Adhesions in the temporomandibular joint: formation and significance

Adhesions are frequently seen in the deranged temporomandibular joint (TMJ). In the early stage of the degenerative process the adhesion does not seem to be a significant factor in reduced mandibular movement. This is reversed in advanced degenerative joint disease where the adhesion requires release to achieve a satisfactory clinical result. Correlation of clinical history and findings within the joint should increase understanding of limited jaw movement.

Arthroscopic examination of deranged TMJs was performed on 75 patients with limited jaw opening and correlated with the history of the derangement.

A progressive maturation of adhesion formation was observed with longer standing symptoms. A different adhesion pattern was noted with derangement caused by direct trauma on the joint.

Internal derangement of the TMJ is associated with formation of intra-articular adhesions. These are unlikely to be associated with reduced condyle movement in the early phase of the derangement. Later stage adhesions are more substantial and require release to achieve a satisfactory clinical outcome.