Most patients with temporomandibular disorders (TMD) can be successfully tr
eated by conservative methods, but approximately 10-20 percent have persist
ent symptoms. The aim of this study was to evaluate the signs and symptoms
of TMD in patients treated with open surgery of the TMJ. Seventy-two patien
ts (13 men, 59 women, mean age 37 years, range 14-68 years) were evaluated
during an eight-year period. Altogether 45 right TMJs and 39 left TMJs were
treated, including both TMJs during the same operation in eight of the cas
es. The patients were evaluated at follow-up in 1997. The degree of TMD at
follow-up was assessed using the anamnestic and clinical dysfunction Helkim
o indices. Most of the patients reported at the follow-up that they were su
bjectively satisfied with the surgical treatment. The main clinical finding
s in the post surgical patients at follow-up were TMJ sounds and deviation
of the mandible during opening. The tenderness in the masticatory muscles a
nd TMJs on palpation was reduced significantly and the ranges of mandibular
movement were improved for all the patients. The mean anamnestic and clini
cal indices decreased with a statistical significance from the shortest fol
low-up group (Group I) to the longest on group (Group IV) (p = 0.000). The
conclusion of this study was that after open surgical treatment of the TMJ,
the patients have significantly better functioning of the masticatory syst
em and reduced signs and symptoms of TMD in the long term.