Modern Views on the Etiology, Clinics, and Diagnosis of Disc Displacements and Inflammatory-Degenerative Diseases of the TMJ and Their Combinations

Abstract

In more than 50% of patients with temporomandibular disorders (TMDs), the simultaneous course of several disorders is detected. A combination of anterior disc displacement (DD) and inflammatorydegenerative diseases (IDD) of the temporomandibular joints (TMJs) is common.
 The purpose of the study is to highlight modern views on the combination of DD and IDD of the TMJ, their etiology, clinic and diagnostic features.
 A review of the literature was conducted by processing scientific and metric databases, as a result of which 56 articles were selected for study the full text.
 To diagnose TMDs, researchers suggest using The Diagnostic Criteria for Temporomandibular Disorder (DC/TMD), which is a standardized tool. MRI and cone-beam computed tomography (CBCT) are used to verify DD and IDD of the TMJ.
 Many articles are devoted to the signs and symptoms of DD and IDD of the TMJ separately, however, there are very few studies that analyze the signs and symptoms in patients with a combination of DD and IDD. The clinical diagnosis of the above diseases is based on the presence of sounds in the TMJ, pain, degree and nature of mouth opening. In the case of the simultaneous course of DD and IDD, the symptoms may combine or overlap each other and, as a result, complicate differential diagnosis. According to the results of the clinical examination of patients, in the case of suspicion of the simultaneous course of DD and IDD of the TMJ, it is necessary to involve different radiological examination methods. A promising way to diagnose the combination of DD and IDD is to combine CBCT and MRI images. This approach allows simultaneous assessment of bone and soft tissue structures of the TMJ. Regarding ultrasonography of the TMJ, the authors advise using it rather to exclude the diagnosis of TMD than to confirm it.
 Conclusions. The combination of DD and IDD of the TMJ remains understudied and requires the study of clinical features of the course, the development and application of improved modifications of modern radiological methods.