A Clinical Study of Internal Derangement of Temporomandibular Joint Diagnosed with Magnetic Resonance Imaging

Abstract

Internal derangement of thee temporomandibular joint (TMJ) can be defined as an -abnormal relationship of the articular disc to the condylar head and articular eminence. Magnetic resonance imaging (MRI) is an excellent method for the primary diagnostic evaluation of TMJ internal derangement. The purpose of this study was to investigate the clinical, radiological, and surgical findings of TMJ internal derangement with the disc position and configuration based upon MR findings and to help diagnosis and treatment of TMJ internal derangement. In seventy eight patients, who were diagnosed as TMJ internal derangement, TMJ sounds had the majority in clinical symptom and past history. The most common articular disc position and configuration seen by sagittal MRI were anterior disc displacement with reduction in 32.7% and deformed in 76.3%. The disc deformation was closely correlated with the disc position. Among the treatments, conservative treatment and arthrocentesis was 87.2%, and open TMJ surgery was performed in 12.8%. The better prognosis was shown in 83.3% of all the patients. Of all open TMJ surgeries, discoplasty was 80.0%, and discectomy was 20.0%. The disc displacement and deformation were observed in all surgical joints, with the condylar degenerative change in 70.0% and the perforation in 40.0%.