Imaging Sci Dent.  2013 Mar;43(1):37-44. 10.5624/isd.2013.43.1.37.

The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

• Cuccia AM
• Caradonna
• Caradonna
• Anastasi G
• Milardi D
• Favaloro A
• De Pietro
• Angileri T
• Caradonna
• Cutroneo G

• KMID: 2167445
• DOI: http://doi.org/10.5624/isd.2013.43.1.37

Abstract

PURPOSE
The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint.
MATERIALS AND METHODS
Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied.
RESULTS
The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint.
CONCLUSION
The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

Keyword

Three-Dimensional Imaging, Computer Generated; Magnetic Resonance Imaging; Temporomandibular Joint; Blood Supply

MeSH Terms

Arteries
Arthroplasty
Female
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Male
Maxillary Artery
Meningeal Arteries
Neck
Temporal Arteries
Temporomandibular Joint
Temporomandibular Joint Disorders

Figure

• 

  Fig. 1 Posterior view of computerized tomography rendering of the temporomandibular joint of a 30-year-old healthy female. The external carotid artery (a), the internal maxillary artery (b), the superficial temporal artery (c), the transverse facial artery (d), with their small diverging arteries (e), the middle meningeal artery (g), the retrodiscal tissue (i), the ramus (l) and the condyle (m)

• 

  Fig. 2 Posterior and lateral view of computerized tomography rendering of the temporomandibular joint of a 30-year-old healthy female. The external carotid artery (a), the internal maxillary artery (b), the superficial temporal artery (c), the transverse facial artery (d), the inferior dental artery (f), the middle meningeal artery (g), the anterior tympanic artery (h), the retrodiscal tissue (i), the ramus (l) and the condyle (m), the temporal posterior artery (t)

• 

  Fig. 3 Posterior view of computerized tomography rendering of the temporomandibular joint of a 30-year-old healthy female. The external carotid artery (a), the internal maxillary artery (b), the transverse facial artery (d) with their small diverging arteries (e), the inferior dental artery (f), the middle meningeal artery (g), the anterior timpanic artery (h), the retrodiscal tissue (i), the ramus (l) and the condyle (m)

• 

  Fig. 4 Computerized tomography rendering of the left temporomandibular joint of a 28-year-old healthy male (A) and diagram (B) show the branches of maxillary artery. The external carotid artery (a), the internal maxillary artery (b), the inferior dental artery (f), the middle meningeal artery (g), the condyle (m), the masseteric artery (n), the pterygoid artery (o), the sphenopalatine artery (p), the sphenopalatine foramen (q), the deep temporal artery (v)

• 

  Fig. 5 Lateral angiograms (A) and diagrams (B and C) of the internal maxillary artery and the superficial temporal artery arising from the external carotid artery. The external carotid artery (a), the internal maxillary artery (b), the superficial temporal artery (c), the transverse facial artery (d), the inferior dental artery (f), the masseteric artery (n), the pterygoid artery (o), the sphenopalatine artery (p), the occipital artery (r), the auricular posterior artery (s), the temporal posterior artery (t), the deep temporal anterior artery (u), the deep temporal artery (v)

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