Internal Derangement of the TMJ

Patients with internal derangement of their TMJ, typically do not respond to non-surgical management benefit from arthrocentesis and/or arthroscopic lysis and lavage.  TMJ internal derangements occur when the meniscus of the TMJ becomes displaced.  These early states of internal derangement of joint clicking and popping can continue to function but may potentially progress to the jaw locking into place. It has has been described to progress through clinical stages, initially presenting as clicking with normal interincisal opening and progressing to limited opening lacking translatory movement where clicking ceases because the disc may not pop back into position.  Excessive loading on the joint with a nonreducible, anteriorly displaced disc, meaning the ability of the condyle to translate on the articular surfaces.

If left untreated, degeneration of the meniscus and arthritic changes of the bones of the joint may occur. At this time, patients may notice a change in the way their teeth meet due to changes in the moving of the joint.