Journal of Dental Medicine

Background and Aims: Internal derangement of the Temporomandibular joint (TMJ) is the most common form of Temporomandibular disorders, which represents an abnormal internal strucural and functional change of the disk, as well as an abnormal relationship of the disk to the condyle, glenoid fossa and articular eminence when the teeth are in the closed- mouth position. The aim of this study was to evaluate the correlation between eminence steepness and condyle disk movements in TMJs affected by internal derangements using magnetic resonance imaging (MRI).

Materials and Methods: In this cross-sectional study, digital MRI files of 90 joints belong to 45 patients in open and closed-mouth positions were evaluated. Patients were subdivided into two groups: 64 individuals with anterior disk displacement with reduction and 26 individuals with anterior disk displacement without reduction. Appropriate oblique sagittal sections were selected and printed. Outlines of the fossa, eminence, condyle and disk were traced on matte acetate sheets and evaluated by an oral and maxillofacial radiologist and a postgraduate student of oral and maxillofacial radiology. Disk rotation, condyle rotation, condyle translation and eminence steepness were measured. The data were analyzed using T-test.

Results: In this study, no significant difference was found in measurements between the two groups, (for steepness P=0.64, for Disc rotation P=0.77, for condyle rotation P=0.28 and for condyle translation P=0.12). Disk rotation showed statistically significant correlation with eminence steepness in the anterior disk displacement with reduction group
(P=0.034). Although this correlation was weak (r=0.27) no statistically significant correlations were found between other variables and eminence steepness in this group (for condyle rotation P=0.3 and for condyle translation P=0.98). Disk rotation and condyle translation had statistically significant relationship in the anterior disk displacement without reduction group (P=0.011, r=-0.49). In addition, a significant difference was found between disk rotation and condyle rotation in this group (P=0.004, r=0.54). The relationship between other variables and eminence steepness were not statistically significant (for disc rotation P=0.06, for condyle rotation P=0.72 and for condyle translation P=0.73).

Conclusion: According to the results of the present study, there is no obvious relationship between eminence steepness and movements of the condyle- disk assembly in patients with TMJ internal derangements. Therefore, the hypothesis that a steep articular eminence of the TMJ is a predisposing factor for disk displacement without reduction could not be verified. Performing prophylactic Eminectomy as a part of patient treatment plan is doubtful and need further evaluations.