Internal derangements of the temporomandibular joint: correlation of arthrography with surgical findings.

The diagnosis of dysfunctional temporomandibular joint (TMJ) disorders unresponsive to nonsurgical treatments heretofore has often been empirical. With the development of TMJ arthrography, diagnosis has been greatly improved; an accurate picture of the condition of the joint now provides a substantial base on which to build a rational and reasonable treatment plan. Clinical symptoms can be accurately correlated with the radiographic picture, a valid surgical procedure can be performed because the joint condition is known, and a meaningful prognosis can be determined. Successful management, however, very often requires multifaceted treatment consisting not only of surgery but also of bite-plate, occlusal, restorative, and physical therapy, both preoperatively and postoperatively.