Dr M P BRAVERMAN & Dr R P GREWAL - Certified Specialists in Oral and Maxillofacial Surgery  
  • Dental Implants
  • Wisdom Teeth
  • Extractions
  • Dentoalveolar Surgery
  • Pre-Prosthetic Surgery
  • Bone Grafting
  • Sinus Lift
  • Socket Grafting
  • Soft Tissue Grafting
  • Corrective Jaw Surgery
  • Facial Trauma
  • TMJ Disorders
  • Anesthesia
Temporomandibular Joint Disorder (TMD)
What is TMJ?
Your upper and lower jaws are held together by a complex joint that moves your lower jaw forward and sideways. When this joint does not work properly, the disorder is called TMD. This condition can be caused by factors within the temporomandibular joint (bone, disc, cartilage) or external factors (muscles of mastication, occlusion).
What are the Signs of TMD?
Some of the most common TMD symptoms include:
Misalignment of the upper and lower teeth (a sudden change in the way they fit together)
Pain when chewing or yawning
Headaches, earaches, pressure behind the eyes
Clicking or popping sound when you open or close your mouth
Jaws that "get stuck"
Tenderness of the jaw muscles
What are some of the causes of TMD?
Rheumatoid Arthritis
Autoimmune Disorders
Foreign Body Reactions
Tumors or Neoplastic Processes
Displaced articular discs
Foreign body reactions
Previous TMJ Surgeries
Hemifacial Microsomia or other congenital deformities
How is TMD Treated?
There are various treatments that may reduce your symptoms dramatically. After we complete the diagnosis, we will create a treatment plan to alleviate your symptoms.
Treatment of TMD generally consists of non-surgical and surgical options
Non-surgical options are generally exhausted first. They provide the benefit of being completely reversible and work in approximately 90% of patients with TMD.
These non-surgical options include:
Occlusal splint therapy
Occlusal adjustments
Pain relievers, muscle relaxants, and anti-inflammatory medications
Warm moist heat
Physical therapy
Diet modifications (soft, no chew diet)
If these non-surgical treatments prove ineffective, then surgical treatment may prove necessary.
We will perform a thorough history and physical exam to diagnose the source of your TMD. They may also use the aid of advanced radiographic techniques such as MRI and Computed Tomography to further aid in the diagnosis.
Surgical options may include
Arthrocentesis/ Lavage of the Joint space
TMJ Arthroscopy
Orthognathic (Jaw) Surgery
Articular disc repositioning with Mitek Anchors
Removal of the disc and substitution with harvested muscle, cartlidge, fat or fascia.
Removal of the disc replacement with high grade medical plastic/ synthetic material
Total Joint Reconstruction with ribs
Total Joint Reconstruction with custom-made CAD/CAM joint prosthesis ( www.tmjconcepts.com )
TMD can be extremely difficult to treat as the cause is often multifactorial in its origin. There is often more than one cause or combination of causes leading to the problems.
Often times correcting a functional problem in the joint, such as repositioning the disc may or may not alleviate the symptoms. It is important to understand this prior to undergoing a TMJ surgery.
We may require the help of a pain management specialist in controlling the extent of your TMD. Often times TMJ pain can be difficult to manage with TMJ surgery alone. This becomes much more important in patients with long standing TMJ pain or TMD.
We will work closely with you and your restorative dentist to devise a treatment plan that best fits you as our patient.
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