Radiographic morphology in the temporomandibular joint after diskectomy.

The purpose of the study was to evaluate the radiographic appearance in the temporomandibular joint after diskectomy in patients refractory to conservative treatment. The diskectomies were performed in patients in which the common diagnosis were internal derangement or symptoms of osteoarthrosis. Postoperative radiographs were taken in 25 patients after 1-17 yrs and compared with the preoperative from both the operated and the nonoperated joints. Moderate to severe osteoarthrotic changes were found on the operated side in all but two patients in contrast to on the nonoperated side where such changes were absent in all patients except in one who had minor to moderate changes. The radiographic examinations showed flattening of the condylar head but also irregularities and bone apposition. In almost all patients the fossa showed a sclerotic surface, flattening but only occasionally bone apposition and irregularities. Sclerotic changes were found in about 50% of the patients but erosions only rarely. Similar postsurgical changes were also seen on the articular eminence. A reduced joint space was seen in 18 patients. The postsurgical radiographic changes are the normal out come of diskectomy and do not have clinical significance even though they resemble degenerative joint disease.