prolotherapy is a well-established conservative system for restoring musculoskeletal stability and joint function. Fortunately, high level athletes have been requesting it (often in the form of PRP), so it is gaining notoriety. Like Amit pointed out, a stable rest position, balanced function, and proper sleep allow the body to repair day-to-day wear. Unfortunately, chronic diseased joints need more. How is your sleep? Do you have a balanced rest position (The 2-finger test)? How is your neck, pelvis, overall alignment and function?

Darick Nordstrom Were the lower 3rd molars going to be gently removed (with PRF or PRGF placed to minimize recovery by dramatically increasing healing) before the joint surgery? Have you had T-Scan to check your occlusion? There is certainly something to be said for gaining joint stability through surgery, and then ALF. What do the 25% failures do next? What is their follow-up? are they happy and comfortable, even though the result isn’t perfect? What constitutes success? One of our current disaster-to-new life patients was used (by the doctor that destabilized him) as a ‘successful’ case example at an academy meeting. Not trying to be negative, just suggesting a check-off list of questions that typically aren’t considered before hand. Lets increase your odds of being the success that you want and need.

Keren Purchase Darick Nordstrom, do you know if the success rates with prolotherapy are dependent on the disc condition, and how displaced the discs are? Are there some cases when discs are displaced in such a way that only surgery can help, or does prolotherapy help to recapture displaced discs?

Darick Nordstrom Great question! Recently, I captured a stubborn displaced disc. We had done 4 or 5 prolo sessions, and on that visit it easily went into position. However, I have had other disks that I couldn’t reduce, and would suggest surgery or possibly just light general anesthesia and reduction, followed by prolotherapy to strengthen the ligaments connected to the disk. Proper Prolo (not just any prolo) can be so effective and nearly every patient feels empowered by it, so I feel it should be done first (even if a disk can be re-captured, the ligaments are stretched and sloppy and need help). I wouldn’t wait very long on medial displacements before considering surgery.

Keren Purchase Thanks for your rely Darick Nordstrom. Is there any reason why you wouldn’t wait long on medially displaced discs before surgery? Do you just mean they’re less likely to recapture without surgery. When you say medially displaced, what about discs which are anteriorly displaced with a large medial component when closed, which recapture when opening, are you referring to those as well?

Darick Nordstrom Discs that are reducible don’t seem to cause as many of the seemingly unrelated body changes that often evade proper diagnosis that un-reduced medial displaced discs do.

Rob Stubbs Interesting, I think prolotherapy could be a good idea for after the surgery to aid healing maybe 5-6 weeks after and then several more sessions over the course of a year.
What is the difference between ‘Proper Prolo’ and any promo? is the solution different?
I first read up about prolo as Rio Ferdinand (Manchester United player) had this in his back and he wrote about how successful it was.

Darick Nordstrom Well-executed surgery should not need prolo for awhile.

Darick Nordstrom When prolo (typically the basic solution + drop of testosterone) is a part of comprehensive osteopathic, myology, ALF-type dental orthopedic team approach, the results are transformational … not just in the TMJs.

Amit Alok Pandey If the major or primary cause is malocclusion, then occlusion needs to be attained. Everything will fall in place with time. Malocclusion needs to be measured and occlusion needs to be executed. Occlusion has tremendous merits. The upper-lower teeth occlude 3000 times a day. this impacts the Cranio-facial structure.

Rob Stubbs Mariam A.rahman Zahran are you refereeing to disc plication? I have spoken to people who have had it done and are better, if it is combined with correct post splint therapy, physio etc ?

Amit Alok Pandey If malocclusion has caused disc displacement then only correction of malocclusion in a precise manner can capture the disc back. If trauma has caused disc displacement then other methods may help.

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