[Current surgical approach to masticatory system pain-dysfunction syndrome (except arthroscopy)].

The surgical treatment of SADAM concerns patients with irreversible lesions who continue to complain (disk displacement with pain and limited opening, painful arthrosis) after all the other therapeutic options have been unsuccessful and when no long-lasting improvement can be reasonable expected. Indications for surgery have declined with progress in aetiological treatment, particularly of occlusion, and arthroscopic treatment, but arthrotomy is the only remaining technique feasible in certain cases. SADAM should be a conservative surgery, protecting the disk (repositioning displaced disks, repairing perforated disks) and the articular surfaces (correcting bone irregularities). Anatomic and functional reconstruction of the joint cannot be successful unless the cause of the dysfunction is treated at the same time.