Morphologic, radiologic and thermometric assessment of degenerative and inflammatory temporomandibular joint disease. An autopsy and clinical study.

TMJ autopsy specimens were examined with tomography. The joint surfaces were examined for structural changes. The radiologic methods was evaluated for ability of detecting these changes. A microscopic examination was performed concerning form and position of the disc, and histological features of radiologic cysts, erosion and sclerosis. Symptom-free individuals and patients with rheumatoid arthritis were examined thermometrically. The patients were also examined radiologically. The sensitivity of tomography increased with severity and extent of the structural changes and was higher for changes localized to the condyle than the temporal component. In areas with radiologic cyst, erosion and sclerosis there were macroscopic lesions in the condyle, while the temporal component more often was intact. Macroscopic structural changes were correlated between right and left TM joints. Anterior disc position was associated with perforation of the posterior attachment of the disc. Severity of radiologic changes in individuals with RA is correlated to duration and severity of subjective symptoms and clinical signs from the joint. The intra-articular temperature range in RA patients is greater than in symptom-free individuals. Pain and tenderness of the TMJ and masticatory muscles are thereby associated with hypothermia of the TMJ.