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Longitudinal MRI follow-up of temporomandibular joint internal derangement with closed lock after successful disk reduction with mandibular manipulation

Division of Oral Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai #980-8575, Japan

*Correspondence to: Dr Masatoshi Chiba, Division of Oral Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai #980-8575, Japan;; E-mail: masatiba{at}mail.tains.tohoku.ac.jp

Received 20 August 2004; revised 29 November 2004; accepted 7 December 2004

We present a case of bilateral temporomandibular joint (TMJ) internal derangement with closed lock, which was followed over 11 years using serial MRI after successful disk reduction with mandibular manipulation. MRI of the bilateral TMJs before and after mandibular manipulation followed by anterior repositioning splint showed that the disk improved from non-reducible to reducible, and that the reducing disk persisted for 11 years, although minor changes in configuration and position of the disk occurred. These MRI findings suggest that non-surgical treatment with successful mandibular manipulation prevents progressive changes in the TMJ. This case report complements observations regarding the longitudinal course of TMJ internal derangement with closed lock after non-surgical treatment.

Keywords: magnetic resonance imaging; temporomandibular joint; manipulation; disk