Diagnostic studies of Temporomandibular Joint Disorders in MRI and Arthroscopy-Correlation with Arthrography and surgical findings

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In diagnosis and therapy of temporomandibular joint disorders magnetic resonance imaging(MRI)in an ideal method for visualizing hard and soft tissue structures of the temporomandibular joint(TMJ)in a short examination. MRI is useful for detection and evaluation of TMJ disk derangements, particularly in disk anterior displacement. Because of its non-irradiative diagnostics capacity, MRI has a superior value for diagnosis of uncomplicated internal derangement of the TMJ.Arthrographic technique has been very significant on diagnosis for internal derangement of TMJ. The single contrast arthrography of the lower joint space made it possible to easily and simply detect approximate position and dynamics of the joint disk. Conventional arthrography was thought as an important procedure to detect a finding of intra-articular adhesion or perforation.Arthroscopic examination was performed on the patients with closed lock of the TMJ. The intracapsular pathosis was clearly detected through the arth … More roscopy, and which enabled significant progress in diagnosis and treatment for closed lock TMJ patients.The effectivity of conservative therapy for internal derangemente with closed rock of the TMJ, confirmed in MRI were investigated. Conservative therapy was gradually applied as follows : 1. oral medication of anti-inflammatory drug and muscle relaxant, 2. mandibular manipulation or pumping manipulation technique, 3. splint therapy. In the results, about 60% were successfully unlocked by the conservative therapy.The patients with TMJ arthrosis were evaluated classified 5 types based on a classification proposed by the Japanese Society of TMJ in 1986. The iype distribution in our clinic was as follows, Type III was most commonly encountered about 45% followed by Type II Type IV, Typel and TypeV. The majority of Type 1IV were females. The cases of which bone changes of the TMJ are not so remarkable and the disks are displaced, could not be clearly determined as either Type III or Type IV. The judgment of Type II was most difficult because of its pain characters being the sole determinant.In regard to complex type, it needs further study to determine its diagnostic criteria and application. Less