Abstract
Diagnosis of temporomandibular joint disease requires good understanding of the relevant pathological patterns. Exploring joint soft tissue structure is particularly important.
Recently we observed intraarticular cavity forms before and after treatment, using double -contrast arthrographic CT and deuble -contrast arthrotomographic pictnres in various temporomandibular joint diseases. Morphological changes were studied.
Disease and cases currently covered were internal derangement of the temporomandibular joint (fibrous ankylosis), patients who underwent arthroscopic surgery to treat recurring dislocation, cases of temporomandibular trauma, suppurative arthrosis, and others.
Therapeutic approaches included disc reduction involving arthroscopic Nd-YAG laser surgery and suturing for cases of internal derangement (Type III) and temporomandibular trauma. Nd-YAG laser surgery comprised of evaporation and ablation was used ir cases of fibrous ankylosis; disc immobilization was used in recurrent dislocation cases. Arthroscopic intra-cavity cleaning and fibrous tissue removal was done in cases of suppurative arthrosis. Postoperative mouth-opening training and others were part of the functional rehabilitation program.
Results showed in postoperative double-contrast arthrographic visualization that surgical cases benefited there was intracavity narrowing at the treated site. Cases of fibrous ankylosis and inflammatory and traumatic diseases showed cavity disappearance.
