The first study on double-contrast arthrotomography of TMJ was reported by Westesson, Sweden (1982). There has been no report on this from other institutes. We have obtained good results on this clinical study for the double-contrast arthrotomographic examination of TMJ.
The evaluation period was July, 1984 through November, 1985. 44 cases were examined, which clinically diagnosed as arthrosis of TMJ. 2 cases were evaluated as normal arthrogram, and 42 cases were diagnosed as anterior disk displacement. Any clinical symptom was found for all of the cases of anterior disk displacements in TMJ.
Of the cases of anterior disk displacements, 22 cases were found anterior disk displacement with reduction, one of these cases was found the perforation in the posterior attachment. 20 cases were anterior disk displacement without reduction, 3 cases were found the perforation in the posterior attachment and the disk.
On the disk configurations, of 22 cases with anterior disk displacement with reduction, 12 cases were biconcave and 10 cases were enlargement of posterior band. Of the cases without reduction, 13 cases were biconvex and 4 cases were even thickness. The disk configurations of 2 cases were not evaluated because of the perforation.
2 cases, over 40mm opening mouth and clinically diagnosed as no limitation of mouth opening, were found anterior disk displacement without reduction.
Using the airway pressure manometer, injection pressure of negative contrast medium were standardized 30 cmH2O for the upper joint compartment in the closing and opening mouth. For the lower joint compartment, 30 cmH2O in the opening mouth and 40 cmH2O in the closing mouth.
To standardize the injection pressure is not only able to minimize the technical differences by operators, but also to compare among arthrograms each other under the same conditions. Therefore, this method brings a good and constant arthrograms.
