Structural hard-tissue changes in temporomandibular joints with internal derangement.

The literature reports contradictory findings concerning the relationship between structural hard-tissue changes and internal derangement of the temporomandibular joint. Therefore, an analysis was undertaken of radiographs, including arthrograms of 128 patients with internal derangement in the form of anterior displacement of the disk. Structural hard-tissue changes were seen in one half of the patients with anterior disk displacement without reduction but very seldom in patients showing anterior disk displacement with reduction. Structural hard-tissue changes were always found in joints with perforation of the disk. Thus, structural hard-tissue changes occurred predominantly in patients with advanced internal derangement and may be interpreted as signs of progression of the disease.