[Anterior and lateral disk and capsule tissue of the temporomandibular joint and its relevance for temporomandibular joint diagnosis].
OBJECTIVE
Fibrocartilage that bears tensile stress is typically fixed bilaterally to adjacent bone by collagenous fibres. For the temporomandibular joint, such disc fixations in the anterior and lateral regions have not been described, even in MRT findings of anterior disc dislocations without reduction. By observing collagenous fibres of the anterior and lateral discuss and capsule tissue, we sought to establish whether tensile load capacities typical for fibrocartilage also apply to the discuss articularis of the mandibular joint in sagittal direction.


METHODS
Using dissection material from 20 adult and 10 newborn temporomandibular joint specimens, the position of the caput mandibulae in the fossa mandibularis or below the tuberculum articulare was ascertained. Serial sections were stained using alternately haemotoxylineosin and the Goldner method.


RESULTS
Collagenous fibres from the medial and lateral discuss insert into the corresponding caput pole and form the limit of the lower joint cavity. In the anterior capsule region, two fibres may be seen coming in similar fashion from the pes disci to the retrodiscal bilaminary zone. They are denoted respectively as inferior and superior stratum anterior. They limit the upper and lower joint cavity in anterior direction. Depending on motion, both experience various tensile loads, together with the inferior and superior stratum posterior. The tensile loads exerted are described and clarified with drawings.


CONCLUSIONS
Collagenous fibres coming anteriorly and laterally out of disc fibrocartilage provide evidence that sagittal tensile loads are also exerted on discs. Disc dislocations without reduction can only occur when the collagenous fibres coming from the disc also have ruptured. A more critical evaluation of anterior disc dislocations would seem to be called for.
Pinkert
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Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Mund- und Kieferheilkunde, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden.
D000328:Adult; D001732:Bite Force; D002358:Cartilage, Articular / Q000473:pathology; D003094:Collagen / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D004204:Joint Dislocations / Q000473:pathology; D008297:Male; D012016:Reference Values; D013704:Temporomandibular Joint / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000473:pathology; D013718:Tensile Strength
D003094:Collagen