Geometric Considerations of Disk Repositioning Procedures

ABSTRACT

One approach to treatment of internal derangements of the temporomandibular joint (TMJ) is surgical remodeling and repositioning of the disk and its attachments. Nine joints exhibiting disk displacements (four histological series and five magnetic resonance imagining (MRI) series) were studied to analyze the geometrical and mechanical implications of surgical repositioning. In the central tomographic plane, for example, these cases would have required repositioning the disk 6.9 mm posteriorly (± 3.3 mm), removing 5.2 mm (± 1.6 mm) of remodeled retrodiskal tissue, and trimming 2.1 mm (± 2.0 mm) of disk. This suggests that from gross geometric considerations alone, there is not sufficient viable joint tissue to recommend disk repositioning as a routine procedure.

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Notes on contributors

Leslie B. Heffez

Dr. Leslie B. Heffez received his D.M.D. degree from the University of Montreal, Quebec, Canada in 1979, as well as specialty training in oral and maxillofacial surgery at Tufts School of Dental Medicine in 1983. He is currently associate professor and associate head of Oral and Maxillofacial Surgery at the University of Illinois at Chicago, TMJ and Facial Pain Center. Dr. Heffez is a member of the American Association of Oral & Maxillofacial Surgeons and a Fellow of the Royal College of Dentists of Canada.

Steven L. Jordan

Dr. Steven L. Jordan received his Ph.D. degree in mathematics from the University of California at Berkeley in 1970. He is an associate professor of mathematics, statistics, and computer science at the University of Illinois at Chicago, and also Acting Director of the University's Office of Mathematics and Computer Education. Professor Jordan is a member of the American Mathematical Society, the Mathematical Association of America, and the International Society for Optical Engineering.

Gary L. Crawford

Gary L. Crawford received his D.D.S. degree from the University of Oklahoma, College of Dentistry in 1986. He was formerly Chief Resident of Oral and Maxillofacial Surgery at the University of Illinois at Chicago. Currently, Dr. Crawford is in private practice In Orem, Utah.