Morphology of the mandibular fossa and inclination of the articular eminence in patients with internal derangement and in symptom-free volunteers

Objective. The purpose of this study was to evaluate temporomandibular joint morphology and to compare possible structural variations in the temporomandibular joint anatomy of symptomatic anterior disk displacement patients with possible structural variations in the temporomandibular joint anatomy of symptom-free volunteers. Study design. Fifty-six symptomatic patients and 25 symptom-free volunteers were included in this Study. All subjects had bilateral high-resolution magnetic resonance imaging scans performed in the sagittal (closed and open) positions. Disk positions were evaluated with these images, and the patients were accordingly classified into 4 diagnostic groups, The angulation between the Frankfort horizontal plane and the posterior slope of the articular eminence, as well as the width and depth of the glenoid fossa and the articular tuberculum, were automatically measured with the aid of a computer. Results. The Mann-Whitney U test demonstrated significant differences in the angular and linear values obtained ill disk displacement with reduction patients in comparison with the values obtained in patients with disk displacement without reduction and in symptom-free volunteers. Conclusion. It is proposed that a steeper posterior slope and higher tuberculum articulaire are predisposing factors for the development of disk displacement with reduction. Flattening of the eminence may progress in time, leading to the onset of disk displacement without reduction.