## 3 Results  
In total, eight patients (five male and three female patients) were included through our inclusion criteria for TMJ TJR. Patients' demographic features are summarized in Table 1. The mean age of the patients was 58.8 years (range 44-80 years). Six patients (patient 1,3,4,5,7,8; 75%) had poor outcome from previous operations. Another two patients (patient 2,6; 25%) did not received surgical therapy before, but patient's subjective discomfort and present illness (pain due to degenerative osteoarthritis and malocclusion due to trauma, respectively) fulfilled indication for surgery. Trauma was the major etiology, occurring 6 of 8 patients (75%). Four patients had a malunited fracture of the mandibular condyle, and two patients had severe osteoarthritis and an open bite caused by condylar resorptions. One patient had total fibrous and bony ankylosis of the TMJ, and one patient had a fractured R-plate that was replaced after condylar mass removal. Relatively young patients (below 50 years; patient 4,7) were included in our study who appealed persisting discomfort even after previous conservative and surgical treatment. And there were patients who showed relatively low level of pain before surgery (below score of 5; patient 5,6,7,8), but they suffered from serious malocclusion complaining chewing discomfort. \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Patient** & **Age** & **Gender** & **Operation Site** & **Diagnosis** &
\begin{tabular}{c} **Previous Treatment** \\ **\& Present Illness** \\ \end{tabular} \\ \hline
1 & 68 & M & Rt. & \
\begin{tabular}{c} (1) Malunion of Rt. condyle \\ (2) TMJ ankylosis \& osteoarthritis \\ \end{tabular} &
\begin{tabular}{c} ORIF \& mouth opening \\ limitation \\ \end{tabular} \\
2 & 80 & M & Rt. & \
\begin{tabular}{c} Degenerative osteoarthritis \\ severe anatomical changes of Rt. condyle \\ \end{tabular} &
\begin{tabular}{c} Severe erosion \& bony \\ ankylosis of condyle \\ \end{tabular} \\
3 & 62 & M & Lt. & \
\begin{tabular}{c} Committed fracture of Lt. condyle \\ \end{tabular} &
\begin{tabular}{c} Closed reduction \\ Arthroplasty \& Chronic pain \\ Mass removal \& reconstruction \\ with rib bone and cartilage \\ Open bite \& mouth opening \\ limitation \\ ORIF \& mouth opening \\ limitation \\ ORIF \& mouth opening \\ limitation \\ ORIF \& mouth opening \\ limitation \\ \end{tabular} \\
8 & 63 & F & Lt. & \
\begin{tabular}{c} Osteoma with degenerative change of \\ Lt. condyle \\ \end{tabular} &
\begin{tabular}{c} Biopsy (Osteoma) \& \\ malocclusion \\ \end{tabular} \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Patient characteristics and diagnosis. Figure 2: Representative post-operative radiographs at the first day after surgery. Table 2 illustrates clinical outcomes and indicates the MMO before surgery and at six months and three years after surgery. The pain score is dictated on an analogue scale with 0 noted as 'no pain' and 10 as 'extremely painful', along with the score at each visit. Results show an increase in mandibular mouth opening from the pre-operative average of 37.5 mm (range 19-49 mm) to the post-operative (at three years) average of 44.1 mm (range 34-57 mm). The average pain visual analogue pain score (VAS score) was 3.5 (range 0-8) pre-operatively, which decreased to an average VAS value of 0 post-operatively. The consistent tendencies of average MMO change and VAS score change are shown in Figure 3. The average MMO was 37.5 mm pre-operatively, and the last average MMO was 44.1 mm post-operatively. The average lateral excursion movement of the mandible was 1.3 mm to operated side and 7 mm to the natural joint side. The alterations of pain VAS scores during various follow-up visits were consistently decreased to 0 from 3.5. Between one month and three months after surgery, the range of mouth opening was increased. The greatest decrease in pain score was observed within one week after surgery. No significant complications were observed by radiographic images and clinical exams in any operated joints within the follow-up periods.