Blood Supply of the Temporomandibular Joint

¹ Department of Anatomy, Indiana University Medical Center, Indianapolis, Indiana, and West Virginia University Medical Center, Morgantwon, West Virginia

We have attempted to give an integrated account of the blood supply of the temporomandibular joint as a whole and of each of its components. The technique involved intravascular precipitation of lead chromate followed by clearing, then microdissection at relatively low levels of magnification. Our aim has been to illuminate in three dimensions the horizon of structure between that seen by the gross anatomist with the naked eye, and that studied at high magnification by the histologist using sectioned material.

The capsule completely surrounds the joint with a connective tissue envelope in which courses an extensive vascular plexus. Vessels from all adjacent areas and of all moderate sizes enter the substance of the capsule to feed the capsular plexus. The greatest supply appears to enter the posterior aspect through the retrodiscal pad. Some of the blood supply to this plexus is seen coming from vessels that arise within the mandible or temporal bone, entering at the line of attachment of the capsule. Communications were also frequently seen between periosteal vessels and the capsular plexus. Finally, the intramuscular vascular bed of the external pterygoid muscle is seen as a major contributor. Within the joint a circumferential channel lying in the marginal, connective-tissue attachment of the disc sends two distinct layers of capillary loops, one to the superior and one to the inferior surface. Each ends in a well defined border. The head of the condyle and the articular fossa show similar vascular patterns, i.e., a circumferential zone of delicate capillary loops ending abruptly and delineating an avascular central area. Both also appear to receive some blood supply from the depths of underlying bone. The synovial membranes of both cavities show an infolded fringe with fine capillary loops on both surfaces.