THE USE OF MAGNETIC-RESONANCE-IMAGING TO DETERMINE SPLINT POSITION IN THE MANAGEMENT OF INTERNAL DERANGEMENTS OF THE TEMPOROMANDIBULAR-JOINT

Internal derangements of the temporomandibular joint (TMJ) can elicit symptoms of pain, clicking and noises described subjectively as popping, grinding or grating. These symptoms may be the precursor of a more severe disease process such as degenerative joint disease (DJD) or osteoarthritis. The most common factor predisposing to degenerative changes within the TMJ is a displaced meniscus. Maintenance of a proper anatomic meniscal-condylar relationship is essential in preventing DJD. In the past, non-surgical treatment utilizing intraoral orthotic devices has been attempted to ''recapture'' the meniscus. The position of the meniscus was then evaluated merely by clinical examination due to the lack of modalities available to verify the meniscal position. The advent of magnetic resonance imaging (MRI) has changed this scenario. The meniscal position can now be visualized, thus enabling the practitioner to treat patients more effectively. Three case reports are presented in this study demonstrating the use of splint therapy utilizing MRI to determine meniscal position.