A Contemporary Approach to Internal Derangement of the Temporomandibular Joint
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The management of temporomandibular joint pain and limited function may involve non-surgical treatment, arthrocentesis, arthroscopy, arthroplasty and total joint replacement. There is no consensus on an appropriate algorithm to follow to ensure good patient outcomes while also reducing the number of surgical procedures needed. Despite the lack of a consensus, there is sufficient evidence to provide relatively robust recommendations that can assist clinicians in developing patient-centric algorithms that can greatly improve the diagnosis and treatment of patients with internal derangement and associated pain and limited function.
Learning Objectives
At the conclusion of this program, participants should be able to:
- Analyze the many sources of orofacial and temporomandibular joint pain and develop history-taking and physical examination techniques to identify those patients likely to benefit from temporomandibular joint surgery.
- Explain the logic of following an evidence-based surgical algorithm that will facilitate appropriate surgical intervention and predictable patient-reported outcomes.
- Analyze how not all patients will benefit from surgical intervention and identifying them is critical.
- Discuss the nature and variety of complications that can follow surgery of the temporomandibular joint.
- Explain the importance of axis II diagnoses that must be recognized and addressed as part of the comprehensive management of patients with temporomandibular joint pain and limited function.
Gary F. Bouloux, DDS, MD, MDSc
Professor in Oral and Maxillofacial Surgery, Chief of Oral and Maxillofacial Surgery Department
Emory University School of Medicine
Atlanta, Georgia
Disclosure: Nothing to disclose.
An Internet-based CDE/CME Activity
Original Release Date: September 17, 2022
Expiration Date: September 17, 2025
Estimated time to complete this educational activity: 1.0 hours
Method of participation: Self-Study
Gary F. Bouloux, DDS, MD, MDSc
Professor in Oral and Maxillofacial Surgery, Chief of Oral and Maxillofacial Surgery Department
Emory University
Gary F Bouloux DDS, MD, MDSc, FRACDS, FRACDS(OMS), FACSJ David Allen Family ProfessorInterim Division Chief of Oral and Maxillofacial SurgeryDepartment of SurgeryEmory University School of Medicine• Dental School, Sydney University, 1989• Graduate Program Residency, Westmead hospital, 1990-1992• Oral and Maxillofacial Surgery Residency, Westmead Hospital, 1993-1996• Masters In Dental Science (OMFS), Sydney University, 1996• FRACDS (OMS), 1997• Fellowship TMJ surgery and orthognathic surgery, Emory University, 1997-1999• Medical School, Emory University, 2004• Faculty, Oral and Maxillofacial Surgery, Emory University, 2006-current• Residency Program Director, OMFS, Emory University 2013- 2020Committees/Scholarly activity• American Association of oral and Maxillofacial SurgeonsChair, Special Committee of Temporomandibular Joint Care, 2019-current• American Society of Temporomandibular Joint SurgeonsPresident 2020- 2022• American Board of Oral and Maxillofacial Surgery, Examiner and Content Expert, 2016-current• Journal of Oral and Maxillofacial Surgery and Oral Surgery, Oral Medicine Oral Pathology reviewer 2008-currentAwards• American Association of Oral and Maxillofacial SurgeonsThe National Research Award Oral and Maxillofacial Surgery Foundation, 2017• American Association of Oral and Maxillofacial SurgeonsThe Daniel A Laskin award (most robust scientific paper published in JOMS 2018), Oral and Maxillofacial Surgery Foundation, 2018Publications• 22 peer reviewed articles• 22 book chapters• 2 book EditorshipsCurrent Grants• CI: National Institute of Dental and Craniofacial Research R00Central mediated pain in patients undergoing temporomandibular joint arthroscopy; Grant $765000• PI: Oral and Maxillofacial Surgery Foundation. Metal hypersensitivity following Temporomandibular Joint Total Joint Replacement; $75000
Disclosures: No relevant financial relationships were disclosed.
Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.0 continuing education credit(s).
AGD - Accepted Program Provider
FAGD/MAGD Credit
11/1/22-12/31/26
Provider ID# 214680
The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Association of Oral and Maxillofacial Surgeons designates this internet-based enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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