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Morphologic changes in the unloaded temporomandibular joint after mandibulectomy
Yoshiki Hamada1, Toshirou Kondoh, Hideki Sekiya
1First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan. hamada-y@tsurumi-u.ac.jp
Summary
Mandibulectomy can lead to temporomandibular joint (TMJ) disc deformation, even without joint loading. Altered disc-condyle relationships, not joint loading, are key to disc deformation in unloaded TMJs.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Radiology
Background:
- Temporomandibular joint (TMJ) disorders can arise from various factors, including surgical interventions like mandibulectomy.
- Understanding intra-articular changes in unloaded TMJs post-surgery is crucial for patient outcomes.
Purpose of the Study:
- To investigate the intra-articular conditions of unloaded TMJs following mandibulectomy.
- To compare TMJs with and without the condyle after surgery.
Main Methods:
- Magnetic resonance imaging (MRI) was used to assess disc configuration, bony changes, and joint effusion in 17 unloaded TMJs.
- Arthroscopic examination was performed on 8 joints to evaluate fibrous adhesions.
- TMJs were categorized into 'without condyle' (WOC) and 'with condyle' (WC) groups.
Main Results:
- Disc deformation occurred in 63.6% of WOC joints but not in WC joints.
- No bony changes were detected in any group.
- Joint effusion and fibrous adhesions were prevalent in nearly all examined joints.
Conclusions:
- Disturbance of the disc-condyle relationship, rather than loading, is the primary driver of disc deformation in unloaded TMJs.
- Articular degeneration in unloaded TMJs appears linked to synovial fluid metabolism disruption, without affecting bony structures.