Table 1.

Wilkes staging classification for internal derangement of the TMJ.

Adapted from Bronstein and Thomas [2]

I. Early stage

Early opening reciprocal clicking, no pain, no reduction in mouth opening, slight anterior disc displacement

II. Early/intermediate stage

Pain, mid to late opening click, transient locking, anterior disc displacement, early anatomic disc deformity

III. Intermediate stage

Multiple episodes of pain, locking, reduced mouth opening, anterior disc displacement with anatomic disc deformity, no hard tissue changes

IV. Intermediate/late stage

Increase in severity of degenerative changes, hard tissue degenerative remodelling, disc adhesions but no perforations

V. Late stage

Crepitus, increased pain, chronic restriction of mouth opening, disc perforation, gross anatomic deformity of disc and hard tissues, degenerative arthritic changes