TMJ Surgery Explained: Arthrocentesis, Fat Grafts & Custom Joint Replacements | Dr. Brian Shah
June 30, 2022
Why do some orthognathic surgery patients relapse years later? Oral and maxillofacial surgeon Dr. Brian Shah of the Piper Clinic found the answer in the TMJ. He walks through every TMJ surgery option, from arthrocentesis to custom total joint replacement, and what general dentists should look for on a CT scan. In this episode: - The relapse patients that led him from Chicago to the Piper Clinic - Is a bad bite the cause of TMJ problems, or the result? - Reading a CT scan: condyle size, shape and joint space - Arthrocentesis, arthroscopy, disc removal with fat grafts, and total joint replacement - How custom TMJ replacements are designed - Why finding the superior joint space is harder than it looks - Disc repair in children, and whether it can restore growth - Why "conservative" vs "radical" is the wrong way to think about surgery Plus 2022 dental news: an ADA honorary membership for North Carolina's Prissy Allen, falling enrollment in hygiene and assisting programs, and a JADA study on opioid prescribing after dental surgery. Dr. Brian Shah is an oral and maxillofacial surgeon and physician who leads surgery at the Piper Clinic in St. Petersburg, Florida. He earned his dental degree at The Ohio State University and his MD and oral surgery training at Harvard, is board certified by the American Board of Oral and Maxillofacial Surgery, and has practiced at Yale and in private practice in Chicago. 🙌 Special shout out to Q-Optics for making this episode possible! Chapters: 0:00 Intro 2:06 News 2:14 News: an ADA honor for North Carolina's Prissy Allen 3:22 News: fewer hygiene and assisting students 5:38 News: opioid prescribing after dental surgery 7:31 The hygiene school bottleneck 10:25 Introducing Dr. Brian Shah 15:14 From Chicago to the Piper Clinic 16:25 The relapse patients that started it 18:31 Treating symptoms vs finding the cause 20:14 A case: missing premolars and one-sided pain 22:26 Start with a CT scan: size, shape and space 24:26 Measuring ramus and condyle height 25:04 Ask how the bite got this way 26:06 Is occlusion the cause or the result? 27:45 TMJ surgery options today 29:09 Arthrocentesis 30:38 Arthroscopy 31:43 Disc removal and fat grafts 32:14 Total joint replacement 33:09 How custom TMJ replacements are made 35:19 Why arthrocentesis is harder than it looks 38:49 Being honest about TMJ surgery's track record 40:00 Disc repair in children 41:25 "Conservative" vs "radical" treatment 42:04 Can disc repair restore growth? 44:36 Viewer question: balloon arthroplasty for the TMJ? 47:07 TMJ, jaw surgery and the airway 49:30 Referring patients to the Piper Clinic 51:22 Closing 🎧 Listen to the podcast: Apple Podcasts: https://podcasts.apple.com/us/podcast/dentists-in-the-know/id1543254763 Spotify: https://open.spotify.com/show/2Elfj6LX0hCUyp0AgdTsij 📺 Make sure you subscribe to catch new episodes live every Wednesday at 8pm ET! https://www.youtube.com/@dentistsintheknow 🌟 Stay up to date on all the latest dental trends when you follow the DINKs: https://fanflet.com/dinks/social-2
