Condylotomy - 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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Orthognathic surgery and TMJ

Surgical treatment for TMJ


Among the different kinds of surgical treatment options for TMD, disc reposition and arthroscopy aim at improving the relative position of condyle and articular disc to relieve pain and recover joint functions. Condylotomy is the only surgical method that needs not to cut open the joint structure but is capable of improving the clinical signs.

Many scholars believe that condylotomy is very effective in treating TMJ internal derangement in all levels of severity, but in fact it applies only in patients with TMJ internal derangement of Wilkes stages I~III (Hall HD, 1993).

Condylotomy is similar to intraoral vertical ramus osteotomy, an orthognathic surgical technique, in which the vertical ramus of mandibular was cut so the relative position of dental occlusion and joint can be rearranged to create more space in the articular cavity and reduce intra-articular pressure. As shown in the upper figure illustrating condylotomy, the condyle is moved forward and downward to create space in the narrow articular cavity. After the surgery, the patient is placed into 1 to 2 weeks of intermaxillary fixation with elastics and mouth opening practice.

The study of Hall investigating the application of condylotomy on 400 patients with TMD in 9 years was the largest scale clinical trial focusing on condylotomy so far and the results showed that the pain caused by TMD was well relieved in 90% of the patients (Hall HD, 1993). Further analysis revealed good outcome of condylotomy in patients with TMJ disc displacement with reduction. The overall success rate reached 94% and MRI follow-up scan showed the displaced TMJ disc in 72% patient reduced back to normal position. An earlier study from the same author showed condylotomy had a success rate of 88% in patients with disc displacement without reduction (Hall HD, 2000).

Compared to other joint open surgery, the advantages of condyletomy include minimal intra-articular scarring with maximal range of joint motion, surgical incision hidden in the mouth and is therefore invisible and extremely high success rate.




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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.