Magnetic resonance imaging (MRI) has recently been used for the diagnosis of internal derangements of the temporomandibular joint (TMJ). Morphological evaluation of the internal derangements of TMJ has shown remarkable progress. However, there are still many questions regarding the relationships between the state of the articular disc and limitation of motion of the mandibular head. In this study, we used MRI to investigate the relationships between these factors in TMJ patients, especially with regard to the range of condylar movement. Bone configurations and articular disc conditions were analyzed in a total of 367 TMJ of 255 internal derangement patients using magnetic resonance imagnig. We examined the influence of articular disc condition on functional disorder and identified the tendencies of the pathology of patients with internal derangements. When we evaluated the direction of disc displacement, anterior disc displacement was most frequently observed. Anterolateral displacement (19.6%) was more frequent than anteromedial displacement (4.1%), and lateral rotary displacement (11.2%) was more frequent than medial rotary displacement (4.1%). Therefore, the articular disc displaced more readily laterally, rather than medially. With regard to the relationship between the articular disc configuration and reduction, enlargement of the posterior band (87.5%) and biconvex (74.3%) discs showed a tendency for articular disc displacement that did not reduce, while discs with even thickness (38.3%) showed a tendency of articular disc displacement which would reduce. Folding (63.6%) and biconvexity (58.6%) tended to limit condylar movement while less limitation occurred with discs of even thickness (17.0%). In cases of disc displacement without reduction, there was a significantly higher percentage of cases with limited condylar movement than in cases of displacement with reduction (p<0.001). In conclusion, this study suggested that the shape of the disc and the presence or absence of reduction markedly influence the functional disorder of TMJ.
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