Temporomandibular Joint Replacement - Biomet (stock) Vs Custom (TMJ Concepts) Implants
May 17, 2014
My oral surgeon brought up the option of joint replacement surgery for my left jaw joint at my last visit. I have a lot of questions, and he is good at answering them. He apparently does use Biomet and TMJ Concepts, but I wondered if anyone had any recommendations on which to use based on their experience. I have never had jaw surgery. I am worried about the possibility of sensitivity to the metals in the implant, but read at the TMJ Association website that there is a company you can send a blood sample to in order to be tested for reactions to some of the metals in the implant. Also, although the left joint is very deteriorated at this point, my right joint also has severe osteoarthritis as well but has been more stable the last few years. I wondered about having one surgery, and then possibly having to face another within a few years. Would it be better to try and wait in order to have both joints done at once? Although, honestly, I don't know if I will be able to tolerate waiting. I am worried about having to do this again in a few years knowing that the recovery period for the surgery may be a while. It is a little overwhelming to think about. I guess I am wondering about the advantages/disadvantages to the Biomet (stock) versus custom (TMJ Concepts) implants. I know the TMJ Concepts require a waiting period. I also read on their website that the company notes that their implant is particularly useful for someone who has had multiple surgeries in the past (which makes sense to me.) Would the stock joints be likely to fit well enough that they would not change your facial appearance (any more than this has already occurred)?
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So I have been advised by 2 different oral surgeons I need total joint replacement of both joints.
For those of who have gone through joint replacement, I would really appreciate knowing:
1) what questions I should be asking the surgeons about the surgery, about the outcomes; about post-op care; risks;
2) what your personal exerpience was - just want to know what to expect.
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I've had TMJ/TMD issues for 33 years after a dog bite at 12. In total I've had 5 surgeries on both sides of my jaw with a 6th to repair an ear canal and eardrum that a surgeon cut into while in surgery. The last time I had surgery it was a 10 hour surgery with 2 doctors, one on each side. So needless to say I'm not looking forward to any more.
I seem to grow bone in the left joint space (my disk and ball joint are long gone) and the right side my body absorbs the tissue they put in and I', bone on bone. Therefore I'm living with daily chronic pain for the last 20 years.
I've heard that the joint replacement has gotten better. It doesn't take away all pain, but it's a different pain.
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I'm 17 years old and have had tmj for the last 3 years. i first was given numerous night splints to see if that would work,they didn't. Next i was referred to a specialist who gave me a night splint which still didn't work. From here i had xrays and then had an mri.
Right side:
There is an anteriorly displaced but intact meniscus, which mostly overlies the articular tubercle. There is thickening of the retrodiscal lamina tissue. The intercondylar head lies within the condylar fossa with a slight deformity to the articular surface. No fluid or inflammation is present in the residual joint space but there is absolutely no anterior translation when the mouth is open. the adjacent soft tissue of the lateral pterygoid, externally auditory canal, parotid and deeper face are normal.
left side:
The left condylar head is normal in morphology. The meniscus is probably normally located although it is quite anteriorly displaced extending on to the articular tubercle with only a small portion overlying the condylar head from 10 o'clock to 12 o'clock. No fluid or inflammation is present within the joint space of note with a small amount of fluid on either side of the intact meniscus more anteriorly. No oedema or erosions are present within the condylar head. The soft tissues adjacent to the joint are unremarkable.
Conclusion:
There is complete anterior displacement of the meniscus on the right which is intact. it now sits on top of the superior boarder of the lateral pterygoid muscle and overlies the articular tubercle. No current inflammation is seen within the temporomandibular joint, erosion's or bone oedema. however on both sides there is no translation during attempted mouth opening.
From here i had an arthrocentesis where he put a cortisone injection in. This also didn't work. From here he put me on amitriptyline for 2 months but that didn't help so we stopped it. 3 months ago I had surgery on my right tmj. My specialist removed the disc, reshaped the bone, and put a fat graft where the disk should be. This also hasn't helped, I am still in constant pain, m jaw locks up, migraines nerve problems and other symptoms. Because of the pain i have only attended 36% of school this year. It's my last year but i am keeping up. Because of tmj i have to stay home next year and study through distance learning for university. My specialist has applied for permission to put me on gabapentin to see if it will keep the pain at bay.
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I suspect from my symptoms that I could be suffering from TMJ. I had to have two of my upper back teeth removed this year and also one wisdom tooth which I am sure is affecting my bite.
I spoke to the surgeon about my symptoms and he said that it could be TMD and that I would probably need to have a splint made. I am currently waiting to go back to my regular dentist for a new x ray and to follow this up.
The sensation I experience I would not describe as painful... annoying/uncomfortable absolutely!
It feels as though the left side of my jaw is in a constant spasm or as though something is pulling it back (hard to describe) I can open my mouth without any problems and there is no clicking.
I sometimes wake up and it is fine but then throughout the day it starts to come back. I notice this mostly when I sit down on my computer or lay my head back on something. It also goes away for a couple of days but then it comes back.
I do not think it is a tooth problem as I have had regular check ups this year and any problems I had have now been dealt with and now I just need to get implants made for the missing teeth when the gum is healed.
I wondered if anyone with a bit more experience thinks this is a TMJ problem or could it be something else like a nerve problem? Most symptom checkers describe TMJ as painful or with clicking noise from the jaw, which I am not experiencing. Hence the confusion!
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I have had clicking in my ears for over two weeks now, whenever I talk or finish a sentence, or if I make a certain manoeuvre with my nose/palate/mouth, not quite sure, but I don't have to open my mouth in order to make the clicks.
It started off in my right ear but is now in both and is so loud I have become so anxious and depressed and don't want to talk to anybody.
The clicks are audible externally, and if I cry and become congested I get slight relief and also if I tilt my head forward or lay my head in certain positions.
I went to the doctors yesterday who instantly diagnosed me with TMJ. I'm not sure whether to believe this, as the clicks aren't there when I open and close my jaw and why does it temporarily ease off when I am congested?
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Wondering if anyone else has this same problem? I have unwanted movements of my jaw that are becoming more frequent to the point I'm affected by this problem most of the day. My jaw will move from center to the left side, or other times in a back and forth direction... these forceful jerking movements are extremely fast, occur repetitively and once they start they go on for hours. At other times my mouth will pop open unexpectedly or it will slam shut really fast and hard like a bear trap, my teeth gnash together when my jaw slams shut. My teeth are in decent shape, considering... but I'm starting to worry lately about how much more abuse my teeth can take before they start getting knocked out.
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For those of you who have already had joint replacements, I am curious if the surgery resulted in any improvement in chin recession, if you experienced that as a result of your joint problems. Also, did anyone have any other procedures to treat chin recession that resulted in improvement.
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I've exhausted all other options. Everyone has told me not to get surgery, but I've tried every conceivable treatment and nothing has worked. Seven years of this and thousands and thousands later I'm still getting worse. Would love to hear someone out there felt better after surgery.
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So, my TMD seems to be presenting in an unusual way. Rather than getting earaches or migraine symptoms, I'm mostly having trouble with my throat, neck, and nose. For the longest time people were telling me it was sinusitis. I even went on Cipro for 4 weeks. Anyway, the thing is that my throat doesn't just hurt, it kills. It'll start up stinging and within an hour or two it'll be raging, often for longer than a day. My jaw starts to quiver and I get pain all over my face: tooth pain and pressure, an extremely sore neck, a totally congested nose. And everything becomes tight: it feels weird to open my mouth and rotate my neck, and lying down doesn't make anything better either.
So my question is: does anyone have any idea how to deal with a sore throat caused by TMJ? Ibuprofen doesn't seem to put a dent in the pain and ice packs on my jaw help for all of ten minutes (and you can't put ice packs directly on the inner throat muscles where the pain is coming from anyway). Whenever one of these comes on (generally about every 4 - 5 days), I feel like I'm completely helpless. 20+ consecutive hours of terrible pain is just so hard to deal with.
I'll be seeing a physical therapist tomorrow who will hopefully help me come up with exercises, etc... to prevent an "attack," and I'll also be seeing a dentist later in the week to see about getting a possible oral splint. I've already tried adjusting my posture, relaxing my jaw and neck, eating soft foods... the dreaded sore throat still seems to strike no matter what.
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I have noticed that I have a hearing loss in one ear along with a lot of pain from my jaw which is dislocated (same side). What can I do?
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I have a problem where my left tmj sits a bit lower and partially dislocates when opening and closes in a c shape. i have been offered laser treatment. i think the disk may be displaced and dehydrated.
i don't know if i should see n osteopath or chiropractor or physiotherapist.
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I have suffered from TMJ in the past but it always cleared up when the bite was adjusted properly. My latest dentist changed my bite with a filling on one side and then ground down the opposite side so it would match. The side he ground down was the "good side" as the other had been ruined and ground down previously because of a root canal. The result are teeth that are much to short and a bite that is all over the place. The facial pain is intense even after I went to another dentist who further adjusted me. It seems as though no one really knows what they are doing...everyone tells me I'm "ok" now and shuffles me off. I honestly feel like a don't have teeth on one side and all the natural ridges have been shaved off ALL the bottom teeth at this point. Frustration does not even cover what I am feeling. Does anyone know how on earth to fix this mess or what type of dentist can best alter the bite for the better. A month ago I was perfect..pain free for over a year and now I feel like a zombie who cannot talk or eat or do anything without extreme facial pain. I'm hoping someone clever can build it up properly or maybe do crowns or onlays ( all very tricky when you have tmj). One dentist offered me the little mouth guard ( the one who messed me up) I felt like yelling fix what you messed up and stop trying to sell me things I didn't need before you touched me. Just wondering if anyone ever suffered from the "too short ground down teeth" dilemma and if anyone was able to fix it. I've been living on pills that have done little to help for over a month.
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A few years back I got TMJ treatment (appliances and then braces). They moved my jaw which helped a little bit with migraines and pain I was dealing with. I had been using the acrylic orthotic night guard and retainer for a couple years at night when all of a sudden I started getting burning lips and then they would peel. I have to wear heavy lipbalm constantly in order not to get a rash.
After a year of trying to figure out what was causing it, I realized it was the retainer and nightguard. When I took them out for a while the reaction subsided. I'm not sure if it's a allergy or more likely a reaction to saliva or something else.
I ended up getting new retainers (like invisalign) and it stopped for a while but then returned after a month or so. The invisalign doesn't keep my jaw in line so I was waking up with pain for awhile. Now, I'm back to my old ones.
Any ideas for what to do? I don't think I can stop using my orthotic because my jaw will move. I've tried contacting other tmj specialists but they all want to charge me a bunch of $$ for a sales pitch and then more $$ for treatments.
I always clean them very well so I don't think it's any kind of bacterial thing, but who knows.
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Basically, long story short, I have been suffering from bilateral pain within my TMJ for close to two years now.
I had an MRI of my jaw joints recently which only uncovered inflammation ( I have an underlying autoimmune disorder that would have caused this inflammation to accumulate to begin with). The problem is, all my specialists agree that I'm having far too much pain for it to be only the inflammation as the culprit.
My doctor thinks that the inflammation is compressing against my Trigeminal nerve, thus the excruciating constant pain ( I'm taking strong painkillers and Lyrica just to attempt to control the pain)
Has anyone heard of this? Or had a similar experience?
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I am 35 years old, from Italy. Since February I am dealing with a strange sore throat. It is not easy to exactly locate its origin, I would say somewhere at the base of the tongue on the right side spreading to the jaw, the occipital area (base of the skull), the sinus and the eye. Sometimes it results in a weird and very annoying kind of headache.
I am wondering if it is tmj relates because I have a crossbite in the same side of the pain and I remember that previously it sometimes happened to wake up with a similar sore throat when during the nigh my jaw was pulled backward on the right. Maybe the disc is irritating some nerve?
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I just wanted to share with everyone that I have tried Magnesium Citrate and Vitamin D for my TMJ pain and if anything, they actually made it worse. My wife recommended that instead of Advil (which does take the edge off a little) to try Aleve. I took (2) 220 mg pills right after dinner on a full stomach and noticed a big difference about 1-2 hours later. It kept me out of pain almost completely all night and I didn't even need to take more yet, knock on wood. I also noticed that a medical journal online posted that Naproxen had proven to be more effective than Ibuprofen or Tylenol for TMJ pain. Anyone else find this to be true for them too?
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I had an accident at work October 2004 (head injury), I complained of hissing in my ears and my hearing was hypersensitive, I had a hearing test at NHS audiology, I was issued with noise generators. I also complained of jaw ache pain, so I visited my Dentist, he had taken an x-ray that shown no problems with teeth. May 2005 after many minor accidents I was referred for neurological examinations and MRI scans. I was diagnosed with Post Concussion Syndrome. Tinnitus and Hyperacusis, I have complained from day one, that my Tinnitus gets louder when I turn my head, it sounds as though it’s from my ears! But I have realised that when I have been talking in a crowded room for a long time this is more prominent. I can live with Tinnitus and Hyperacusis that seems to be in my head due to Neuro rehab CBT, and Tinnitus therapy, could it be I am temporally damaging my jaw cartilage or muscles through raising my voice, I feel discomfort and fullness of ears, the Tinnitus and Hyperacusis that then radiates from my ears lasts for hours or a couple days, but aggravates the Tinnitus and Hyperacusis that seems to be in my head, this is when I am accident prone. I am 58 and my occupation is lorry driver. I feel that when I explain this to the medical profession that they do not listen. My dentist suggested trigeminal nerve, cartilage, TMJD, I have lived with this condition for 4 and half years but would prefer a better quality of life. I would be very grateful for any information.
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I have been dealing with TMD for a number of years. I have been diagnosed with tmj degeneration. It is pretty severe, but it has been under control for a while now and I have been pain free. But on Sunday I woke up with pain in my joint that I have never experienced. Then yesterday I noticed I had a cold sore, and then this morning I found a lump right next to my jaw (lymph node). I am assuming the lymph node and cold sore are related. But I wonder if this swelling could be throwing my TMJ off and causing the pain. I plan to contact my doctor about it...or dentist. Not sure which one.
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Is there a difference between disc displacement and dislocation? I see those terms being used around here a lot and was wondering if one indicates whether a disc could be recaptured and whether a disc is not reducing?
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I have had a toe joint replaced - all is not good. Has anyone had this done that I could speak with?
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