The use of arthrography in management of temporomandibular joint problems

Morphologic changes in the elastic fibers of the temporomandibular joint after experimental disc perforation in the rabbit

PURPOSE

Elastic fibers in the attachment regions of the temporomandibular joint (TMJ) are considered important in the movements of the disc during jaw motion. This study was designed to determine whether there are change in the elastic fibers of the TMJ when the disc is perforated for a long period.

MATERIALS AND METHODS

Each TMJ of five rabbits was surgically exposed, and a mediolateral perforation was made in the center of the articulating region of the disc with a scalpel. Five untreated and three sham-operated rabbits were used as controls. The TMJs were removed after 10 months and processed for histochemical demonstration of elastic fibers.

RESULTS

Osteoarthritic changes and a significant decrease in number of the elastic fibers in the anterior-inferior attachment and posterior-inferior attachment of the TMJ disc were observed after disc perforation. Conversely, elastic fibers appeared in the fibrous tissue on the resorbed bone of the articular eminence.

CONCLUSIONS

Experimental disc perforation changes the distribution and density of the elastic fiber in the TMJ as well as causes osteoarthritis. A knowledge of these facts may improve our understanding of perforation of the disc.

Effect of experimental disc perforation in sheep temporomandibular joints

The effect of surgical perforation of the disc on intra-articular morphology was examined using sheep. Eight sheep had bilateral perforations and 2 animals were used as controls. After 8 months the sheep were killed and the joints examined radiologically and histologically. Osteophytes were seen on all the condylar radiographs. Histologically, there were proliferative changes in both the condylar and temporal surfaces adjacent to the disc perforations.

Temporomandibular joint arthrography: a comparison between a fluoroscopic and a nonfluoroscopic technique

A nonfluoroscopic temporomandibular joint arthrographic technique is contrasted with a more widely employed fluoroscopically guided technique. The nonfluoroscopic technique uses a posterior approach to joint injection, as contrasted with the lateral injection approach of the fluoroscopically guided technique. The advantages of the nonfluoroscopic technique are less radiation dose to the patient, less expensive and less sophisticated imaging equipment, and less potential for neurovascular trauma. The fluoroscopic technique offers greater control of the procedure, less patient and operator time, and the capability for a dynamic videofluoroscopic study. Both techniques appear to be safe and efficacious. Differences in anatomy, imaging modalities, patient radiation exposure, and potential complications are also discussed as part of this comparison.