Quando e qual cirurgia indicar para os transtornos da articulação temporomandibular?

Abstract

Dysfunctions that affect the temporomandibular joints (TMJs) are among the main orofacial disorders. Treatment options for these dysfunctions should be primarily conservative and when these are not effective or sufficient, more invasive therapies, such as surgeries, should be used. This paper aims to review the literature on TMJ surgical treatment, focusing on information on when and which modality to indicate. A literature review was performed in the Lilacs, Pubmed/Medline, Scielo and ScienceDirect databases, including literature review articles, systematic review, meta-analysis, randomized clinical trials, in addition to books relevant to the subject, published in 1992 to 2021. Among the surgical modalities indicated for TMJ is arthrocentesis, a minimally invasive technique aimed at joint lavage, indicated for anterior disc displacement with and without reduction, disc adhesions, inflammatory and degenerative TMJ diseases. Arthroscopy has the same indications as Arthrocentesis, which is a slightly more invasive washing process, allowing the professional to look directly at the joint with better visualization. Among the open surgery techniques, we can cite Disc Anchorage, Discectomy, Disc Repositioning, Tuberculotomy and Condylectomy. Each case needs to be evaluated individually, considering its particularities and respecting the growing scale of invasiveness