Arthrotomography of the temporomandibular joint: new technique and preliminary observations

A technique for arthrography of the temporomandibular joint using multidirectional tomography is described that greatly simplifies interpretation. In 21 attempts, 20 successful arthrograms were obtained in patients complaining of pain, tenderness, and clicking and locking of the joint who had not responded to conservative therapy. Abnormalities demonstrated were perforation of the meniscus, anterior dislocation and subluxation of the meniscus; and redundancy of the bilaminar zone. In all 11 patients who underwent surgical meniscoplasty, disc abnormalities included thinning, perforation, flaccidity, and bilaminar redundancy. No permanent complications of the arthrographic procedure occurred, but temporary postprocedure discomfort was frequent. This preliminary experience with temporomandibular joint arthrotomography suggests this easily performed procedure offers reliable information about disc function and integrity that may assist in a selection of patients for meniscoplasty and other surgical treatment.