Correlation between the lateral pterygoid muscle attachment type and temporomandibular joint disc position in magnetic resonance imaging

Abstract

Objectives: The aim of this study was to investigate the correlation between the lateral pterygoid muscle (LPM) attachment type and temporomandibular joint (TMJ) disc position on sagittal and coronal MR scans. Methods: 191 patients (148 females, 43 males), aged 14-60 years, underwent MR investigations of the TMJs in the intercuspal position (IP) and open-mouth position (OMP). The disc position was evaluated on oblique sagittal and coronal images in the IP and OMP on many MRI sections showing all portions of the joint. Relationships between the LPM attachment patterns and articular disc positions were evaluated by z and x 2 tests. Results: Three types of the LPM attachment were found. There was a statistically significant correlation between the LPM attachment type and the disc position in IP (x 2 5 24.29; p , 0.01). The type of muscle attachment did not determine the prevalence of normal, lateral and medial disc positions. There were differences between the muscle attachment types in the anterior, anteromedial and anterolateral disc positions. There was a statistically significant association between TMJ disc position in OMP and particular attachment types in the sagittal plane (x 2 5 9.702; p , 0.01). Conclusions: Certain types of the LPM insertion are correlated with TMJ disc position.

Sex‐related differences in symptoms of temporomandibular disorders and structural changes in the lateral pterygoid muscle after whiplash injury

“…However, in another MRI study of patients presenting with symptoms of TMD after sustaining whiplash injury, >50% of the patients had abnormal TMJ and LPM features . Considering that the LPM moves the TMJ forward and because the superior LPM is connected to the disc, LPM attachment to the TMJ disc may be correlated with disc displacement . In addition, because the masticatory muscles function cooperatively and elaborately during jaw movement, the pathological changes in the LPM will ultimately affect other masticatory muscle pathologies.…”

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials

“…Apart from apparent need when LPM and/or MPM are a particular reason for the direct or referred pain with developed MTPs, there also is a diagnostic application for LPM injections as well as the potentiality to treat certain types of TMJ internal derangements [ 70 ]. Litko et al, in the study based on MR scans of 191 patients, determined three main patterns of LMP attachment to the TMJ’s disc–condyle complex and stated a positive correlation primarily between anteromedial displacement of the disc and the presence of LMP head inserting solely the TMJ capsule [ 71 ]. Importantly, it was highlighted that the attachment type is most likely just a cofactor of the internal derangements and there have to be other factors, such as trauma or a disrupted joint structure, for the displacements to occur [ 71 ].…”

“…Litko et al, in the study based on MR scans of 191 patients, determined three main patterns of LMP attachment to the TMJ’s disc–condyle complex and stated a positive correlation primarily between anteromedial displacement of the disc and the presence of LMP head inserting solely the TMJ capsule [ 71 ]. Importantly, it was highlighted that the attachment type is most likely just a cofactor of the internal derangements and there have to be other factors, such as trauma or a disrupted joint structure, for the displacements to occur [ 71 ]. In the cases discussed, application of the botulinum toxin into the LMPs may allow for treatment of the derangements as well as aid in the diagnosis of the acoustic symptoms originating from TMJ, as weakening the LMPs should result in a reduction of the reciprocal click [ 70 , 72 ].…”

Redirection of Para-sagittal Cuts of Magnetic Resonance Imaging For Temporomandibular Joint

“…This influence started with plain radiographic techniques, like transcranial and trans-orbital techniques (8,9) and flourished with conventional tomography (10) , and extended to contemporary X-ray based crosssectional techniques like multislice and cone beam computed tomography (11,12) and even non-ionizing radiation dependent modalities, like MRI (13) . In some cases the outline of the condyle is not clear enough in axial MR images (14) , this lack of clarity is due to either changes in the condyle itself or due to insufficient quality of localizing axial cuts.…”