Combined TMJ Surgery and Orthognathic Surgery

Temporomandibular joint (TMJ) surgery and orthognathic surgery are both performed to correct problems related to the jaw and its function. Although it is possible to have TMJ surgery at the same time as a corrective jaw (orthognathic) surgery, several factors determine whether to combine these procedures.

What is TMJ Surgery?

TMJ surgery is performed to treat certain diseases and disorders of the temporomandibular joint with the goal of reducing pain, improving joint function and restoring proper jaw movement. TMJ surgical treatment options may involve a variety of techniques including:

• Arthrocentesis — flushing fluid from the joint and gently stretching it
• Arthroscopy — using a miniature camera and surgical device to diagnose and repair the joint
• Arthroplasty — open-joint surgery for more complex cases

What is Corrective Jaw Surgery?

Corrective jaw surgery – also known as orthognathic surgery – is performed to correct misaligned jaws and teeth, enhance facial esthetics and improve basic functions such as breathing, chewing and speaking. The procedure typically includes changing the position of the upper jaw (maxilla), lower jaw (mandible) or both to achieve proper alignment and harmony of the jaw and facial features.

Who is a candidate for TMJ Surgery Combined with Orthognathic Surgery?

An oral and maxillofacial surgeon (OMS) will need to complete a comprehensive evaluation before deciding if combined temporomandibular joint surgery and jaw correction is right for you. This evaluation may include a thorough examination of the temporomandibular joint, typically consisting of imaging studies (e.g., X-rays, cone-beam computed tomography), analysis of joint function and assessment of specific TMJ conditions. Based on the evaluation, your OMS will determine the suitability and feasibility of the treatment combination.

Common Involvement and Severity

Whether to combine TMJ surgery with corrective jaw surgery depends on the extent of your disorder and the severity of your symptoms. If your TMJ disorder significantly impairs joint function and causes jaw misalignment, combining multiple surgeries to achieve overall improvement may be the correct approach for you.

Surgical Planning and Expertise

Combined TMJ and orthognathic surgery requires careful planning and expertise. Your OMS may create a customized treatment plan that considers your unique needs and goals. Coordination among the multidisciplinary team is critical for a smooth and successful surgery.

Benefits of Combined Surgery

Your OMS will discuss with you the considerations of combining these surgeries. Potential benefits include:

• Improved treatment results: Combining TMJ surgery with orthognathic surgery provides a comprehensive and integrated treatment approach. Treating jaw misalignment and TMJ disorders simultaneously can improve jaw function, reduce pain and improve overall treatment outcomes.
• Reduced recovery time: Performing both surgeries at the same time may reduce overall recovery time compared to performing them separately. You also will only need one hospital stay as opposed to two.

Each patient’s situation is different, and the decision to combine TMJ surgery with orthognathic surgery must be made on an individual basis. Your OMS will consider factors such as general health, severity of medical conditions and potential risks and benefits of combining procedures.

Sometimes a combination of procedures is not appropriate or necessary, and not everyone with TMJ disorders will require surgical treatment. This decision should be made in consultation with your OMS and other healthcare professionals involved in your care. If you have concerns about your temporomandibular joints and jaw position, it is important to consult an OMS who can assess your condition and suggest the appropriate treatment plan.