TMJ Disorders
Internal Derangement
An abnormal relationship of the articular disc to the condyle.
- Disc displacement WITH reduction — the disc reduces on opening → a reciprocal click.
- Disc displacement WITHOUT reduction — the disc blocks translation → closed lock with limited opening.
Wilkes Classification
Five stages charting progression from early clicking to late degenerative changes.
Management Ladder
Conservative first (soft diet, NSAIDs, splints, physiotherapy). Arthrocentesis is the simplest surgical intervention; arthroscopy and open surgery for refractory cases.
Exam Tips ⭐
Click = displacement with reduction; lock = without reduction; Wilkes = 5 stages; arthrocentesis = simplest surgery.
📝 Practice MCQs — TMJ Disorders
Q1. A reciprocal click in the TMJ indicates disc displacement:
A. Without reduction
B. With reduction
C. Perforation
D. Ankylosis
Show Answer
✅ Answer: B
Disc displacement with reduction produces a click as the disc reduces.
Q2. The Wilkes classification has how many stages?
A. 3
B. 4
C. 5
D. 6
Show Answer
✅ Answer: C
Wilkes describes 5 stages of internal derangement.
Q3. The simplest surgical treatment for TMJ internal derangement is:
A. Open joint surgery
B. Arthrocentesis
C. Condylectomy
D. Total joint replacement
Show Answer
✅ Answer: B
Arthrocentesis (lavage) is the least invasive surgical option.
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