Temporomandibular Joint (TMJ) Pathology Unit

Clinical approach to mandibular function

The Temporomandibular Joint (TMJ) Pathology Unit at the Publio Cordón Memorial Hospital is a highly specialised department dedicated to the diagnosis and treatment of functional and structural disorders of the temporomandibular joint and associated orofacial pain. Under the direction of Dr Álvaro Sada, the Unit addresses clinical presentations of varying complexity, ranging from early-stage dysfunctions to advanced joint pathologies, using a structured clinical approach and sound therapeutic judgement.

Care is delivered within an organised care model, where each case is analysed on an individual basis, prioritising diagnostic consistency and evidence-based treatment decisions.

Specialist care for temporomandibular joint dysfunction and complex orofacial pain

This unit is aimed at patients presenting with persistent jaw pain, limited mouth opening, joint locking, recurrent joint noises, associated headaches or symptoms resulting from bruxism and jaw overload.

A specialist assessment is particularly recommended when symptoms interfere with eating, speaking or sleeping, when symptoms have persisted for a long time, or when conventional treatments have not led to sustained improvement.

Comprehensive management of the main TMJ disorders

The unit routinely deals with a defined set of joint and muscle disorders that require expert assessment. Each case is analysed taking into account the patient’s medical history, examination findings and the functional impact of the condition.

Among the most common clinical conditions are:

• Internal TMJ disorders (disc displacement with or without reduction).

• Inflammatory joint conditions.

• Degenerative temporomandibular disorders.

• Recurrent joint blockages.

• Myofascial pain associated with bruxism or functional overload.

These conditions may present with variable progression and varying degrees of functional impairment; they therefore require a structured assessment to determine the most appropriate treatment strategy in each case.

Specialist clinic for temporomandibular joint dysfunction

The assessment begins with a specialist consultation in oral and maxillofacial surgery, during which a comprehensive functional examination of the temporomandibular joint and associated muscles is carried out.

Where indicated, this is supplemented by high-resolution imaging tests, such as magnetic resonance imaging (MRI) or specific TMJ studies, which enable the assessment of joint structures, disc position and the extent of inflammatory or degenerative changes.

The analysis takes into account both structural and functional factors, as well as any potential occlusal abnormalities or instances of overuse. In selected cases, the approach is coordinated with other specialities, ensuring a comprehensive assessment before a treatment plan is established.

Advanced treatments with individualised indications

The unit’s therapeutic model is based on a stepwise and proportionate approach. Conservative measures are prioritised where there is a reasonable prospect of clinical control, with invasive procedures reserved for clearly indicated situations.

Notable interventions carried out by the unit include:

• TMJ arthrocentesis for the treatment of lockjaw or persistent inflammatory processes.

• Temporomandibular arthroscopy, which enables intra-articular diagnosis and treatment with minimal tissue trauma.

• Intra-articular injections and regenerative medicine techniques aimed at promoting tissue recovery in selected cases.

Open surgery is considered only when structural pathology requires it and following a thorough analysis of risks, benefits and alternatives.

Expert team and coordinated care model

The unit comprises oral and maxillofacial surgeons who specialise in temporomandibular disorders and have experience in managing complex cases. Their practice is based on prudent decision-making, individualised planning and precise technical execution.

The care model at the Publio Cordón Memorial Hospital is characterised by a well-organised structure, multidisciplinary coordination where necessary, and a detailed information process. Sufficient time is taken to explain the diagnosis, treatment options and expected outcome, facilitating decision-making based on understanding and clinical judgement.

The combination of specialisation, advanced diagnostic technology and structured support throughout all stages of the process enables the provision of care aimed at restoring jaw function and managing pain on a sound medical basis.