The posterior disc attachment (bilaminar zone) is the vascular, elastic retrodiscal tissue connecting the posterior margin of the articular disc to the posterior glenoid fossa and mandibular condyle. It consists of superior elastic and inferior inelastic laminae.
The elastic superior lamina recoils the disc posteriorly during jaw closing, while the inferior lamina limits forward disc translation. The richly vascularised and innervated tissue between the laminae is the primary pain source in TMJ disc displacement.
The bilaminar zone becomes compressed and painful when the disc is displaced anteriorly and the condyle rides directly on this tissue. Retrodiscitis produces exquisite posterior joint pain worsened by biting. Bilaminar zone injection targets this tissue for pain management.
Inflammation of the bilaminar zone from condylar loading of the retrodiscal tissue in anterior disc displacement, producing posterior TMJ pain worsened by mastication.
Tearing of the posterior disc attachment in severe disc displacement, allowing condyle-fossa direct bony contact and progressive joint degeneration.
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