The purpose of this study was to investigate the clinical symptoms and MR findings of the 60patients, 92 joints diagnosed as internal derangement of the temporomandibular joint, to evaluate the relationship between the disc position and
configuration,
and to compare the disc position and configuration with the TMJ pain.
@ES The results obtained were as follows.
@EN 1. The most common disc position of the TMJ internal derangement was anterior disc displacement without reduction, and the disc deformation was 75.0% in about three times as many as the normal configuration.
2. In the disc configuration of anterior disc displacement with reduction, the ratio between normal and deformed was 1:1 in the closed mouth position, and was 2:1 in the open mouth position. The normal disc was more common than the deformed
disc.
3. In the disc configuration of anterior disc displacement without reduction, the ratio between normal and deformed was 1:3.6 in the closed mouth position, and was 1:22 in the open mouth position. The deformed disc was more common than the
normal
disc,
and was increased about 6 times in the open mouth position than in the closed mouth position.
4. In the disc configuration of anterior disc displacement without reduction and osteoarthrosis, the configuration of all disc was deformed in the closed and open mouth position. The disc deformation was closely related with the degenerative
bony
change.
5. In the TMJ internal derangement, the anterior disc position preceded the disc deformation. The more the disease progress became worse, the more the disc was deformed. The disc deformation was more severe in the open mouth position than in the
closed
mouth position.
6. Of the joints of anterior disc displacement with reduction, 23.3% had no TMJ pain. Of the joints of anterior disc displacement without reduction, 23.9% had no TMJ pain. Of the joints diagnosed as TMJ internal derangement, the joint with no
TMJ
pain
was 22.9%. In anterior disc displacement without reduction and osteoarthrosis, the most joints had TMJ pain.
7. In the TMJ internal derangement, the results which had compared the disc position and configuration with TMJ pain showed that about 2/3-3/4 of all joints with the normal disc configuration had TMJ pain, and about 1/4 of all joints with the
deformed
disc configuration had no TMJ pain.
8. In the TMJ internal derangement, the disc position and configuration were important, but were not directly related to TMJ pain.
9. In the TMJ internal derangement, the change of the disc position and configuration was not necessarily to produce TMJ pain, and so the relief of TMJ pain without the disc repositioning and the original restoration of deformed disc could be a
treatment object. The surgical treatment of arthroscopic lysis and lavage and arthrocentesis including the conservative treatment was valuable.
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