Temporomandibular Joint (TMJ) Surgery | University Clinic Rechts der Isar Munich

At the Clinic for Oral and Maxillofacial Surgery of the TUM University Hospital Rechts der Isar, open surgery of the temporomandibular joint (TMJ) represents the final, decisive frontier in restorative jaw medicine. While our first priority is always conservative management, ranging from specialized bite splints to minimally invasive needle-lavage (arthrocentesis), we reserve open surgical intervention for the approximately 5% of patients facing severe mechanical degradation, trauma, or complex growth disorders. In the heart of Munich, our surgeons utilize refined pre-auricular or retro-auricular access points that leave virtually imperceptible scars, allowing direct structural access to rebuild the joint's intricate anatomy. The scope of open TMJ surgery at Rechts der Isar is entirely patient-specific, adapting to the level of degeneration or injury present. In cases of chronic painful friction or early arthrosis, we may perform condylar shaving, a delicate contouring of the joint head to smooth irregular bone surfaces and promote functional adaptation. For more severe conditions, such as tumors or complete joint fusion (ankylosis), a condylectomy may be necessary to remove the damaged joint head and recreate the joint space. To prevent the joint from fusing back together, our surgeons often interpose autologous tissue, such as muscle fascia from the temple or cartilage transplants, ensuring long-term mobility. A primary focus of our clinical excellence is the management of the articular disc (discus articularis), the essential "shock absorber" of the jaw. If the disc is displaced but intact, we perform advanced disc reconstruction to stabilize and return the cartilage to its physiological position. However, if the disc is irreparably damaged or perforated, disc replacement becomes vital. We use either the patient's own tissue, such as a graft from the temporal muscle, or biocompatible synthetic materials to restore a smooth, gliding surface. For patients with chronic jaw dislocations in which the joint head repeatedly slips out of its socket, we perform an eminectomy, carefully removing the anterior articular eminence to facilitate a smoother return of the joint head to its resting position. In the wake of acute trauma, the Rechts der Isar team is renowned for specialized TMJ fracture repair. Utilizing the retro-auricular approach, we provide anatomically precise repositioning of fractured segments, securing them with microscrews and plates to allow immediate post-operative movement—a significant advancement over the traditional weeks of "jaw-wiring. " When the joint has reached a point of total destruction where biological repair is no longer feasible, we offer the ultimate solution: the total temporomandibular joint prosthesis. These artificial joints are individually engineered from the patient’s CT data, creating a 3D-printed, custom-fit replacement that restores the ability to eat and speak without pain. The success of these complex procedures at our Munich university clinic is underpinned by an intensive post-operative physical therapy regimen and a close interdisciplinary collaboration. By merging high-resolution imaging with the latest microsurgical techniques, we ensure that every patient receives a tailored intervention, whether it's a subtle bone contouring or a total joint replacement.