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Private DentMetrik Oral and Dental Health Clinic
Prof. Dr. Beynun Akyavas Avenue No:33/AA, 34680 Uskudar/Istanbul, Turkiye.

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Temporomandibular joint (TMJ) disorders and surgery is a specialized surgical discipline that covers the diagnosis and treatment of functional disorders, pain, and structural deformations occurring in the jaw joint—which connects the lower jaw to the skull—and the chewing muscles that move this joint. These conditions, which directly affect vital functions such as chewing, speaking, swallowing, and yawning, can significantly reduce patients' daily quality of life. At Dentmetrik, we utilize the most advanced 3D imaging technologies to diagnose jaw joint problems and offer a wide range of treatments, from non-surgical preventive approaches to the most complex open-joint surgeries, to restore our patients' painless and healthy jaw function.

Definition and Purpose of Temporomandibular Joint Disorders and Surgery

The TMJ (Temporomandibular Joint) is a bilateral joint system where the lower jawbone (mandible) meets the temporal bone at the base of the skull; it is one of the most complex and constantly active joint systems in the human body. "Temporomandibular Joint Disorders" refer to conditions where the joint structure is compromised due to the displacement of the cartilaginous disc (which acts as a cushion), increased friction from reduced joint fluid, muscle spasms, trauma, or rheumatological diseases. Clicking sounds (clicking), severe pain in front of the ear, jaw locking, restricted mouth opening, neck pain, and unexplained tinnitus (ringing in the ears) are the most prominent clinical symptoms of these disorders.

The primary goal of surgical and conservative (non-surgical) treatments for TMJ disorders is to alleviate inflammation and severe pain in the joint area and to restore the anatomical integrity of the intra-articular structures. This allows the patient's restricted mouth-opening capacity to return to normal physiological limits (averaging 4-5 cm). Early interventions prevent the complete disintegration of the cartilage disc and stop the jawbones from rubbing against each other, which leads to irreversible erosion (osteoarthritis). These treatments planned by Dentmetrik specialists aim not only to repair the joint but also to improve the patient's impaired sleep quality and psychological well-being.

Types and Applications of TMJ Disorders and Surgery

The treatment of TMJ disorders is categorized into different types based on whether the source of the problem is muscle-related (myofascial) or a structural intra-articular (cartilage/bone) defect, as well as the stage of the disease. The main treatment types applied step-by-step (from simple to complex) at Dentmetrik clinics according to the patient's clinical presentation are:

  1. Conservative (Non-Surgical) Treatments: Preferred in the early stages of the disease. Custom-made hard acrylic night guards (occlusal splints) are the most common method to relieve the joint load caused by teeth clenching and grinding (bruxism). Additionally, botox (Botulinum Toxin) injections into the chewing muscles, muscle relaxant medications, stress management, and physical therapy exercises are included in this group.
  2. Arthrocentesis (Joint Lavage): A minimally invasive surgery applied in cases of sudden restricted mouth opening, where the joint disc has shifted and the joint fluid has lost its structure. Under local anesthesia, two very thin needles are used to enter the joint space to wash out inflammatory fluid with sterile solutions. Following the lavage, hyaluronic acid or PRP injections are performed to nourish the joint and increase lubrication.
  3. Arthroscopy (Closed Joint Surgery): A closed surgical intervention performed by entering the joint space with a millimeter-sized special camera (arthroscope) and micro-instruments. Adhesions inside are directly visualized and released, worn tissues are cleaned, and the displaced cartilage disc is sutured back into its natural position (fixation) using special techniques.
  4. Open Joint Surgery (Arthrotomy): Advanced major surgeries performed in cases where the cartilage disc has become completely irreparable, the joint has ossified and fused (ankylosis), severe jaw trauma has occurred, or intra-articular tumors are present. The joint is reached directly through an aesthetic incision made in front of the ear, and the compromised anatomical structure is reshaped.
  5. Total Joint Replacement (Artificial Prosthesis): In the most advanced cases where the patient's own natural jaw joint is completely lost due to disease or rheumatic destruction, the procedure involves replacing the jaw joint entirely with a custom-produced, titanium-alloy artificial TMJ prosthesis.

The Procedure and Process

The treatment process for TMJ disorders begins with an accurate and definitive diagnosis. Patients applying to our clinic first undergo a comprehensive clinical examination by our maxillofacial surgeons. In this exam, maximum mouth opening is measured in millimeters, spasm points (trigger points) in the chewing muscles are palpated, and clicking or grinding sounds (crepitus) during jaw movements are monitored using a stethoscope. 3D Dental Tomography (CBCT) or Magnetic Resonance Imaging (MRI) technologies are utilized to clearly see whether the problem is bone-related or cartilage disc-related.

Following the diagnosis, the treatment protocol that will cause the least trauma to the patient is determined. Procedures such as splint fabrication or botox are performed in minutes during standard clinical appointments. Procedures like arthrocentesis (joint lavage) take an average of 30-45 minutes under local anesthesia and, if necessary, conscious sedation, ensuring the patient feels no pain; the patient can return to their normal life the same day. More complex operations, such as open joint surgery or prosthesis placement, are meticulously carried out by our expert surgical team under general anesthesia in fully equipped operating rooms.

The recovery process depends entirely on the scale of the treatment. Recovery is extremely rapid for conservative treatments and closed lavage procedures. Following open surgeries, a soft diet (liquid/puree-based nutrition) for several weeks is usually mandatory. The biggest key to the success of TMJ treatments is the post-operative period. After all surgical or non-surgical interventions, it is essential to perform the specially taught jaw physical therapy exercises and maintain regular splint use so the joint can adapt to its new position and the muscles can strengthen.

What Are the Advantages of TMJ Disorders and Surgery?

TMJ treatments provide unique relief by permanently eliminating chronic head, neck, and facial pain that drains a patient's vital energy. Following a successful surgical or conservative intervention, patients can freely and at full capacity perform essential human functions—such as yawning, laughing, and chewing solid foods—without the fear that "my jaw will lock" or "it will hurt." With the improvement in nutritional quality, the patient's general health and digestive system are also positively affected.

Early-stage treatments prevent the irreversible erosion of the cartilage disc and the formation of asymmetry in the jawbones. This avoids the need for much more costly and heavy open surgeries (joint prosthesis, etc.) that might be required in later years. Additionally, night guards and muscle relaxant methods applied as part of TMJ treatment halt cracks in tooth enamel, wear, and prosthesis fractures caused by teeth clenching, thereby extending and protecting the life of other dental investments (implants, zirconium crowns, etc.) in the mouth.

To receive detailed information about the diagnosis of temporomandibular joint (jaw joint) disorders, non-surgical treatment methods, surgical operation prices, and the services provided by our Ankara Dentmetrik clinic within the scope of health tourism, or to schedule an appointment, contact us immediately.

Frequently Asked Questions

If it is not accompanied by pain, restriction in mouth opening, or locking, just the sound is not an urgent danger, but it is a harbinger that the articular disc has slipped (degeneration has begun). To stop its progression, it must absolutely be examined by a specialist maxillofacial surgeon, and preventive measures must be taken.

In muscle-related pains and joint fatigue due to clenching and grinding teeth (bruxism), personalized hard occlusal splints largely solve the problem and provide definitive relief by reducing the pressure inside the joint. However, if there is severe disc tear or bone resorption, more advanced interventions (arthrocentesis, etc.) may be required.

Botox injection applied to the chewing muscles (masseter and temporal) relieves the destructive load on the joint by weakening involuntary contractions and excessive teeth clenching force. It relieves both severe jaw/headaches and provides an aesthetic benefit by thinning the angular/square appearance in the lower part of the face.

No, arthrocentesis is a minimally invasive (closed) procedure performed under local anesthesia in clinical conditions. The joint is entered with fine needles, the inflamed fluid is cleaned, and lubricating hyaluronic acid is injected. After the procedure, the patient returns to normal life on the same day.

Open joint surgery is a method resorted to only in very advanced cases (ankylosis, tumors, etc.) where conservative methods are insufficient. When performed by experienced maxillofacial surgeons with 3D tomography plannings, it gives highly reliable, permanent, and face-smiling results.

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