RADIOGRAPHIC SIGNS OF TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT 30 YEARS AFTER NONSURGICAL TREATMENT

The aim of this study was to evaluate with radiographs the long-term s tatus of temporomandibular joints that were treated nonsurgically for reducing disk displacement (group 1) or permanent disk displacement (g roup 2) 30 years ago. Transcranial and transpharyngeal radiographs wer e made before (T1), 2 to 4 years after (T2), and 30 years after (T3) n onsurgical treatment in 65 former patients with temporomandibular join t osteoarthrosis. To control the results for aging 35 matched subjects (group 3) underwent the same radiographic examination. The number and severity of radiographically visible degenerative changes increased s ignificantly from T1 through T2 to T3 in group 1 and in group 2. The i ncrease in these changes was not simply caused by aging, because in ap proximately three quarters of the temporomandibular joints in group 3, no radiographically visible degenerative changes were found. At all o ccasions group 2 showed significantly more severe changes than group I . At T3 in 64% of the temporomandibular joints in group 1, no or only slight radiographically visible degenerative changes were observed, wh ereas in 86% of the temporomandibular joints in group 2, moderate to s evere changes were observed. A persisting reducing disk displacement i n part of the temporomandibular joints in group 1 might explain this s ignificant difference. In 79% of the temporomandibular joints with mod erate to severe radiographically visible degenerative changes at T1, n o or only slight progression in the extent of these changes was seen b etween T2 and T3. Apparently a radiographically stable end stage may b e reached within a few years after permanent displacement in most case s. It was concluded that in temporomandibular joints with reducing dis k displacement, no or only slight radiographically visible degenerativ e changes develop, even if this condition persists for several decades . On the other hand, in temporomandibular joints with permanent disk d isplacement, radiographically visible degenerative changes are extensi ve in the vast majority of cases.