Temporomandibular joint pathologies: pictorial review

In this pictorial review, an introductory paragraph emphasizes the significance of some anatomical aspects for optimal imaging of the temporomandibular joint (TMJ). The most frequent pathologies: internal derangement (ID) and osteoarthritis (OA) are comprehensively discussed and illustrated. Less common conditions: ID and OA-like changes in children and adolescents, idiopathic condylar resorption, inflammatory arthritis, and juvenile idiopathic arthritis are briefly discussed. A short paragraph on differential diagnostics in young patients is included followed by a brief comment on expansile lesions that occasionally may occur in the TMJ.

[Clinical example of complex diagnostic and treatment of patient with temporomandibular joint internal derangements with arthroscopic surgery]

OBJECTIVE

Improvement and evaluation of effectiveness of the arthroscopic surgery based on individual anatomical sizes in the treatment of patients with the temporomandibular disorders (TMD).

MATERIAL AND METHODS

The article presents the results of complex treatment of patient with TMJ internal derangements and osteoarthritis using arthroscopic surgery. In the pre- and postoperative period, the patient was examined clinically, as well as by computed tomography (CT) and magnetic resonance imaging (MRI). In the preoperative period, the individual sizes of anatomical structures and their localization were determined according to MRI data. That made it possible to carry out surgical intervention with minimal risk. During the operation, fibrous adhesions inside the joint were eliminated with a cold plasma coblator, the disc was mechanically moved to its normal position. At the end of the operation, blood plasma and hyaluronic acid were injected into the joint.

RESULTS

As a result of the treatment, an increase in mouth opening by 80% of the initial state, disappearance of crepitus sounds, and complete relief of pain syndrome were documented. According to objective examination methods (MRI, CT), the elimination of internal disorders, restructuring and regeneration of intra-articular elements were recorded.

CONCLUSION

No complications were revealed during the surgery. Arthroscopic TMJ surgery performed according to the described protocol is an effective and safe procedure that allows quickly restore the mobility of intra-articular elements, eliminate pain and improve the patient's quality of life.