Diagnostic Imaging and Different Modalities of Treatment of Temporomandibular Joint Dysfunction

Document Type : Original Article


1 Department of plastic surgery; Faculty of Midicine; Sohag University.

2 Department, Faculty, of Medicine General Surgery, Sohag University

3 Department of plastic surgery; Faculty of Medicine; Sohag University.


 Temporomandibular joint dysfunction (TMD) is a common condition that affects up to 39% of the population and associated with a wide range of clinical signs and symptoms such as, pain, clicking, crepitation, restriction of movement, deviation of the jaw, headache, vertigo, and tinnitus. The etiology of TMD is of multifactorial origin like trauma, parafunction, malocclusion and degenerative joint diseases.
Materials and Methods
This study included 18 patients who had symptoms of temporomandibular joint dysfunction. The patients were evaluated in the plastic surgery department at Sohag University Hospital.
The study conducted on 18 patients; 8male and 10 female, the mean age is 26 years ranging from 17 to 40 years.
From the 18 patients; 2 cases received no treatment and 16 patients (7 males and 9 females) had received several modalities of treatment.
In this study we used a variety of modalities of treatment such as, medical treatment to 8 cases, relaxation to 1 case, splint to 2 cases, arthrocentesis to 1 case, arthroscopy to 2 cases, discectomy for 1 case and arthroplasty for 1 case.

1. Aiken A, Bouloux G, Hudgins P. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am 2012; 20: 397-412.
2.  Greenberg MS, Glick M, Slip J. Burket’s oral medicine, diagnosis and treatment. Hamilton: Decker; 2008. p. 223-57.
3. Maizlin ZV, Nutiu N, Dent PB, et al. Displacement of the temporomandibular joint disk: correlation between clinical findings and MRI characteristics. J Can Dent Assoc. 2010; 76:1-5.
4. Orlando B, Chiappe G, Landi N, et al. Risk of temporomandibularjoint effusion related to magnetic resonance imaging signs of disc displacement. Med Oral Patol Oral Cir Bucal 2009; 14:188-19.
5. Bakke M, Møller E, Werdelin L, Dalager T,Kitai N, Kreiborg S.Treatment of severe temporomandibular joint clicking with botulinum toxin lateral pterygoid muscle in two cases of anterior disc displacement. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2005; 100: 693–700.
6. Tomas X, Pomes J, Berenguer J, et al. MR imaging of temporomandibular joint dysfunction: a pictorial review. Radiographics2006; 26:765-81.
7. Vasilki Karlis, Robert Glickman. Non surgical management of Temporomandibular Disorders. In, Michael Miloro(Ed). Peterson s principles of maxillofacial surgery, second edition. London, BC Decker Inc, 2004; 950.
8. Mercuri LG (2006). Surgical management of TMJ arthritis. In: TMDs, an evidence-based approach to diagnosis and treatment. Laskin DM, Greene CS, Hylander WL, editors. Chicago: Quintessence, pp. 455-468.
9. Barclay P, Hollender LG, Maravilla KR, et al. Comparison of clinical and magnetic resonance imaging diagnosis in patients with disk displacement in the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:37.
10. Westesson PL O-YM, Sano T, Okano T. Anatomy, Pathology, and Im aging of the Temporomandibular Joint. In: Som PM, Curtin HD, ed. Head and Neck Imaging. St. Louis: Mosby, 2011: 1547-613.
11. Westesson PL, Katzberg RW, Tallents RH et al.: Temporomandibular joint: comparison of MR images with cryosectional anatomy. Radiology 1987; 164:59.
12. Emshoff R, Brandlmaier I, Gerhard S, et al. Magnetic resonance imaging predictors of temporomandibular joint pain. J Am Dent Assoc. 2003; 134:705-714.
13.  Zhang S, Yang C, Chen M et al.: Magnetic resonance imaging in the diagnosis of intra-articular adhesions of the temporomandibular joint. Br J Oral Maxillofac Surg 2009; 47:389.
14. Choi YS, Asaumi J, Hisatomi M et al.: Analysis of magnetic resonance images of disk positions and deformities in 1,265patients with temporomandibuar disorder.open dent j 2009; 3:1.
15. Ingawale Shirish and Tarun Goswami. Temporomandibular Joint: Disorders, Treatments, and Biomechanics. Annals of Biomedical Engineering 2009; 37: 976–996.
16. Chung, S. C., Y. K. Kim, and H. S. Kim. Prevalence and patterns of nocturnal bruxofacets on stabilization splints in temporomandibular disorder patients. Cranio.2000; 18:92.
17.  Raphael, K. G., J. J. Marbach, J. J. Klausner, et al. Is bruxism severity a predictor of oral splint efficacy in patients with myofascial face pain? J. Oral Rehabil.2003; 30:17–29.
18. Kuruvilla V. E and K. Prasad. Arthrocentesis in TMJ Internal Derangement: A Prospective StudyJ. Maxillofac. Oral Surg. 2012; 11:53–56.
19. Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res 2008; 87: 296-307.
20. Cleveland Clinic. Health information. Retrieved on 09/21/ 2007, from http://www.clevelandclinic.org/health/.patients with temporomandibular disorder. Open Dent J 2009; 3:1
21. White RD: Arthroscopy of the temporomandibular joint: technique and operative images. Atlas Oral Maxillofac Surg Clin North Am 2003; 11:129.
22.  Gundlach KK: Ankylosis of the Temporomandibular joint. J Cranio-Maxillo-Fac Surg, 2010; 38: 122–30.
23. Cannizzaro E, Schroeder S, Müller LM, et al. Temporomandibular joint involvement in children with juvenile idiopathic arthritis. J Rheumatol 2011; 38: 510-515.
24. Saeed NR, Kent JN. A retrospective study of the costochondral graft in TMJ reconstruction. Int J Oral Maxillofac Surg 2003; 32:606–609.
25. Mercuri LG, Edibam NR, Giobbie-Hurder A. Fourteen-year follow-up of a patient-fitted total temporomandibular joint reconstruction system. J Oral Maxillofac Surg 2007; 65:1140– 1148.