Roberto E. Sanchez-Woodworth

Bilateral internal derangements of temporomandibular joint: Evaluation by magnetic resonance imaging

Two hundred eleven patients with signs and symptoms of temporomandibular joint (TMJ) internal derangements were referred for magnetic resonance imaging. Both TMJs of each patient were routinely evaluated in this prospective investigation. With 422 joints examined, 29% (61) of the patients had bilaterally normal findings, 21% (45) of the patients had one normal side and one abnormal side, and 50% (105) of the patients showed bilateral internal derangements. This clinical study demonstrated a high likelihood of bilateral internal derangements in patients with symptoms of TMJ internal derangements.

Comparison of internal derangements of the TMJ with occlusal findings

Two hundred five patients were examined because of temporomandibular joint pain and dysfunction. Arthrograms were performed on 222 joints (188 unilateral and 17 bilateral). No significant differences were found between arthrographic groups with respect to Angle classification, horizontal and vertical overlap, posterior tooth wear, missing posterior teeth, cuspid-protected occlusion, balancing-side contacts, deflective occlusion, and clenching of the teeth. Tilted teeth on the contralateral side were more common in cases of reducing meniscal dislocation than in cases of normal meniscus position or of nonreducing meniscal dislocation.

Comparison of arthrographic findings of the temporomandibular joint with palpation of the muscles of mastication

Abstract Two hundred five patients were examined for temporomandibular joint pain and dysfunction and specifically for tenderness to muscle palpation. Arthrograms were performed on 222 joints (188 unilateral and 17 bilateral). Significant findings were ascertained for the middle portion of the temporal muscle in “normal” patients versus “with and without meniscus reduction” patients. The superficial masseter muscle was more tender in “normal” patients and in “reducing meniscus” patients than in “without meniscus reduction” patients. The medial pterygoid muscle was more tender in “normal” patients and in “without meniscus reduction” patients than in “reducing meniscus” patients. Though there are some significant findings with respect to muscle palpation, by itself muscle palpation is not a specific indicator of temporomandibular joint internal derangement.

Clinical and arthrographic evaluation of the location of temporomandibular joint pain

Two hundred five patients were prospectively examined for temporomandibular joint pain. Arthrograms were performed on 222 joints (188 unilateral and 17 bilateral). Pain in the ear occurred more frequently in arthrographically normal patients and in nonreducing meniscus patients compared with reducing meniscus patients. The location of pain in front of the ear, in the temples, or in the neck or the degree of pain intensity did not correlate to specific meniscal abnormalities. No correlation between the distribution and the character of headaches was observed. Pain characterization alone does not clinically separate meniscal abnormalities.