Search

Meniscectomy of the temporomandibular joint (TMJ) was frequently performed until a few years ago but now is seldom employed. This procedure induces important articular modifications but the complete extent of ultrastructural changes is still unknown. Twenty-one Wistar rats were submitted to unilateral meniscectomy. Animals were randomly divided into three groups and followed for 15, 35 or 60 days. After killing both meniscectomized and contralateral TMJ specimens were sectioned sagittally and prepared for light and scanning electron microscopy studies. Normal TMJs are characterized by glenoid fossa and condylar process with distinct conjunctive layers in which regularly arranged type 1 collagen fibres predominate. Meniscectomized animals initially exhibit a different tissue covering the eroded articular surface of the condyle with the prevalence of type 3 collagen fibres but type 1 fibres predominate in the late postoperative period. Subchondral cysts are clearly visible. A complex remodelling process of the TMJ after meniscectomy is evident with important ultrastructural modifications that may correlate to unsatisfactory clinical results. The dynamic nature of this process is also observed when specimens from different postoperative periods are compared. Surgeons should always bear in mind these alterations when indicating this procedure.

The bilaminar zone (BZ) in the human temporomandibular joint (TMJ) of toothed adults (GI) and toothless, elderly humans (GII) were analysed using light and scanning electron microscopy (SEM). In both groups the BZ consists of an upper and a lower stratum of connective tissue separated by a vascularized middle region. The superior stratum contains bundles of collagen fibres disposed in different directions. The fibres are fairly thick and transversely oriented immediately posterior to the TMJ disc. The initial part of the inferior stratum contains curved bundles of collagen fibres oriented anterio-posteriorly. From the middle to the posterior part of the inferior stratum, the fibres are right-aligned in GI and clearly sinuous in nature in GII. In both groups, the middle and posterior portions of the middle region are distinguished by the presence of vessels and vascular spaces. Loosely arranged connective and adipose tissues are also evident. The vascular spaces are wider in GII than in GI. The predominance of type I collagen fibres is clear in all regions of the BZ in both groups. The elastic fibres lie parallel to the collagen fibres in both groups and they are thicker and more abundant in GI, apparently decreasing in GII.

The articular disc of the temporomandibular joint was studied in a foetuses and children group (GI), a dentate group of adults (GII) and an edentulous, elderly group of humans (GIII) by light microscopy. The main, constituent bundles of type I collagen fibres are stratified and are orientated sagittally, transversely and obliquely in the middle portion of the disc. In the thick, posterior portion, transverse bundles constitute the main feature. In the anterior portion of the disc, the fibres are sagittally and obliquely orientated. Type III collagen fibres, intermingled with type I collagen fibres are present in all groups. The disc is cellular in nature in foetuses and children, becoming more fibrous with age. Chondroid cells are observed in all portions of the discs in groups GII and GIII. Elastic fibres are numerous in GI discs and decrease in number in the disc with age. These fibres lie parallel to the collagen fibres in all three portions of the three groups.