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Revista de la Sociedad Española del Dolor

versión impresa ISSN 1134-8046

Resumen

ROSA-VALENCIA, A. et al. Nerve distribution in human temporomandibular articular disc using Sihler staining technique: a cadaveric descriptive approach. Rev. Soc. Esp. Dolor [online]. 2018, vol.25, n.6, pp.335-341. ISSN 1134-8046.  https://dx.doi.org/10.20986/resed.2017.3646/2017.

Introduction:

Variable expression of symptomatology in temporomandibular disorders (tMD) is a challenge for clinician, because source of pain is not easy to identify. Articular disc is directly linked to the mandibular function and in pathological conditions can be altered its position and consequelty its zone of load. The aim of this study was to describe the intradiscal nerve distribution of temporomandibular joint disc in human cadavers. Although the presence of sensitive nerve terminals in the disc and the nerve trunks potentially involved have been identified, the way the nerves are distributed inside disc remains unprecised.

Material and method:

Anatomical dissection of 8 articular discs of the temporomandibular joints on the right side of preserved cadavers was performed. The articular discs were subjected to the Sihler staining method and then observed under a stereoscopic loupe and transillumination, A standardized photograph was perform by arbitrarily dividing the disk into 5 zones (medial, lateral, anterior, posterior, central) and characterized the nerve distribution.

Results:

Presence of nerve structures was observed in all areas except the central zone. Nerve structures run as a single or multiple trunk in anterior-posterior direction with a variable number of collateral in lateral and medial areas of disc, comunicating retrodiscal zone and posterior zone of lateral pterigoid muscle in all samples.

Conclusion:

It can be identified a common inervation pattern in all discs. The disc is innervated in its periphery by nerve trunks that present an anterioriposterior path. The communication between different anatomical regions by nervous continuity, as well as the innervation pattern of the disc, could explain situations of local pain and referred in TMD.

Palabras clave : Temporomandibular joint; articular disc; Sihler staining; innervation pattern.

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