Temporomandibular joint surgery for internal derangement.

Surgery of the temporomandibular joint (TMJ) plays a small, but important, role in the management of patients who have temporomandibular disorders (TMDs). There is a spectrum of surgical procedures for the treatment of TMD that ranges from simple arthrocentesis and lavage to more complex open joint surgical procedures. It is important to recognize that surgical treatment rarely is performed alone; generally, it is supported by nonsurgical treatment before and after surgery. Each surgical procedure should have strict criteria for which cases are most appropriate. Recognizing that scientifically proven criteria are lacking, this article discusses the suggested criteria for each procedure, ranging from arthrocentesis to complex open joint surgery. The discussion includes indications, brief descriptions of techniques, outcomes, and complications for each procedure.