The effect of surgical treatment of the temporomandibular joint: a survey of 70 patients.

: Most patients with temporomandibular disorders (TMD) can be successfully treated by conservative methods, but approximately 10-20 percent have persistent symptoms. The aim of this study was to evaluate the signs and symptoms of TMD in patients treated with open surgery of the TMJ. Seventy-two patients (13 men, 59 women, mean age 37 years, range 14-68 years) were evaluated during an eight-year period. Altogether 45 right TMJs and 39 left TMJs were treated, including both TMJs during the same operation in eight of the cases. The patients were evaluated at follow-up in 1997. The degree of TMD at follow-up was assessed using the anamnestic and clinical dysfunction Helkimo indices. Most of the patients reported at the follow-up that they were subjectively satisfied with the surgical treatment. The main clinical findings in the post surgical patients at follow-up were TMJ sounds and deviation of the mandible during opening. The tenderness in the masticatory muscles and TMJs on palpation was reduced significantly and the ranges of mandibular movement were improved for all the patients. The mean anamnestic and clinical indices decreased with a statistical significance from the shortest follow-up group (Group I) to the longest on group (Group IV) (p = 0.000). The conclusion of this study was that after open surgical treatment of the TMJ, the patients have significantly better functioning of the masticatory system and reduced signs and symptoms of TMD in the long term.