Surgical Treatment Modalities in the Management of Temporomandibular Joint Disorders

Objectives: Temporomandibular joint disorders (TMD) are diseases that affect the temporomandibular joint and the supporting structures. The goal of treatment for temporomandibular disorders is the elimination of pain and return to its normal function. This aim of this study was to assess the various surgical treatment modalities employed in the management of Temporomandibular joint disorders and to evaluate the oral health related quality of life post-surgery in patients with temporomandibular disorders visiting saveetha dental college. Methods: This retrospective study included data of 53 subjects who reported to Saveetha Dental College and diagnosed with TMD and surgically operated during June 2019 - May 2021. After assessment in the university patient data registry, consecutive case records of 30 patients who were diagnosed with Temporomandibular joint disorders [Disc-condyle complex] and underwent surgical therapy was included in the study; and consecutive case records of 23 patients with TMJ ankylosis who underwent surgical treatment were also included in the study. Descriptive (Frequency, percentage, mean and standard deviation) and Inferential statistics (chi square test, paired ‘t’ test) were employed Using SPSS software. Level of significance was set at p<0.05 and results obtained. Results: The age group of 31-40 years underwent most of the surgical treatment for TMD (31%). Male patients predominantly underwent surgery for TMD (55.17%). Among patients undergoing surgical treatment for TMD, TMJ subluxation/ dislocation was present in 44.83% of patients followed by disc displacement without reduction (41.38%). 41.38% of patients were treated by High condylectomy and discopexy. The association between age and gender of the patients, type of temporomandibular joint disorder with the type of surgical treatment done for TMD was evaluated and the results were statistically significant (p<0.05).The age group of 11-20 years presented with higher incidence of TMJ ankylosis (36.36%). Males showed higher incidence of TMJ ankylosis with 63.64%. Sawhney’s type II (45.45%) was predominantly present among the TMJ Ankylosis patients. Right side of TMJ showed higher incidence of TMJ ankylosis (45.45%). Interpositional arthroplasty was the predominant surgical treatment done for TMJ ankylosis patients (86.36%). Dermis fat graft was commonly used in 63.64% patients as an interpositional material. The association between age and gender of the patients, site of involvement of TMJ ankylosis with Sawhney's classification of TMJ ankylosis was evaluated and the results were statistically significant (p<0.05).