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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Published online: June 17, 2011
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