What is Idiopathic Condylar Resorption (ICR)?

  • Plain English: ICR is a type of arthritis that eats away at the jaw joint. As ICR progresses the jawbone breaks down causing the joint to not function properly. Often this loss of bone in the jaw joint causes jaw, neck, ear and sinus pain, an open bite, trouble eating, talking, and even breathing.
  • Technically: “Idiopathic condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain.” Dr. Larry Wolford (article can be found under Resources)

What is TJR?

  • Total Jaw Joint Replacement. The jaw joint is replaced by a metal prosthesis that acts as the new joint- much like a hip or knee replacement. The replacement of the joint is often accompanied by other orthogenetic surgeries to assure proper alignment for optimal success.

When did you have surgery?

  • October 2010

What kind of surgery did you have?

  • Plain English: I had both of my jaw joints replaced – my upper jaw was broken and the bone was shaved down,  a fat graft from my stomach to my new joints, and small bones in my sinus were shaved down to help create a better airway.
  • Technically: I had bilateral TMJ reconstruction and mandibular advancement with TMJ concepts, maxillary osteotomies to advance the maxilla forward and move it upwards anteriorly about 2mm, bilateral TMJ fat grafts harvested from the abdomen, bilateral partial turbinectomies.

Did you have prior surgeries on your TMJ?

  • No, I had no prior surgeries on my TMJ.

 What type of joints do you have?

  • I have joints made by TMJ Concepts. These are custom made joints.
  • More information on joint types can be found under resources.

 Who did your surgery?

Would you do it again?

  • Absolutely. The way I felt before surgery compared to how I feel now is amazing. I practically have full function of my jaw back which has truly given me my life back.

Did you have a metal allergy test before hand?

  • No, but I have spoken with a number of people that have.

Were you wired shut?

  • No, I was banded shut. Those that I have spoken with that were wired shut it was typically due to an emergency situation that resulted in surgery. Thus they didn’t have the time to get braces.
  • The bands are very similar to rubber bands you might have experienced with braces. Except they are really strong and linked top to bottom in more areas.

How bad was your pain when you woke up?

  • I was mostly uncomfortable rather than in pain. From what I can remember, everything was pretty numb. I had a pain pump I could press every few minuets if needed. Baylor Hospital was great and they kept me as comfortable as possible. The most painful part was my stomach where they took the fat graft. There were sporadic pains over the first year as things woke up, but eventually that all went away.

 Did you throw up while banded shut?

  •  No, I largely contribute that to the diet I maintained before surgery. I had two non-jaw related surgeries years before my TJR. With those surgeries, I woke up and threw up for hours. In an effort to avoid this, for one month before and after surgery I went on a no dairy, no caffeine, no refined sugar, and low sodium diet (also no nicotine, but I don’t smoke so that was easy for me).
  • I had no issues with throwing up and minimal swelling. It was super hard to stick to the diet, especially with the liquid component, but I would absolutely do it again. **Check with your surgeon and see what they recommend if this is a concern for you **

What is your pain/numbness like now?

  • I have some minor muscle pain on my left side. It is uncomfortable to sleep on my side so I’ve ordered a TMJ Pillow and it helps. My right side is phenomenal and absolutely pain free.
    • Cold weather causes my facial muscles to spasm so I always have a scarf or hat to help cover my face when it is cold.
    • My left ear often clogs now and it drives me crazy… in the annoying sense not the painful sense. I have found if I avoid dairy and caffeine then my ear is not as much of an issue. Recently I’ve tried a daily nose spray recommended by my doctor and it is helping.
    • I am only partially numb on a tiny bit of my lower right chin.

Do you have any scars?

  • Not on my face, ears, or neck. My belly button does have a small scar from where they took the fat graft. The only person that has made mention of it was a doctor during an physical exam. Basically you’d be really hard pressed to find any scaring.
    • I used Cica-Care silicone gel over my incisions to prevent scaring. Honestly I don’t know if it was needed because Dr. Wolford’s incisions were so fine. **Check with your Doctor before using Cica-Care. Always run everything past your doctor**

What is your diet like now?

  • For the most part, I can eat like any normal person. There are things I avoid – no gum, nuts, caramel or taffy. I have some trouble tearing chewy breads and crusts. I always appreciate softer and easier to chew foods, but if I want a steak or apple or sandwich I can eat it. I do make concessions and wouldn’t eat several meals in a row that are hard to chew because then I would have some discomfort.

Do you miss moving your mouth side to side/ back and forth?

  • I can’t say that I do. I don’t even notice it. Having that minor loss is greatly out measured by the massive gain of getting to chew, talk, look, and breathe normally.

 How long will your joints last?

  • My joints failing was a huge fear of mine when I first had surgery, but now new research has come out that supports that my joints are expected to last upwards of 20 years. I am hoping to break some records and for them to last until I am a little old lady. There is always an exception to the rule – why not me?

Now that my surgery is close, I am having second thoughts. What should I do?

  • First speak with your doctor as to why you are having doubts.
  • While I cannot tell you what to do, I can tell you that many of the patients I speak with are people that have been living with pain and a severely diminished quality of life for years. However, as soon as their surgery date gets near they being to talk themselves out of surgery.
  • For me, and many of the patients I talk to, this turns out to be nerves:
    • I had days before my surgery where I thought the pain wasn’t too bad and I wanted to talk myself out of surgery. Looking back, I now realize it was just my nerves speaking. I was still in a ton of pain and not living a normal life.
    • My baseline of what I thought was normal had changed because I was so used to constantly being in pain and compromising my life to avoid pain.
    • My quality of life had degraded to where my ‘good’ days were based on a comparison to how bad I knew I could feel rather than based off of how good I felt prior to my jaw issues.
  • However only you know how good or bad you are feeling so talk with your doctor!