Surgical Management: Clearing the Path

The hierarchies of management objectives for recurrent TMJ dislocation are to cause no harm, restore function and restore anatomy. More conservative options should be considered prior to surgical intervention such as dextrose prolotherapy, autologous blood injection or botulinum injections described elsewhere in this text. Both stability and range of movement of the TMJ are dictated by: The occlusion (or lack of it) Shape of the glenoid fossa including the slope and size of the articular eminence The TMJ capsule—a thickening of the deep fascia, being strongest laterally The TMJ ligaments—sphenomandibular and stylomandibular