TMJ Arthroscopy

depiction of TMJ ArthroscopyTMJ arthroscopy is a minimally invasive operation to diagnose and treat problems such as locking, pain and restricted mouth opening, without the need for a large cut on the skin. If you suffer from jaw joint pain that hasn’t responded to non-invasive treatments, TMJ (temporomandibular joint) arthroscopy is an effective option to explore. This is an outpatient surgery that allows Dr. Bolourian to diagnose and treat various TMJ conditions. If you are a candidate who would benefit from TMJ arthroscopy, the most important goal for you should be to find a surgeon skilled in arthroscopic surgery of the TMJ. That is an Oral and Maxillofacial Surgeon, trained in TMJ arthroscopy and a practice that is devoted to perform frequent TMJ surgeries. Dr. Bolourian is one of the few surgeons in California, skilled and trained in TMJ arthroscopic procedures. A major part of our practice in Orange County, Ca is devoted solely to hundreds of TMJ patients living with pain and other TMJ conditions.

What is a TMJ arthroscopy?

An arthroscopy allows a trained surgeon to see inside your temporomandibular joint (TMJ) using a camera inserted through a small cut on the skin. Dr. Bolourian can diagnose problems such as a torn cartilage and damage to the surface of the joint through a very small camera. Through this approach, Dr. Bolourian may be able to treat many TMJ conditions that cause pain and clicking using surgical instruments without making a larger cut.

What are the benefits of Arthroscopy?

TMJ illustration of minimally invasive solutions

The benefits of TMJ Arthroscopy are numerous. No cuts on the skin, ability to visually inspect the joint, to treat many conditions and a quick recovery sums it up. This is a minimally invasive procedure that is versatile and in trained hands can reduce pain and treat lockjaw. Arthroscopic surgery can effectively treat temporomandibular joint conditions with fewer and less severe complications compared with an open-joint surgery.  During arthroscopy, the Dr. Bolourian can insert instruments and operate through multiple small entry points, preventing the need for open joint surgery.

During arthroscopic surgery, Dr. Bolourian may:

  • Remove scar tissue and thickened cartilage
  • Reshape parts of the joint
  • Reposition the disc and tighten the joint to limit movement
  • Flush (lavage) the joint
  • Insert an anti-inflammatory or lubricating medicine

What does the operation involve?

images from TMJ Arthroscopy

The operation is performed under general anesthesia and usually takes about 40 minutes or longer for each joint.  A camera is inserted through a small cut in front of your ear to examine the inside of the joint for damage to the cartilage and joint surfaces. Dr. Bolourian may introduce one or two small needles into the joint and use them to wash out any loose material caused by wear of the joint surfaces. Depending on his findings, he may also introduce surgical instruments to treat scarring, improve the joint surfaces or to use a stitch to change the position of the cartilage disc. Dr. Bolourian may offer a series of autogenous platelet rich plasma (your blood products) injections within the joints. Recent studies have shown platelet rich plasma (PRP) help release growth factors which helps promote bone healing and bone quality in the joint. PRP has also shown to significantly reduce pain within the TMJ in long terms.

What complications can happen?

Complications with TMJ arthroscopy are generally rare and minor in experienced surgeon’s hands. Some of the complications may include:

  • pain
  • bleeding
  • bruising and swelling
  • infection of the surgical site (wound)
  • Difficulty opening the mouth for some time
  • Temporary nerve bruising, which may cause minor and temporary facial weakness

How soon is the recovery from TMJ Arthroscopy?

The swelling and discomfort is usually at its worst for the first few hours. Patients should be able to go home the same day. To reduce the risk of bleeding, swelling and bruising, we recommend to avoid strenuous exercise, have a hot bath or bend down for 2 weeks. It is important to keep the joint moving. Dr. Bolourian will give you stretching exercises to do to help improve how your mouth opens. You should be able to return to work after a few days, depending on your type of work.

When should you expect to notice an improvement, if surgery is successful?

Arthroscopy, if performed by an experienced arthroscopic TMJ surgeon is very successful. Patients typically experience pain relief and improved range of motion of their jaw within few days after surgery, providing the patient follows Dr. Bolourian’s post arthroscopy care. Keep in mind, every patient and every condition encountered within the TMJ may defer. Therefore, it is difficult to determine the timeline for improvement. Again, most patients report a significant improvement after few days.

Are there any alternatives to surgery?

Problems inside a joint can often be diagnosed using tests such as CT scans, MRI scans or diagnostic arthroscopy. Non-surgical treatment such as rest, taking anti-inflammatory painkillers and wearing a TMJ splint can sometimes help. If the problem is with the chewing muscles around the joint, muscle-relaxing medication or injections of Botox therapeutics can reduce joint stiffness but do not treat the underlying cause. A steroid injection into the joint can sometimes reduce pain for several months but may cause side effects if repeated too often.