In an article published in the ODF Review in 1987, we described the static relationships existing between and among the different components of the temporomandibular joint. This new article completes that work by supplying a dynamic vision of the range of movement, as well as recent anatomical and electromyographic data concerning the lateral pterygoid muscle.

Athletes of various sports are required to utilize mouthguards during practice and competitions for protection against orofacial and dental injuries, regardless of the effects on performance. Recent advances in neuromuscular dentistry have led to the development of a mouthguard touted also to enhance the performance through jaw realignment. The purpose of this study was to compare the effects of a neuromuscular dentistry-based mouthguard to a standard, custom-fitted mouthguard (CFM) on muscular endurance, anaerobic power and anaerobic capacity in competitive athletes. Professional and Division I college athletes (n = 22, Mweight = 86.2 ± 3.1 kg) participated in this double-blind, crossover study. Subjects were randomly assigned to order of use of either the experimental (Pure Power Mouthguard (PPM)) or the traditional CFM. Subjects completed two separate sessions in which they completed three performance tests, which included vertical jump (VJ), bench press (BP) and a 30 s Wingate anaerobic test (WAnT)+eight 10 s intervals, while wearing the assigned mouthguard. Significantly better performance was found for PPM compared with CFM for VJ (67.6+9.4 cm vs. 65.3+8.6 cm; P = 0.003), 30 s WAnT peak power (11.6 ± 1.7 W kg− 1vs. 11.1 ± 1.5 W kg− 1, P = 0.038), average peak power for WAnT+intervals (10.6 ± 1.4 W kg− 1vs. 10.1 ± 1.2 W kg− 1, P = 0.025) and average mean power for WAnT+intervals (9.0 ± 1.1 W kg− 1vs. 8.7 ± 1.0 W kg− 1, P = 0.034). There were no significant differences for either BP or 30 s WAnT mean power (P>0.48). Compared with a CFM, a neuromuscular dentistry-based mouthguard appears to enhance peak power output, performance and repeated maximal efforts. When required to wear a mouthguard, athletes may benefit from wearing a neuromuscular dentistry-designed mouthguard compared with a CFM.

Synovial chondromatosis is a condition which often affects the major joints. On rare occasions, it may affect the temporomandibular joint. We report such a case, which was mistakenly diagnosed and treated as a parotid mass. We include relevant radiological and histological investigations and a brief literature review.

Malignant (invasive) otitis externa (MOE) is an infection involving the external auditory meatus (EAM), most often found in elderly diabetics, which carries a high morbidity and mortality. In advanced cases it may give rise to osteomyelitis and cranial neuropathies. This is a case of MOE, which invaded the posterior wall of the right temporomandibular joint (TMJ), resulting in severe trismus and pain. Subsequently, this required treatment by replacement of the glenoid fossa with a Silastic® prosthesis.

A case of an eight-month-old girl with an abscess in the temporomandibular joint as a complication of acute otitis media is described. The complications of acute otitis media in general and the probable explanation for the development of this complication are discussed.

This report describes the clinical and radiographic findings together with surgical management of temporomandibular joint contents herniation through the tympanic plate of the external auditory canal. Two patients are reported. A review of the literature is presented, including a brief discussion of the embryological development of the external auditory canal. Excluding infection, trauma or neoplasm, the defect in the tympanic plate of the external auditory canal represents a developmental aberration with failure of the foramen of Huschke to close during development.

A pre-auricular approach with insertion and fixation of an onlay polyethylene implant to prevent prolapse of the peri-articular tissues into the ear canal is presented and described.

Malignant (invasive) otitis externa is an infection involving the external ear canal, often in elderly diabetic patients, which carries a high morbidity and mortality. It may involve widespread areas of soft tissue around the skull base, and in more advanced cases, may give rise to osteomyelitis and cranial neuropathy. We describe two patients who were treated for malignant otitis externa complicated by destructive osteomyelitis of the temporomandibular joint (TMJ). For both patients, diagnosis was made using magnetic resonance imaging (MRI), and repeat scans were employed during follow-up. Improved scan appearances mirrored improvements in clinical condition in both cases.

A study was carried out on the discomalleolar ligament by dissection of adult human cadavers. The ligament corresponds to the most internal portion of the superior lamina of the temporomandibular joint capsule. It extends from the posterointernal portion of the temporomandibular joint disc, penetrates the petrotympanic fissure and reaches the malleus of the middle ear. Because of its morphology and anatomical arrangement the discomalleolar ligament should be considered as an intrinsic ligament of the temporomandibular joint and distinguished from the tympanic portion of the sphenomandibular ligament (anterior ligament of the malleus).

Pigmented villonodular synovitis, a benign but locally destructive fibrohistiocytic proliferative lesion involving tendon sheaths, bursae and diarthrodial joints, is distinctly rare in the temporomandibular joint. We report one such case occurring in a 42-year-old housewife who presented with a progressively enlarging right zygomatic mass for six months. On exploration, an orange-brown firm mass, 5 × 3 × 2 cm, was seen adherent to the lateral aspect of the capsule of the right temporomandibular joint, and eroding into the inferior aspect of the right temporal bone and part of the mandibular condyle. The mass was completely excised. Pathological examination showed features typical of those of pigmented villonodular synovitis and the lesion was entirely extra-articular in location. The patient remained well with no evidence of local recurrence two years after operation. Review of the literature and careful analysis of the clinicopathological features showed that the vast majority of the reported cases of pigmented villonodular synovitis of the temporomandibular joint belonged to the extraarticular variant, which is associated with a more aggressive local infiltrative behaviour and higher rate of local recurrence than the localized type. The recommended treatment for this condition is therefore wide local excision, aiming to remove the lesion as completely as possible without producing severe disability for the patient.

Tumours and pseudotumorous lesions originating from the synovial membrane of the temporomandibular joint are rare. We report a series of six cases of such disorders. There were two cases of synovial chondromatosis, two of calcium pyrophosphate dihydrate crystal deposition disease, one nodular synovitis and one synovial sarcoma. Three patients were female and three were male. Their ages ranged from 36 to 70 years. All had atypical clinical and radiographical presentation. The prevalence, clinical and radiographical findings and pathological features of each disease entity are discussed and a review of the literature is made concerning all tumours and pseudotumours arising from the temporomandibular joint.

Pigmented villonodular synovitis is a benign reactive process of the synovial tissue, that usually involves the knee or other major joints. Reports of this entity in the temporomandibular joint are rare. The authors describe a case involving this joint, initially clinically diagnosed as a parotid tumour.

Loss of bony integrity of the temporomandibular joint may result in prolapse of the joint capsule into the external auditory canal. This in turn gives rise to arthralgia, trismus and earache and a risk of septic arthritis.

We describe a technique of repair which is simple, uses autologous tissue and has an acceptable cosmetic and functional result.