Total TMJ Replacement Surgery

There are several reasons why someone may need TMJ replacement surgery. The most common is severe osteoarthritis or rheumatoid arthritis, which has caused significant damage to the TMJ. Often, there is an “Idiopathic” (meaning there is no distinct underlying disease) cause of condylar resorption.  TMJ arthritis or resorption means that the head of the joints dissolves or shrinks away (on both sides), causing the lower jawbone (mandible) to shrink backward, which can cause bite issues, appearance issues, pain at times, and airway or breathing issues.  Lyme disease, autoimmune disorders, other arthritides, or no clear underlying cause can be responsible for this condition (it may be linked to estrogen or estrogen byproducts like estradiol).  Other types of issues requiring TMJ replacement include traumatic injury, tumor growth in the joint, or congenital deformities that affect the joint’s position or function.

Yes. Total temporomandibular joint replacement surgery is considered a major procedure. This surgery should only be performed by an experienced and board-certified surgeon like Dr. Derek Steinbacher at our boutique, highly specialized center, West River Surgery Center.  The surgery itself can take several hours to complete and usually entails concurrent jaw surgery (moving the upper jaw – Le Fort, as well as chin / genioplasty) and other procedures (like under-chin liposuction and fat grafting).  We are one of the first centers to effectively and efficiently perform these in an outpatient ambulatory surgical center.  This outpatient setting provides privacy and safety and enables discharge home the same day, with close follow-up.  In some cases, they may be done in a hospital setting with overnight admission. 

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TMJ prosthetic replacement relieves symptoms of pain, clicking, and grinding while enabling the jaw bone to be more ideally positioned, which has benefits for facial aesthetics and jawline projection, for the bite or occlusion (teeth), and for the airway (breathing and helping to mitigate snoring, sleep apnea).  Functionally as well, if pain existed in the TMJs prior to surgery, this is typically removed or relieved. Additionally, for those patients with limited mouth opening, joint replacement allows for much greater motion and mobility of the jaws.  In patients who had arthritis or resorption, the absolute mouth opening maybe less linear or laterally, but is occurs pain free, and in some instances is a greater amount of opening.  

The recovery process after the TMJ replacement surgery varies for each patient, but most patients are treated in our outpatient surgical center with close follow-up.  If done in a hospital, they are typically discharged the next day after the procedure. Patients must follow all post-operative instructions provided by Dr. Derek Steinbacher, which might include wearing a splint or specific exercises to aid in healing and rehabilitation.  Typically, patients feel quite a bit better after the first week and may return to school or work as soon as 9-10 days post-op to certainly by 6 weeks, and the usual time frame is 3-4 weeks after surgery.  There are certain dietary and exercise restrictions we will review with you as well.  

There are a few things to be prepared for as you heal from total temporomandibular joint replacement surgery. You might experience swelling, bruising, and discomfort in the area for a few days or weeks after the procedure. Dr. Derek Steinbacher also advises you to adhere to a blenderized and then a soft diet for some time to avoid putting excessive strain on your newly replaced joints and jaw. It is essential to follow these restrictions carefully to ensure proper healing and reduce potential complications.

Dr. Derek Steinbacher of Guilford, CT, is a board-certified surgeon, uniquely trained in Craniofacial Surgery, Plastic and Facial Plastic Surgery, and Oral and Maxillofacial Surgery.   He has patients traveling worldwide for total TMJ joint replacements, orthognathic jaw surgery, rhinoplasty, facelift, and all other aspects of cosmetic plastic surgery and cranio-maxillofacial surgery.  We adeptly span the interdigitation of cosmetic, elective, and medically necessary surgeries, comprising both Form and Function).  Dr. Steinbacher can help! Call (203) 453-6635 to request an upcoming visit with our professionals to discuss possible surgical interventions. We frequently start with video visits from out of town as well.  We welcome new and established patients in Suite 1-8 at 5 Durham Road.