Internal derangement of the temporomandibular joint (TMJ) is one of the most common
temporomandibular disorders. In 1983, Dolwick defined it as an abnormal relation between
the temporomandibular disc with respect to the mandibular condyle, the temporal fossa,
and the temporal eminence of the TMJ. Anterior disc displacement, with or without
reduction, perforation of the retrodiscal tissue or the articular disc, and degenerative
changes of the disc and/or the joint surfaces, may be present. Clinically, it may
be accompanied by pain, limitation of mouth opening, clicking, and locking. In 1989,
Wilkes first established a classification to correlate clinical and radiological signs
with surgical findings. The Wilkes classification consists of 5 stages based on clinical,
radiologic, and intraoperative findings, varying from a slight forward displacement
with symptom-free normal joints to degenerative arthritic changes with severe clinical
symptoms. In 1992, with the advent of minimally invasive surgical approaches, Bronstein
correlated Wilkes stages with arthroscopic findings.
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Further readings
- Clinical staging for TMJ internal derangement: application to arthroscopy.J Craniomandib Disord. 1992; 6: 7
- Advances in diagnostic and surgical arthroscopy of the temporomandibular joint.WB Saunders, Philadelphia1993
- Arthroscopic surgery for treatment of closed lock.J Oral Maxillofac Surg. 1991; 49: 704-707
- Internal derangements of the temporomandibular joint: fact or fiction?.J Prosthet Dent. 1983; 49: 415-418
- A review of 56 cases of chronic closed lock treated with temporomandibular joint arthroscopy.J Oral Maxillofac Surg. 2002; 60: 519-524
- Operative versus simple arthroscopic surgery for chronic closed lock of the temporomandibular joint: a clinical study of 344 arthroscopic procedures.Int J Oral Maxillofac Surg. 2008; 37: 790-796
- Visually guided temporomandibular joint irrigation in patients with chronic closed lock: clinical outcome and its relationship to intraarticular morphologic changes.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95: 552-558
- Efficacy of arthroscopic lysis and lavage in patients with chronic closed lock of the temporomandibular joint.Int J Oral Maxillofac Surg. 1994; 23: 262-265
- Arthroscopic surgery of the temporomandibular joint: report of 64 patients with long-term follow-up.J Oral Maxillofac Surg. 1989; 47: 439-441
- Correlation between preoperative mouth opening and surgical outcome after arthroscopic lysis and lavage in patients with disc displacement without reduction.J Oral Maxillofac Surg. 1998; 56: 1394-1397
- Visually guided irrigation for patients with symptomatic internal derangement of the temporomandibular joint: a preliminary report.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95: 544-551
- Arthroscopy of the human temporomandibular joint.J Oral Maxillofac Surg. 1988; 46: 648-655
- Temporomandibular joint arthroscopy: a 6 year multicenter retrospective study of 4,831 joints.J Oral Maxillofac Surg. 1992; 50: 926-930
- Arthroscopic surgery of the temporomandibular joint: comparison of two successful techniques.Br J Oral Maxillofac Surg. 1999; 37: 397-400
- The effects of arthroscopic lysis and lavage of the superior joint space on TMJ disc position and mobility.J Oral Maxillofac Surg. 1989; 47: 674-678
- Arthroscopic surgery for the treatment of restrictive temporomandibular joint disease. A prospective longitudinal study.in: Clark G. Sanders B. Bertolani C. Advances in diagnostic and surgical arthroscopy of the temporomandibular joint. WB Saunders, Philadelphia1993: 35-40
- Outcome of arthroscopic surgery for internal derangement of the temporomandibular joint: long-term results covering 10 years.J Craniomaxillofac Surg. 2000; 28: 64-71
- A functional approach to the treatment of temporomandibular joint internal derangement.J Craniomandib Disord. 1991; 5: 19-27
- Kokubyo Gakkai Zasshi. 1975; 42 ([in Japanese]): 207-213
- A prospective evaluation of the effectiveness of temporomandibular joint arthroscopy.J Oral Maxillofac Surg. 1990; 48: 1029-1032
- Arthroscopic surgery of the temporomandibular joint: treatment of internal derangement with persistent closed lock.Oral Surg Oral Med Oral Pathol. 1986; 62: 361-372
- Diagnostic and surgical arthroscopy of the temporomandibular joint: clinical experience with 137 procedures over a 2-year period.J Craniomandib Disord. 1987; 1: 202-213
- Arthroscopic lysis and lavage in different stages of internal derangement of the temporomandibular joint: correlation of preoperative staging to arthroscopic findings and treatment outcome.J Oral Maxillofac Surg. 2005; 63: 471-478
- Long-term evaluation following temporomandibular joint arthroscopy with lysis and lavage.Int J Oral Maxillofac Surg. 2000; 29: 259-263
- Short-term outcome of arthroscopic surgery of temporomandibular joint osteoarthrosis and internal derangement: a randomized controlled clinical trial.Br J Oral Maxillofac Surg. 1993; 31: 3-14
- TMJ arthroscopic diagnosis and surgery: clinical experience with 152 procedures over a 2 1/2-year period.Cranio. 1991; 9: 107-119
- Internal derangements of the temporomandibular joint. Pathological variations.Arch Otolaryngol Head Neck Surg. 1989; 115: 469-477
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Published online: June 17, 2011
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