Histologic appearance of the bilaminar zone in internal derangement of the temporomandibular joint

Light microscopy was used to examine twenty-six specimens of bilaminar zone tissue excised during surgery for correction of internal derangement of the temporamandibular joint. Each of the specimens was examined for the presence of inflammation, amount of vascularity, arterial wall thickness, presence of fat, appearance of collagen, and amount of elastin present. Wide variation in the histologic appearance was noted among the specimens, although no significant inflammation was observed in any of them. Some indications that this tissue is undergoing adaptive changes include the presence of thickened arterial walls suggesting a decreased blood flow and the tendency for decreased amounts of elastin to be associated with denser-appearing collagen. There is also a tendency for patients with complete dislocation to exhibit less elastin than those with partial dislocation of the meniscus.