Displacement of the TMJ articular disc can result in decreased joint space; clicking, popping, or crepitation during jaw function; arthritis; condylar resorption; jaw deformities; malocclusion; inflammation; and compression of the bilaminar tissue--all of which can cause various degrees of pain and dysfunction (3).
In 1979, McCarty et al reported a 94% success rate for disc-repositioning surgery; their technique involved removing 3 to 4 mm of the posterosuperior condylar surface and a posterior wedge resection (2 mm) of the bilaminar zone with suture reapproximation (9).
The remaining bilaminar tissues, capsule, subcutaneous tissue, and skin are then closed in a routine manner.
Posteriorly, the bilaminar zone attaches the disk and capsule to the condyle and temporal bone.
As the fibers of the posterior bilaminar zone loosen, the disk no longer reduces.