A guide for temporomandibular joint surgery using a simple surgical classification - A narrative-style review

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Temporomandibular Joint Disorders

Background:

• Temporomandibular joint (TMJ) disorders encompass a range of conditions affecting the jaw joint.
• Surgical interventions are considered for specific TMJ pathologies when conservative treatments fail.
• A practical surgical classification system aids in standardizing TMJ disorder management.

Purpose of the Study:

• To review and clarify the role of temporomandibular joint (TMJ) surgery in managing specific TMJ disorders.
• To introduce and discuss a practical surgical classification for TMJ pathologies.
• To validate the clinical utility of this TMJ surgical classification over the past decade.

Main Methods:

• Narrative review of existing literature on TMJ surgery and classification.
• Analysis of a decade-old surgical classification system for TMJ disorders.
• Discussion of proposed surgical options for each category within the classification.

Main Results:

• The classification categorizes TMJ disorders into five escalating degrees of joint pathology.
• Category 1 involves painful but structurally normal joints, managed non-surgically.
• Categories 2-5 outline treatments for disc displacement, degenerative disc changes, and end-stage joint disease, including arthrocentesis, arthroscopy, disc repositioning, discectomy, and total joint replacement.

Conclusions:

• The reviewed TMJ surgical classification provides a practical framework for managing TMJ disorders.
• Studies over the last decade have validated its usefulness in clinical practice.
• The classification helps clinicians better understand and apply TMJ surgery in everyday practice.