Temporomandibular Joint In Patients Research Articles

Minimally Invasive Temporomandibular Joint Surgery Methods using Surgical Treatment of Hyaluronic Acid in Patients with Various Diseases

The complex approach to the treatment of patients with RD has been elaborated at the department. At the preparatory stage, the doctor rheumatologist assesses the activity of the disease and, in case of necessity, provides the adjustment of therapy in order to get the lowest activity / remission of the main disease for about ≥1 months. Temporomandibular joint (TMJ) involvement occurs in patients with different rheumatic diseases (RDs). Pain, limitation of mouth opening can lead to significant problems. Conservative treatments for TMJ lesions are not always effective. Objective: to evaluate the efficiency of minimally invasive surgical interventions (TMJ arthrocentesis and arthroscopy) in patients with RDs. Patients and methods: In case of TMJ dysfunction (the mouth opening, closure, chewing, speaking), and lateral and/or protrusion, discomfort, pain, all the degenerative changes detected on MRI need surgical treatment. 80 patients turned to our clinic center. Most of them (n = 70) were diagnosed with RD. Objective examination resulted revealed 93.8% of cases of the limitation in mouth opening and the articulation disorder. 19 patients (28.1%) had masticatory muscle hypertonicity, mostly bilateral (88,9%). In 62.9% of patients participating in the study, the damage to TMJ according to the international classification of Wilkes was attributed to stage IV, in 21.9 and 14.9% - to stage III and V, respectively. The clinical and instrumental investigations, patients with stages IV and V according to the Wilkes International Classification, underwent TMJ arthroscopy and patients with III – TMJ arthrocentesis with arthro lavage. All the patients underwent TMJ magnetic resonance imaging at baseline and 6 months after treatment. After a surgical intervention, a gel containing hyaluronic acid was used as a fluid implant. 14th day and, 1, 6,12 months after the operation, the examination of the disks in the joints showed their normal movement and normal amplitude of the condyles. Results and discussion: After surgical treatment, all the groups were noted to have a significant decrease in TMJ pain intensity compared with the baseline level; moreover, the severity of TMJ pain most significantly decreased on day 7 after surgery. Later on, positive changes remained 12 hours after the operation, the patient noted mild periodic pain of the right TMJ while the mouth opening, which was estimated by VAS scale up to 10 mm by the patient. The size of the mouth opening increased up to 35 mm.

Automated Analysis of X-Ray Images of the Temporomandibular Joint in Patients with Orthognathic Bite and Physiological Occlusion

Objective: to propose a procedure for analyzing the X-ray image of the temporomandibular joint (TMJ) through the automated calculation of linear and angular measurements from craniometry points in comparison with the reference values.Material and methods. Fifty TMJ cone beam computed tomography images were analyzed in 25 volunteers aged 18-25 years with orthognathic bite and physiological occlusion. All the tomography images were analyzed from craniometric points, by using a section corresponding to the midsagittal plane of the TMJ. Angular and linear measurements characterizing the functional capacities of the TMJ were determined. A statistical analysis involved descriptive methods and was carried out by the IBM SPSS 21 statistics.Results. The introduction of automated estimation of TMJ functional capacities from angular and linear measurements made it possible to obtain the following data: the α-angle was 11.99±2.44° for the right TMJ and 12.12±2.78° for the left one; the β-angle was 11.58±2.31° for the right TMJ and 12.42±2.81° for the left one; the γ-angle was 156.41±4.57° for the right TMJ and 155.46±5.50° for the left one. A descriptive statistics checking revealed no gross errors.Conclusion. It is expedient to take into account the findings as reference values to characterize the anatomical and functional state of the TMJ on the x-ray image.

Role of digital volumetric tomography in assessing morphological variations in condyle and temporal components of patients with asymptomatic temporomandibular joint

Background: Radiographic features of remodeling are difficult to analyze. This has led to the popularity of using digital volumetric tomography (DVT) for temporomandibular joint (TMJ) imaging. To understand variations in normal anatomy and morphology of the condyle and temporal components of the TMJ, it is necessary to differentiate normal variant from pathology. Methods: A total of 160 condyle and temporal components of TMJ in patients with asymptomatic TMJ were assessed by two observers using orthopantomograph (OPG) and compared with DVT using axial, coronal, and sagittal sections for the different condylar and temporal changes separately. Different relationship between variables were evaluated and statistically analyzed. Results: The assessment made by two observers showed agreement between two observers for OPG and DVT (P

Adulthood presentation of the neglected childhood temporomandibular joint ankylosis – “An airway challenge”

Temporomandibular joint (TMJ) ankylosis is commonly seen in childhood and its etiology is multifactorial. Common causes include congenital malformations, use of forceps during delivery, local or systemic infections or systemic autoimmune diseases (rheumatoid arthritis, psoriasis, and sickle cell anemia), burns, and trauma. TMJ ankylosis leads to dentofacial deformity, restricted mouth opening, malocclusion, difficulty in mastication, malnutrition, dental caries, poor oral hygiene, impaired speech, and cosmetic disability. Neglected childhood bilateral TMJ patients present in adulthood with micrognathia, retrognathia, and severe symptoms of obstructive sleep apnea (OSA). They have narrow airway passages due to pseudoglossia, subatmospheric intrapharyngeal pressure, and hypotonicity of the oropharyngeal muscles which make the mask ventilation difficult. Highlights of the management of the case include the use of the awake fiber-optic-assisted intubation, a gold standard for difficult airway management, and incorporation of Brainlab Kick navigation station 18070 (USA) aiding in the precise surgical dissection and preventing injuries to great vessels and nerves. Extubation strategy with preextubation dose of hydrocortisone and dexmedetomidine helped in the smooth recovery. Early recovery and rehabilitation were further facilitated with the use of nasal continuous positive airway pressure postextubation which helped in reducing symptoms of OSA and airway obstruction.

Patient symptoms and magnetic resonance imaging correlation in temporomandibular joint internal derangement

Temporomandibular joint (TMJ) internal derangements consist of reduced and nonreduced disc dislocations and are often diagnosed by magnetic resonance imaging (MRI). The main symptom of these derangements is TMJ pain. This study aimed to evaluate whether there is a correlation between TMJ pain and disc dislocation. One hundred and four patients experiencing pain were evaluated retrospectively with the examination charts that we use routinely in our clinics and MRI. Patients were separated into two main groups as MRI(+) and MRI(-) groups according to their internal derangement findings in MRI. Mean VAS levels were compared between these two groups. There were no significant differences between the MRI(+) and MRI(-) groups and no differences between the reduced disc dislocation group and nonreduced disc dislocation group. Although pain is maybe the most irritating symptom for TMJ patients, it cannot take the diagnostic place of MRI and MRI is still the gold standard method to make the exact diagnose of internal derangement.

Morphological analysis of the temporomandibular joint in patients with malocclusion using three-dimensional models

Morphological analysis of the temporomandibular joint in patients with malocclusion using three-dimensional models

Prevalence of internal derangements of temporomandibular joint in patients with cleft-lip/palate

Aim: The aim of this study was to estimate the prevalence of internal derangements (ID) of temporomandibular joint (TMJ) in patients with cleft-lip/palate. Also, to evaluate the correlation of diagnosis between Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) clinical examination and Magnetic resonance imaging (MRI). Methods: Twenty patients with cleft-lip/palate, were clinically evaluated by RDC/TMD and by MRI. The ID of TMJ evaluate were disc displacement with reduction (DDWR) and disc displacement without reduction (DDWOR). Results: The present study showed that 9 (45%) of the patients were diagnosed with ID of TMJ (8 [40%] patients with DDWR and 1 [5%] with DDWOR) and 11 (55%) present no disorders, by RDC/TMD. MRI examination revealed that 15 (75%) of the patients had ID of TMJ (13 [65%] patients with DDWR and 2 [10%] with DDWOR) and 5 (25%) present no disorders. The Kappa index between the clinical and imaging diagnosis was 0.01. Conclusion: In the present study, DDWR was diagnosed in 40-65% by the RDC/TMD and MRI, respectively; DDWOR was diagnosed in 5-10% by the RDC/TMD and MRI, respectively. The diagnostic correlation between the clinical examination based on RDC and on MRI was weak.

Comparison of the Bony Changes of TMJ in Patients With and Without TMD Complaints Using CBCT.

Temporomandibular joint disorders (TMD) may show a poor correlation between their clinical findings and radiological characteristics. The aim of this study was to assess the osseous alterations of temporomandibular joint (TMJ) in symptomatic and asymptomatic subjects by employing cone beam computed tomography (CBCT) images. In this study, CBCT images of 120 temporomandibular joints in 30 patients with TMJ disorder and 30 age- and sex-matched individuals without TMJ complaints were evaluated. Osteoarticular derangements of the joint were assessed by two experienced examiners. Data was statistically analyzed with SPSS software using chi-square test (p <0.05). Out of 120 CBCT images (60 in each group), at least one osseous change was observed in 90% and 86.7% joints in symptomatic and asymptomatic subjects, respectively. There were no significant differences between symptomatic and asymptomatic subjects regarding frequency of osteoarticular changes including flattening (73.3% vs. 75%), irregularity (36.7% vs. 48.3%), sclerosis (20% vs. 8.3%), cyst (3.3% vs. 3.3%), erosion (13.3% vs. 21.7%), hypoplasia (3.3% vs. 5%), ankylosis (1.7% vs. Zero), osteophyte (43.3% vs. 40%), decrease joint space (3.3% vs. 3.3%), and increase joint space (5% vs. 5%). (p> 0.05). By employing CBCT as a modern diagnostic imaging tool, findings of this study revealed that the frequency of various temporomandibular joint alterations on CBCT images is comparable in patients with and without TMD complaints, suggesting that some people with TMJ structural damage may not display clinical manifestations. Moreover, CBCT imaging might not be necessary for TMD patients and more attention should be given to clinical examination.

Rheumatoid Arthritis of the Temporomandibular Joint, A Clinical and Radiographical Study

To determine the extent of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis compared with a matched control group. And to evaluate the correlation between clinical findings and radiographical findings.The studied sample comprised 50 patients with rheumatoid arthritis, age ranged from 18 to 72 years with the mean age of 40.98 (± 13.67.The control group consisted of 63 subjects age–matched non rheumatic patients: Each patient was informed about the purpose of the investigation and that it would include questionnaire, clinical and radiographical examinations. The radiographic examination was done by using double TMJ lateral panoramic technique.It was found that 64% of RA patients complained of two or more clinical signs and symptoms compared with 44% of the control group ,the difference was statistically significant (P&lt; 0.05), the most important clinical findings were pain on palpation and on opening and closing, crepitation, limitation of jaw opening and morning stiffness, difference were statistically significant (P&lt; 0.05). Among the clinically involved subjects in study RA group 28 subjects (56%) had bilateral involvement, 3 subjects (6%) had right side involved and 1 subject (2%) had only left side involvement. The radiographic involvement of TMJ was found in 16 subjects (32.0 %) of the study group compared with 1subject (1.6 %) of the control group. There is a highly statistically significant difference between the study group and the control group (P&lt; 0.05); the most common radiographical finding was erosion. Complete condylar destruction was found in 1 patient which resulted in anterior open bite. Among involved cases 11 subjects (22%) had bilateral involvement, 5 subjects (10%) had unilateral involvement (3subjects (6%) had left side involved and, 2 (4 %) subjects had only right side involved. There was no correlation between clinical and radiographic find ings. There was correlation between the extent of radiographical findings and duration of Rheumatoid Arthritis p value (P&lt; 0.05).The clinical and radiographic findings were more common in RA group than in control individual. The clinical and radiographic findings are not always bilateral in TMJs of patients with rheumatoid arthritis.Key words: TMJ disorders, TMJ

Incidence of anterior disc displacement without reduction of the temporomandibular joint in patients with dentofacial deformity

The aim of this study was to investigate the incidence of anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) in patients with dentofacial deformity. Eighty-eight female patients (176 joints) with skeletal class III malocclusion and 33 female patients (66 joints) with skeletal class II malocclusion, with or without anterior open bite and asymmetry, were evaluated. Magnetic resonance imaging (MRI) of the TMJ was used to diagnose ADDwoR. A statistical analysis was performed to examine the relationship between ADDwoR and skeletal structure. ADDwoR was present in 37 of the 66 joints (56.1%) in class II compared to 34 of the 176 joints (19.3%) in class III (P<0.05). In class III, ADDwoR was significantly more common in joints with mandibular asymmetry (24/74; 32.4%) than in joints with open bite (9/62; 14.5%) and joints with open bite and without mandibular asymmetry (1/38; 2.6%). In class II, ADDwoR was significantly less common in joints with mandibular asymmetry and without open bite (1/8; 12.5%). ADDwoR was only observed on the deviated side in both class III and class II with mandibular asymmetry. The prevalence of ADDwoR differed according to the dentofacial morphology.

Long-term management of temporomandibular joint degenerative changes and osteoarthritis: An attempt

Background: Osteoarthritis is the inflammation of body joints characterized by chronic degeneration of various hard and soft tissues around joint. Stress-bearing joints of body such as knee, hips, spine, fingers, and temporomandibular joint (TMJ) are commonly affected. Aims and Objectives: The aims were (1) to study whether constant masticatory mechanical overloading causes osteoarthritis and degenerative changes of TMJ in patients who underwent segmental mandibulectomy with primary repair (without microvascular free flap reconstruction) for malignancies of the mandible, floor of the mouth, and lower gingivobuccal sulcus; (2) to evaluate the effect of nutrition supplements such as glucosamine, chondroitin, and esterified fatty acids in reducing TMJ osteoarthritis and internal derangement; and (3) to assess whether joint flexibility and function improved after using the above medication. Materials and Methods: Patients with osteoarthritis and internal derangement of TMJ as well as patients who underwent segmental mandibulectomy followed by postoperative radiotherapy were randomly selected and included in the study. Age group of the patients ranged between 20 and 76 years. Results: One hundred and ninety-two patients of segmental mandibulectomy were screened and 79 patients were found to develop osteoarthritis in the longer contralateral mandibular segment (41.14%). This finding was statistically significant in our study (P

Surgical Treatment of Dentofacial Deformities Caused by Juvenile Idiopathic Arthritis.

The purpose of our retrospective study was to evaluate the results of orthognathic treatment, distraction osteogenesis, and/or prosthetic reconstruction of the temporomandibular joints in patients with juvenile idiopathic arthritis (JIA).Twelve patients with severely affected temporomandibular joints (TMJs) and reduced ramus height were treated with mandibular advancement with orthognathic surgery (11) and additional bilateral or unilateral mandibular ramus distraction (3) or additional bilateral or unilateral prosthetic reconstruction of the TMJ (3). One patient was treated surgically with bilateral TMJ prosthetic reconstruction only. The patients were followed up clinically and radiologically with emphasis on healing, TMJ function, stability of the occlusion, skeletal stability, and facial appearance for an average of 2.3 years after the final surgery. The mean mandibular advancement was 10.1 mm. The mean relapse at pogonion was 2.1 mm, which represents 20.8% of the surgical advancement. The occlusion was stable in 11/12 patients. The TMJ function was good and the facial esthetics improved in all patients. Orthognathic treatment and mandibular ramus distraction osteogenesis provide beneficial lengthening of the mandibular body in JIA patients with asymptomatic and stabile condyles. In adult patients with relapse of the disease or postoperative condylar relapse prosthetic total joint replacement is a reliable and safe alternative.

Intraoperative arthroscopy of temporomandibular joint in patients with condylar head fracture

Intraoperative arthroscopy of temporomandibular joint in patients with condylar head fracture

The impact of arthrocentesis with and without hyaluronic acid injection in the prognosis and synovial fluid myeloperoxidase levels of patients with painful symptomatic internal derangement of temporomandibular joint: a randomised controlled clinical trial.

We aimed to assess the relationship between myeloperoxidase (MPO) and internal derangement (ID) of temporomandibular joint (TMJ) and effects of arthrocentesis procedure, either alone or in combination with hyaluronic acid (HA) injection on the prognosis of ID of TMJ. A prospective randomised controlled trial has been conducted through patients, who underwent arthrocentesis for the treatment of ID of TMJ, were randomly divided into two groups. Group SS (n=10) and Group HA (n=14) patients were assigned 0·9% NaCl solution and sodium hyaluronate intra-articularly, respectively. Synovial fluid samples were assayed for MPO at the time of arthrocentesis and pain visual analogue scale (VAS) and maximum mouth opening (MMO) scores were recorded at pre- and post-operative periods as well as first-week, first-month and third-month intervals. There was a statistically significant decrease in MPO levels between the first to second arthrocenteses only in Group 2 (P=0·001). Both VAS scores and MMO measurements decreased in the course of time following arthrocentesis and donot differ between the patients administered HA or SS. Similarly MPO levels do not change significantly between the two groups at either first or second arthrocenteses. In HA group, MPO levels significantly decreased from first to second sessions. In HA group, MPO levels decreased significantly only in patients with clinical success. Arthrocentesis procedure improves both pain VAS and MMO scores in the course of time, but these parameters do not differ between patients receiving either HA or SS. HA significantly reduces levels of MPO in synovial fluid, but SS does not. HA appears to alleviate inflammation inside the TMJ in patients with TMJ-ID.

Assessment of radiological changes involving the articular surface of the temporomandibular joint in patients with osteoarthritis and rheumatoid arthritis using computed tomography scan: A prospective clinico-radiological study

Background and Objective: The purpose of the present study was to assess the radiological changes involving the articular surfaces of temporomandibular joints (TMJs) in patients with osteoarthritis (OA) and rheumatoid arthritis (RA) using computed tomography (CT) scans. Materials and Methods: A total of 20 patients with OA and 20 patients with RA were subjected to a detailed examination, routine radiography, and CT imaging of the TMJs. CT scanning was carried out for the direct axial view and reconstructed to coronal and sagittal planes with contiguous slice thickness of 2 mm using bone window. All the images were evaluated for the presence of osteophytes, flattening of the articular surfaces, sclerosis, and narrowing of the joint space and subjected to statistical analysis. Results: The female to male ratio of the study group for OA and RA was 2:1, respectively. Of all the CT findings, namely, osteophytes, flattening of the articular surfaces, sclerosis, and narrowing of the joint space, statistically significant values (P = 0.056) for osteophytes were obtained. Flattening and narrowing of joint space were seen in both types of arthritides, however, a relatively higher percentage of such patients was seen in RA group. Conclusion: OA and RA of the TMJ are the two most commonly seen conditions which can impair the functional capacity of the entire masticatory system. Their in-depth clinical and radiological evaluation is a must to assess the disease activity. Likewise, CT is a valuable tool in assessing osseous abnormalities and should be used in cases where osseous involvement of the TMJs is suspected.

Pilot study of the short-term effects of range-of-motion exercise for the temporomandibular joint in patients with temporomandibular joint disc displacement without reduction.

[Purpose] This study investigated the effectiveness of a short-term exercise program combining range-of-motion exercise for the temporomandibular joint and self-traction therapy in patients with temporomandibular joint disc displacement without reduction. [Subjects and Methods] The study participants comprised 36 females with jaw trismus and moderate to severe functional pain. The range-of-motion exercise for the temporomandibular joint was performed at the first visit by the therapist, and the patients were instructed to perform self-traction therapy in the morning and during daily bathing until the next visit 2 weeks later. Maximum mouth opening distance and the visual analogue scale score were used to compare pain on motion and mastication as well as the impact of the program on daily activities at the first consultation and 2 weeks later. [Results] All symptoms were significantly improved after 2 weeks of treatment. [Conclusion] A program that combines exercise for the temporomandibular joint and self-traction therapy can improve range of motion at the joint in the short term and reduce pain and difficulty associated with daily activity in patients with temporomandibular joint disc displacement without reduction. The results of this study suggest that such a program can serve as an effective conservative treatment.

Minimally invasive surgical treatment for temporomandibular joint in patients with various rheumatic diseases

Temporomandibular joint (TMJ) involvement occurs in patients with different rheumatic diseases (RDs). Pain, limitation of mouth opening can lead to significant problems in both oral hygiene and when eating. Conservative treatments for TMJ lesions are not always effective. Objective: to evaluate the efficiency of minimally invasive surgical interventions (TMJ arthrocentesis and arthroscopy) in patients with RDs. Patients and methods. The investigation enrolled 64 patients with different RDs (43 with rheumatoid arthritis, 11 with psoriatic arthritis, 8 with systemic lupus erythematosus, and 2 with ankylosing spondylitis) who were divided into three groups in relation to the severity of TMJ involvement in accordance with the Wilkes classification. All the patients underwent TMJ magnetic resonance imaging at baseline and 6 months after treatment. Also at baseline, 14 days, and 1, 6, and 12 months after surgery, the investigators assessed TMJ pain intensity by visual analogue scale and the parameters of mandibular movements. Patients with Wilkes stages IV and V TMJ involvement underwent arthroscopic intervention into the TMJ and those with III stage received TMJ arthrocentesis with arthrolavage. Results and discussion. After surgical treatment, all the groups were noted to have a significant decrease in TMJ pain intensity compared with the baseline level; moreover, the severity of TMJ pain most significantly decreased on day 7 after surgery. Later on, positive changes remained within subsequent follow-up months. There were data similar in the higher degree of mouth opening. The results of surgical treatment in patients with Wilkes stage V TMJ involvement were worse than in those with stages III and IV. Conclusion. Minimally invasive TMJ surgery in patients with RDs is effective and associated with the low frequency of postoperative complications and exacerbations of RDs. The efficiency of minimally invasive TMJ surgery is higher in patients with the early and middle stages of TMJ involvement according to the Wilkes classification. Further investigations are needed to assess the long-term results of minimally invasive TMJ surgery in patients with RDs.

Assessment of Temporomandibular Joint Diseases in Patients with Rheumatoid Arthritis by Panoramic Radiography and Magnetic Resonance Imaging

1. Abstract 1.1.Objective: To assess the temporomandibular joint in patients with rheumatoid arthritis by both panoramic radiography and MRI. 1.2.Study design: Panoramic radiograph and MRI imaging were performed to forty joints of twenty patients from both sexes and varying ages, complaining of signs and/or symptoms of TMJ involvement. Diagnoses of Rheumatoid Arthritis were according to 1987 ACR criteria for RA. All images were analyzed and scored. 1.3.Results:Comparison between panorama and MRI revealed that there was statistically significant difference regard condyles position in panorama and condylar osseous changes in MRI, temporal cortical bone integrity in panorama and osseous condylar changes in MRIs and finally joints space narrowing in panorama and disc position, disc morphology, and joint effusion in MRIs. While, there was no statistically significant difference regard condyles morphology in panorama and osseous condylar changes in MRIs, and finally joint space narrowing in panorama and revealed retrodiscal band hyper intense signal detected in MR images. Conclusion:There is a significant relation between TMJ involvement and RA disease called TMD-RA. Early diagnosis and management of RA presents an important opportunity to alter the course of this progressive disease. MRI has a great role in detection of early involvement of TMJ in RA patients. This study recommends investigating TMJ in all diagnosed RA patients by MRI as a routine diagnostic tool due to its marvelous benefits.

Evaluación de la movilidad de la articulación temporomandibular en pacientes postintubación orotraqueal mayor de 24 horas

IntroductionThe evaluation, identification of symptoms, and measurement of range of motion of the temporomandibular joint (TMJ) in patients subjected to orotracheal intubation (OTI) is very important in the early rehabilitation of the patient when focusing the intervention on the functionality and identifying TMJ disorders associated with problems related to intubation. ObjectiveTo evaluate joint range of motion of the TMJ in patients subjected to OTI for more than 24hours in an adult intensive care unit in the city of Cali–Colombia, between December 2011 and January 2012. MethodsA cross-section descriptive study was performed by measuring the range of motion of the TMJ with a mandibular aperture analyser on 13 patients on OTI for more than 24hours. ResultsThe mean oral aperture in men was 50.5mm and 46.7mm for women. A total of 31% of the participants reported moderate pain in the TMJ according to the Visual Analogue Scale. A total of 55% of the patients who had bitten the orotracheal tube reported TMJ pain. ConclusionsThere was hypermobility in the mandibular aperture and hypomobility in the lateral deviation. The TMJ pain associated with biting the OTI was not statistically significant.

Ультразвуковая диагностика остеоартроза височно-нижнечелюстного сустава

&lt;p class="p1"&gt;&lt;span class="s1"&gt;The article describes the sensitivity, speci city and accuracy of ultrasound diagnostics of the early stages of of the temporomandibular joint (TMJ) osteoarthritis (OA). The study involved 16 patients with TMJ OA (1 man, 15 women; median age – 56,1±3, and 57 years) and 12 volunteers with normal TMJ (3 men, 9 women; median age – 25,4±2,7 years). Clinical, radiographic, and ultrasonic examination of the TMJ was conducted. The echogram detected thickening of the joint capsule to accompany the TMJ. The width of the front, middle and rear parts of the joint gap was narrower than in the comparison group. The width of the capsule-cervical space in the TMJ patients ranged from 0.5 to 4 mm. In 18.8% of patients with the TMJ capsule width-cervical space was more than 1.9 mm, which is an indirect sign of synovitis. In the descriptions of linear tomograms (TMG) and echogram in patients with TMJ OA were identi ed: subchondral sclerosis, of the joint space narrowing, attening of the limited mobility of the lower jaw head, marginal osteophytes, small subchondral cysts, effusion. The linear tomograms TMJ diagnostic accuracy is 79,2%. The Ultrasonic diagnostics is informative during at the early stages of the TMJ, the diagnostic accuracy was being 59%. TMG and ultrasonic diagnostics of the AO TMJ are not the alternative methods of research. When diagnosing the of early stages of TMJ OA, and determining secondary synovitis priority should be given to the ultrasound. &lt;/span&gt;&lt;/p&gt;