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• W2027699089 abstract "Nitzan's thoughtful analysis of how internal derangement (ID) of the temporomandibular joint might occur 1 Nitzan DW The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: A theoretical concept. J Oral Maxillofac Surg. 2001; 59: 36 Abstract Full Text Full Text PDF PubMed Scopus (183) Google Scholar is based on the plausible suggestion that overloading induces a change in the lubricating fluid, which causes an increase in friction. However, friction alone seems unlikely to cause disc displacement. A sticky disc may have a role in progression from Wilkes stage III to stage IV, 2 Hall HD Navarro EZ Gibbs SJ One- and three-year prospective outcome study of modified condylotomy for treatment of reducing disc displacement. J Oral Maxillofac Surg. 2000; 58: 7 Abstract Full Text PDF PubMed Scopus (54) Google Scholar but it does not explain pure medial or lateral disc displacement or other observations in joints with ID. We have previously proposed that the disc acts like a wedge between the condyle and fossa and is mechanically displaced when it is under load. 3 Werther JR Hall HD Gibbs SJ Disk position before and after modified condylotomy in 80 symptomatic temporomandibular joints. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 79: 668 Abstract Full Text PDF PubMed Scopus (50) Google Scholar This hypothesis is based on the following: 1) The reducing disc abruptly moves away from the condyle when the mouth closes from the full open position. If friction is great, the disc would tend not to move away from the condyle, and certainly not abruptly. 2) The reducing disc spontaneously moves in a posterior and superior direction after modified condylotomy. The resulting increase in joint space likely relieves load on the disc, allowing this movement. 3) Localized subchondral elevations of bone and differential thickening of the posterior band of the disc are commonly observed, especially in the lateral aspect of the joint. During arthrotomy, if the surgically repaired disc is manually loaded by the condyle, it displaces again. The particular location of the thickening determines the direction of the displacement and, when these areas are surgically reduced, 4 Piper MA Microscopic disc preservation surgery of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 1989; 1: 279 Google Scholar the displacement is prevented. These thickened areas may also offer clues as to how the initiation of displacement occurs. Point concentration of overloads in the range that induces hypertrophy could account for the phenomenon. We are not aware of any findings in joints with ID that are inconsistent with these hypotheses." @default.
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• W2027699089 date "2001-08-01" @default.
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• W2027699089 title "The mechanism of disc displacement" @default.
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• W2027699089 doi "https://doi.org/10.1053/joms.2001.26042" @default.
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