Disc Repositioning Surgery - 謝明吉、姜厚任 顎顏面 美學 重建 專科診所-風華整形聯合診所
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Surgical Treatment for TMJ
Disc Repositioning Surgery


Surgical treatment for TMJ

Disc  Repositioning Surgery

Patients and clinicians should consider the option of open joint surgery when facing long-term TMJ pain or functional loss caused by structural abnormalities or pathological changes that do not respond well to conservative treatment or minimally invasive surgery. The purposes of surgical treatment are reparation of the injured or diseased tissues, removal of the part that cannot be repaired and reconstruction.


(Oral Maxillofacial Surg Clin N Am 27 (2015) 85–107 )                            

TMJ disc repositioning serves as the surgical treatment for disc derangement. As mentioned above, disc derangement refers to the condition that the articular disc does not locate in the normal anatomical position and may combine with disc deformation or damage. The purpose of TMJ disc repositioning is to reposition and restabilize the dislocated and deformed TMJ that cause pain or limited joint movements to a normal anatomical position so as to improve the signs of joint pain and limited mouth-opening.

The 6-year clinical follow-up study of Montgomery et al. showed that after TMJ disc repositioning surgery the signs of pain and functional abnormalities improved significantly in patients with TMJ pain and functional defects; the successful rate was about 80-95%.


published the first surgical treatment method for TMJ disc displacement. Afterwards the surgical approach to TMJ has been improved by Thomas Anandale published the first surgical treatment method for TMJ disc displacement. Afterwards the surgical approach to TMJ has been improved by Stimson、Murphy and Wakely to a smaller and better-hidden surgical incision but still provide sufficient vision for surgical exposure. The surgical approach can be divided in 2 types: preauricular approach and endaural approach.


顳顎關節(TMJ)手術發展始於19世紀。1887年Thomas Anandale醫師在Lancet發表以手術方式將治療顳顎關節盤異位(disc  displacement)。顳顎關節手術切線設計經過Stimson、MurphyWakely等人的改良,逐漸改良成較隱藏式的手術傷口,又提供醫生足夠的手術視野,可分為耳前切線(preauricular approach)、耳內切線(endaural approach)。

Early stage of TMJ disc derangement may show little or even no signs. Remodeling of condylar head and glenoid fossa may occur with disc dislocation, which can lead to improvement in clinical signs (Dolwick MF,2001, Dimitroulis,2005). Therefore early stage of TMJ internal derangement can be well managed with conservative treatments. But conservative treatments are not fundamental solution for patients with severe or end stage TMD and may result in clinical deterioration and decrease in life quality. It is important to consider surgical treatment options based o the severity and extent of TMD.





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All Written Contents and Pictures Created by Dr. Adrian M. Hsieh and Dr. Scott H. Jiang





Results of surgery vary among patients. Please consult your doctor.