This document discusses TMJ disc derangements, including indications for surgery, goals of surgery, and how to assess outcomes. The key indications for surgery are moderate to severe pain and dysfunction, including restricted or excessive jaw motion. Goals of surgery include reducing pain, improving jaw function and range of motion. Outcome assessment focuses on reduced pain levels, improved jaw function, stable occlusion, limited disability, and patient understanding and acceptance of the procedure and its outcomes.

1. TMJ DISC DERANGEMENTS
INDICATIONS,GOALS AND OUTCOME
ASSESSMENT
JAMEEL KIFAYATULLAH

2. INDICATIONS
1) Moderate to severe pain
a) Localised TMJ pain
b) Preauricular pain
c) referred pain(e.g otalgia)
2) Dysfunction that is disabling and characterized by any of
the following:
a) restricted range of motion
b) excessive range of motion
c) joint noises
d) Abnormal masticatory function
3) Imaging evidence of disc derangement
4) Arthroscopic evidence of disc derangement

3. Goals for surgery of TMJ disc
displacement
1) Relief or reduction of TMJ pain
2) Limited period of disablility
3) Improved range of jaw motion and /or function
4) Elimination or reduction of noise in the joint
5) Appropriate understanding by patient of
treatment options and acceptance of treatment
plan
6) Appropriate understanding and acceptance by
the patient of favorable outcomes and known
risk and complications

4. OUTCOME ASSESSMENT
1) a level of pain that is of little or no concern to the
patient, preferably measure objectively(e.g visual
analog scale)
2) improved mandibular function that is compatible with
mastication,deglutition,speech and oral hygiene.
3) a stable occlusion
4) acceptable clinical appearance(e.g absence of motor
deficits,absence of hypertrophic scar formation etc)
5)limited period of disability
6) Patient acceptance of procedure and understanding of
outcomes