Maxillofacial clinic

My appt for the maxillofacial clinic came through for Monday. Never have I been so excited to receive news of a hospital appointment and impending surgery! I'm hoping that they can fit in me in ASAP for surgery and that they can be flexible with dates because work is manic and I'm going on holiday in May. That said, I just want it sorted now, so I'll have to juggle some things around.

Has anyone had a jaw arthrocentesis and steroid injection? Did it help because the surgeon didn't seem very hopeful? Jaw replacement is the ultimate goal but we are trying to bide our time and manage my symptoms in a conservative way.

Thanks in advance.

10 Replies

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  • I have problems with my jaw, I have arthritis and sometimes I have to be sedated as I am unable to open my jaw fully for dental work. Sometimes an injection is given for relief. Many years ago was seen in clinic where they decided if I required Surgical work on the jaw. They sedated and worked on my jaw and teeth, they then gave a splint for the lower jaw and then a partial metal denture for the strong over bite that extraction of teeth had caused and was putting stress on the jaw.

    The actual replacement of the full jaw I have not heard about, possibly a metal jaw joint could be put in although again I am not sure if they would do a complete jaw replacement. Remember I am no dentist or Dental Surgeon

    for my own knowledge I would be interested to know if that had been done. or they had managed that procedure on you

    Good Luck

    BOB

  • Thank you for the reply, Bob.

    Fortunately, I don't need dental work, so it's not an issue but they did think I might need root canal treatment and said I'd need to be sedated/put under general because of my limited mouth movement. Thankfully though, the issue resolves itself.

    I'm not sure about what a joint replacement might entail and I hope it won't be in the next few years. I have a list of questions to ask on Monday.

  • Hello

    Crash Doll

    Most of my treatment in the early days was the fixing of fillings, root canal work all to correct the bite. From the beginning of treatment for this they had to sedate me, and are still doing it, eventually they stablized the the jaw and sadly now most of my teeth have gone.

    as all my problems started in the seventies, now I am sixty five and they are unable to work on me without the sedation.

    Good Luck

    BOB

  • Hi Crashdoll. I live in the States. I have RA AND LUPUS ( RHUPUS). I had arthrocentesis once on both TMJ JOINTS , numerous injections into the joints also. No picnic. Ultimately a year later ( this was 1995) I was 32, had custom total joint replacements to both sides. Custom works so much better as they are made specifically to fit UR bone contour i dont know if the UK does custom joints. Anyway it's 20 yrs later and from that aspect I'm doing great. Joint replacement is an extremely difficult surgery ESP in the TMJ joints as they are the only 2 joints in the body connected and they never stop moving. But never the less I'm glad I did it as U know TMJ pain is awful. Glad you have a Maxillofacial surgeon. Hope he is very skilled. Mine actually is listed in top 10 Maxillofacial surgeons in US FOR 17 Years now. In fact , my joints are his creation and bear his name. They are made specifically for each individual off MRI And CT scans then a company in Colorado, I live in Florida, make them to fit each individual's bone structure. Unique process than a stock joint. I wish u the best of luck. Any questions , I'd be glad to answer.

  • Thank you, Jamie. I think a recall a post from you about this before. I don't know how likely it is that I will have a replacement in the near future. I have lots to ask at my appt on Monday.

  • I will be watching to see how this all turns out for you. I pray it will. P.S. I was so thrilled with my results I went to work for my Maxillofacial surgeon as his registered nurse.

  • Very interesting

    Now wonder in the seventies if they would have changed my treatments as my condition has lasted for so long. I can understand the main joints, can they do a complete jaw after an accident yet,?? the reason I ask my father was the Chief Orthodontist for our County in the UK. Dead now for ten years

    BOB

  • Hi Bob

    Yes, Here in the states we do complete jaw replacements, gunshot wounds that blow half the face off, congenital deformities or even with necrosis of the jaw bones themselves. All are made from Titanium as are the Total joints for TMJ REPLACEMENTS. I had total necrosis of both my condyles so my TMJ replacements were not a question. Had to be done. It's a very interesting process how they actually make a model of UR head ( interior) from the MRI AND CT SO they can make custom joints to fit UR bone contine. The model and the joint go back and forth between company making the custom joint and the Maxillofacial surgeon with " putty" on the prosthesis and the surgeon marks and does modifications until he's happy with it and then it's sent to be cast in titanium. It wasn't a picnic by any means and the patient if lucky can have about a 30 mm opening. Here in the states you go to a TMJ physical therapist who works with you until your maximal opening is obtained. I wasn't as lucky because with the total bone death I was more of a challenge so on good days I get 28 mm and some days when I cheat and eat something I shouldn't it goes to 24 mm. It's been 20 yrs, and I still do my mouth stretches ( physical therapy) daily I was very blessed to have the surgeon I did and the custom joints had replaced the stock joints. Plus being a RN myself , I understood I was going to do what I was told because I wasn't going to have them redone! Didn't mean to give U a full tutorial! But thanks. I'm glad I could answer your question

  • I'm booked for another MRI scan and waiting for a date for the bilateral arthroscopy. He did feel that a complete replacement was probably my best option. :( I didn't ask much as I felt a bit frazzled. We both acknowledged the concern that the replacements don't last forever and I'm only 26, so would need quite a few revisions over the course of my lifetime. The unknown is frightening. I am trying to take it one step at a time and pray that the arthroscopy gives me relief.

  • Hi Crashdoll, me again, yes the unknown is whether they will last a lifetime and or how many revisions or scar tissue removal u may need over time. I was 30 when I had finally done all protocol, splints etc, b4 the bones ( consoles) and the joint themselves " died" or necrosis. I'm a RN so I try to be conscious of the terms I use as most ppl do not know what necrosis means. So I'm not trying to offend, just help with these medical terms. I do not know if your Rheumatologist has explored with you that auto immune diseases attack small joints first , such as out TMJ joints. They are the only 2 joints in the body connected and the only 2 in constant motion , so the wear and tear as you have found is or can be quite a problem

    But back to your original concern over the longitivity of the joints was DEFINITELY unknown in 1995 when I received my first custom fitted ( not a stock one size fits all joint) joint then in 2001 my left side was done, it's now 2015 and tho I must follow protocol , I only see my maxillofacial surgeon once a year for a Panoramic CT Scan. Never have had scar tissue develop and wrap around the new console binding it down or any other reason to go back into that joint. Ppl who are " scar tissue" producers know it if any type body surgery has been done as the scar " keloids" and makes for a bumpy ugly scar. I had 2 c-sections prior to my TMJ REPLACEMENTS and definitely knew I wasn't a keloid maker. BTW the incisions for your TMJ JOINT replacements are a puncture wound at ur Templ and the large scar follows the natural contour from ur ear along the natural crease of ur neck. Mine healed so well u can not see anything was done. So in my experience it's been 20 years and I've never had to go back to the OR or back to my surgeon except for the protocol I must follow. No injections , sometimes I do have to take a anti inflammatory at times if I chew certain things, gum is a no - no but my issue is licorice ! lol. I wish u luck and keep me posted on what is happening with u

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