Investigating TMJ Disc Perforation: Insights from Cadaveric Study

JAPAN: In a collaborative effort involving researchers from Tulane University School of Medicine and esteemed institutions in Tokyo and Kurume, a cadaveric anatomical study delves into the intricate relationship between temporomandibular joint (TMJ) disc perforation and bony changes of the mandibular condyle. 

The study, titled “Perforation of the temporomandibular joint disc: cadaveric anatomical study,” provides valuable insights into this often intricate aspect of craniofacial anatomy.

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Extensive Cadaveric Investigation

The research utilized 135 cadaveric mandibles (69 male, 66 female; all White) with a mean age at death of 78.7 years. The primary focus was on investigating disc perforation and assessing variations in the perforated area concerning different types of bony changes, including erosion, flattening, and osteophyte formation. The prevalence of disc perforation was examined, and differences based on age groups were analyzed.

Prevalence and Patterns of Disc Perforation

Results from the study indicated that disc perforation was observed in 34.8% of all mandibles. Unilateral occurrences were noted in 53.2% of cases, while bilateral perforations were identified in 46.8%. A noteworthy finding was the significant difference in prevalence between age groups, with 16.4% in cadavers below 80 years old and a striking 52.9% in those aged 80 years or older.

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Correlation with Bony Changes

The research shed light on the association between disc perforation and various bony changes. Osteophyte formation, occurring alongside other bony changes, was identified in 21.7% of cases and never in isolation. 

The study revealed that the area of perforation was significantly larger in groups with bony changes compared to the ‘no bony change’ group. Notably, groups with osteophyte formation and flattening displayed larger perforated areas than their counterparts without these changes.

Clinical Implications and Future Considerations

The study’s findings highlight the potential secondary nature of osteophytes and flattening following disc perforation. Researchers recommend suspicion of disc perforation when imaging identifies these specific bony changes. This insight has practical implications for clinicians and underscores the importance of comprehensive understanding in diagnosing and managing conditions related to the temporomandibular joint.

This international collaboration contributes to the expanding knowledge base in craniofacial anatomy and provides a foundation for further research and clinical applications in the realm of temporomandibular joint health.