Complications of temporomandibular joint surgery

Abstract

The complications of temporomandibular joint surgery were reviewed in The Oral and Maxillofacial Surgery Clinics of North America in 1990 [1]. Several reviews of complications and unfavorable outcomes also have been published [2–4] in the last decade. The purpose of this article is to review new contributions to the literature in light of the changing nature of temporomandibular joint surgery. In the late 1970s and early 1980s, in response to the ability to image the internal structures of the joint, there was a trend to address internal derangements, perforations, and other anatomic deviations using open joint surgery. With this trend came the use of alloplastic materials and the subsequent realization of the damage that these materials could produce. Because of the severity of the destructive lesions caused by giant cell foreign body reactions and other postoperative sequelae, there was a move away from open joint procedures to less invasive procedures, such as arthroscopy and arthrocentesis. Open joint surgery remains a necessary part of the armamentarium. A group of patients who have continuing problems as a result of multiple surgical interventions still remains. This article reviews complications of open joint and arthroscopic surgery, with an emphasis on new information that has become available over the last decade and reviews the current knowledge of the multiply operated patient. The available outcome data for all types of temporomandibular joint surgery are discussed. Complications of open temporomandibular joint surgery Complications of open temporomandibular joint surgery previously reviewed [1–4] include fifth and seventh nerve injury, vascular injury, infection, otologic complications, parotid gland injury, cranial fossa perforation, implant failure, malocclusion, degenerative arthritis, adhesions, and ankylosis. These complications are not addressed in this article.