Abstract
The anterior displacement of the articular disc is the most frequent cause of pathological
alterations in the TMJ. Although it is an extremely common pathology, there is no
certainty about the aetiopathogenesis of this disease. The main aim of the present
report is to describe new anatomical findings that could help clarifying the aetiopathogenesis
of this disease and determine a typology of treatment based on the cause of the disease.
All the operative records of patients who underwent arthroscopic osteoplasty of the
medial TMJ wall in our centre from January 2021 to September 2021 were reviewed and
analysed to identify specific anatomical features observed in every procedure. Fifty-two
joints were included for analysis in this study. Twenty-two joints were classified
as Wilkes stages II-III and 30 as Wilkes stages IV-V. The most common complication
observed in our sample was the dysaesthesias found in the temporal and preauricular
regions. Other complications observed were frontal branch paresis (n = 2), intraoperative
bleeding (n = 1), and postoperative malocclusion (n = 1). The compression of the superior
head of pterygoid lateral muscle (SPLM) on the medial bony wall and the consequent
muscle atrophy could be key for the aetiology of the anterior TMJ disc displacement.
Therapeutic actions on the osseous and muscular component in this anatomical area
could improve the outcomes of patients affected by TMJ internal derangement. A meticulous
dissection of the fascia of the superior fascicle of the lateral pterygoid muscle
allows a remodelling of the bone surfaces with minimal complications
Keywords
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References
- Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation.J Appl Oral Sci. 2019; 27: e20180433
- Arthroscopy versus arthrocentesis for treating internal derangements of the temporomandibular joint.Oral Maxillofac Surg Clin North Am. 2018; 30: 325-328
- The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: a theoretical concept.J Oral Maxillofac Surg. 2001; 59: 36-45
- Etiology of the pain-dysfunction syndrome.J Am Dent Assoc. 1969; 79: 147-153
- Impingement syndrome of the shoulder.Dtsch Arztebl Int. 2017; 114: 765-776
- Ankle impingement J Orthop Surg Res. 2016; 11: 97
- Femoroacetabular impingement syndrome.Curr Sports Med Rep. 2020; 19: 360-366
- Factors associated with severity of intra-articular lesions in patients with severe hip displasia.Arthroscopy. 2016; 32: 1581-1589
- New anatomo-radiological findings of the lateral pterygoid muscle.Surg Radiol Anat. 2016; 38: 1033-1043
- Insertions of the lateral pterygoid muscle: an anatomic study of the human temporomandibular joint.J Oral Maxillofac Surg. 1988; 46: 477-482
- Pathologic changes of the lateral pterygoid muscle in patients with derangement of the temporomandibular joint disk: objective measures at MR imaging.AJNR Am J Neuroradiol. 2007; 28: 1537-1539
- A possible etiology of the internal derangement of the temporomandibular joint based on the MRI observations of the lateral pterygoid muscle.Surg Radiol Anat. 2005; 27: 19-24
- The evaluation of lateral pterygoid signal intensity changes related to temporomandibular joint anterior disc displacement.Oral Radiol. 2021; 37: 74-79
- Osteoplasty of medial wall of TMJ. A new vision for treating of disc displacement.J Craniofac Surg. 2022; 33: e322-e326
- Anatomy of the temporomandibular joint.Semin Ultrasound CT MR. 2007; 28: 170-183
- Histological study of the extratympanic portion of the discomallear ligament in adult humans: a functional hypothesis.J Anat. 2012; 220: 86-91
- Temporomandibular joint: relation of the retrodiskal zone to Meckel's cartilage and lateral pterygoid muscle.J Dent Res. 1970; 49: 626-630
- The discomallear ligament and the anterior ligament of malleus: An anatomic study in human adults and fetuses.Surg Radiol Anat. 2004; 26: 39-45
- The medial capsule of the human temporomandibular joint.J Oral Maxillofac Surg. 1997; 55: 363-369
- A radiographic and histology study of the topographic relations in the temporomandibular joint region.J Oral Maxillofac Surg. 1990; 48: 953-961
- Complications of TMJ arthroscopy.J Oral Maxillofac Surg. 1988; 46: 256
- Endoscope-assisted avulsion of the masseter nerve attached to the temporomandibular joint disc for the treatment of hemimasticatory spasm: a report of two cases.World Neurosurg. 2019; 125: 443-448
- Use of coblation in arthroscopic surgery of the temporomandibular joint.J Oral Maxillofac Surg. 2010; 68: 2085-2091
- Arthroscopic eminoplasty for habitual dislocation of the temporomandibular joint: preliminary study.J Craniomaxillofac Surg. 1999; 27: 390-397
- Clinical evaluation of arthroscopic eminoplasty for habitual dislocation of the temporomandibular joint: comparative study with conventional open eminectomy.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95: 390-395
- Arthroscopic eminoplasty of temporomandibular joint: surgical technique.Craniomaxillofac Trauma Reconstr. 2018; 11: 161-164
- Arthroscopic eminoplasty: a new choice of treatment for TMJ internal derangement.Minerva Stomatol. 2017; 66: 141-147
- Modified arthroscopic anterior myotomy for internal derangement of the temporomandibular joint: clinical and radiological results.Int J Oral Maxillofac Surg. 2020; 49: 1311-2138
Article info
Publication history
Published online: November 11, 2022
Accepted:
November 6,
2022
Received in revised form:
October 19,
2022
Received:
August 11,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
