Magnetic resonance imaging evaluation of discal attachment of superior head of lateral pterygoid muscle in individuals with symptomatic temporomandibular joint

Omami, Galal; Lurie, Alan G.

doi:10.1016/j.oooo.2012.07.482

Cited by 20 publications

(23 citation statements)

References 26 publications

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“…Naidoo [19] studied the anatomy of the lateral pterygoid in 40 cadaveric dissections and found that the IHLP (inferior head of the lateral pterygoid) inserts into the condylar neck and capsule, and the SHLP (superior head of the lateral pterygoid) has a complex insertion into the condyle and the disccapsule complex. Based on MRI findings, Omami and Lurie [20] classified the anatomy of lateral pterygoid based on the insertion of the superior head. Type I: the superior head of lateral pterygoid inserted solely into the disc and Type II: the superior head of lateral pterygoid inserted into the disc and condyle.…”

Section: Discussionmentioning

confidence: 99%

Disc Anchoring with an Orthodontic Mini-Screw for Chronic Meniscocondylar Dislocation of TMJ

Thomas

Neelakandan

Ahamed

2014

J. Maxillofac. Oral Surg.

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Introduction Various surgical modalities have been tried for the correction of chronic recurrent dislocation of the temporomandibular joint. However, most of these techniques are aimed at creating an artificial block or removing any interference in the path of the translating condyle. Chronic dislocation can also be classified as meniscotemporal and menisocondylar, depending upon whether the dislocation occurs between the condyle-disc unit and temporal bone (meniscotemporal), or between the disc and condyle (meniscocondylar). Very few procedures address the primary issue of a malpositioned disc, which is the cause of meniscocondylar dislocation. Materials and Methods This study was conducted on 17 patients (27 joints) who reported with chronic dislocation of the temporomandibular joint, with MRI-proven meniscocondylar dislocation. After exposure of the condyle and disc through a standard pre-auricular incision, an orthodontic mini-screw was fixed to the posterior aspect of the condylar head and a 1-0 Prolene suture passed through the screw-head eyelet, plicating the posterior edge of the disc to the condyle. This ensured that the condyle and disc would move in unison.Results All the patients showed improvement in their symptoms of dislocation in the postoperative period, including seven patients in whom only a unilateral procedure was carried out. None of the patients had any recurrence till the 1-year followup. Conclusion Our procedure addresses the fundamental etiology of meniscocondylar dislocation by anchoring the disc to the condyle by using an orthodontic mini-implant and correcting the condyle-disc disharmony. This technique is reliable, technically feasible, and cost-effective in the Indian set up.

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Section: Discussionmentioning

confidence: 99%

Disc Anchoring with an Orthodontic Mini-Screw for Chronic Meniscocondylar Dislocation of TMJ

Thomas

Neelakandan

Ahamed

2014

J. Maxillofac. Oral Surg.

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“…4 It is believed that this disorder may stem from LPM dysfunction or from poor co-ordination between the two heads. 1,6 However, there is currently no compelling scientific evidence that LPMs of TMD patients are functionally disturbed.…”

Section: Discussionmentioning

confidence: 99%

“…3 Although temporomandibular disorders (TMDs) are multifactorial, it is widely accepted that disturbances in lateral pterygoid muscle activity play an important role in the etiology of these disorders. 4 However, there is currently no rigorous scientific evidence correlating the two conditions. 1 Moreover, the role of LPM in normal functioning remains controversial.…”

Section: Introductionmentioning

confidence: 99%

“…The technique is able to provide morphological and positional information of the articular disc through high resolution images of soft tissue without exposing patients to radiation. [2][3][4][5] Although the LPM has been extensively studied in recent years, its anatomy and physiological and clinical implications are not fully understood. 4 The aim of this study was to determine the relationship between articular disc position and area measurements of the SH and IH of the LPM using MR imaging.…”

Section: Introductionmentioning

confidence: 99%

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Dimensional changes in lateral pterygoid muscles and disc position during mandibular movement using magnetic resonance imaging

et al. 2014

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| The lateral pterygoid muscle (LPM) has been the focus of numerous studies attempting to elucidate its possible role in temporomandibular disorders (TMDs). Disc displacement is widely accepted as a fi nding characteristic of this clinical condition. However, few studies have investigated the association between disc position and morphological alterations of the LPM. Objectives: to investigate the relationship between articular disc position and area measurements of the superior head (SH) and inferior head (IH) of the LPM using magnetic resonance (MR) imaging. Methods: The sample comprised 148 temporomandibular joints (TMJs) of 74 patients with complaints of pain and/or dysfunction in the TMJ area. Sagittal plane images were used for assessments of disc position and for tracings. Tracings of the areas of the heads were performed under 4 mandibular positions (at rest, and openings of 10 mm, 20 mm, and 30 mm) with the aid of image processing software. Data acquired was subjected to statistical analysis. Results: Statistical tests revealed changes in LPM head areas during mandibular opening movement, showing a reduction in total IH area and more heterogeneous changes in SH area. Relevance: The IH mean area was reduced in the positions assessed and showed no correlation with disc displacement. For the SH, reduced mean area was associated with anterior disc displacements without reduction, while increased mean areas were correlated with anterior disc displacement with reduction.descrIPtors | Magnetic Resonance Imaging; Temporomandibular Joint; Pterygoid Muscles. resuMo | Avaliação por ressonância magnética da alteração dimensional do músculo pterigóideo e da posição do disco articular no movimento mandibular • O músculo pterigóideo lateral (MPL) tem sido o foco de inúmeros estudos que tentam elucidar o seu possível papel na disfunção temporomandibular, condição na qual o deslocamento do disco é amplamente aceito como um possível aspecto clínico. No entanto, poucos estudos investigaram a associação entre a posição do disco e alterações morfológicas do MPL. Objetivos: investigar a relação entre a posição do disco articular e a área da porção superior e da porção inferior da músculo pterigóideo lateral usando ressonância magnética. Métodos: A amostra foi composta por 148 articulações temporomandibulares de 74 pacientes com queixa de dor e/ou disfunção articular. Imagens em plano sagital foram utilizadas para a avaliação da posição do disco e para traçados. Traçados das áreas do músculo foram realizados em 4 posições mandibulares (em repouso, e em aberturas de 10 mm, 20 mm e 30 mm) com a ajuda de software de processamento de imagem. Os dados adquiridos foram submetidos à análise estatística. Resultados: Os testes estatísticos revelaram mudanças nas áreas superior e inferior do músculo pterigóideo lateral durante o movimento de abertura mandibular, mostrando uma redução na área total e mudanças mais heterogêneos na área superior. Relevância: Observou-se que a área média da porção inferior muscular estava reduzida...

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“…[1][2][3] However, recent literature has brought speculation and controversy on the anatomical variations of the LPM, particularly regarding the insertion into the disc-condyle complex. [4][5][6][7] Studies on human specimens have revealed the presence of a third head of the LPM. Moreover, from three to four different types of muscle attachment have been distinguished.…”

Section: Introductionmentioning

confidence: 99%

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

Litko¹,

Szkutnik²,

Berger³

et al. 2016

Dentomaxillofacial Radiology

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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.

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Magnetic resonance imaging evaluation of discal attachment of superior head of lateral pterygoid muscle in individuals with symptomatic temporomandibular joint

Cited by 20 publications

References 26 publications

Disc Anchoring with an Orthodontic Mini-Screw for Chronic Meniscocondylar Dislocation of TMJ

Disc Anchoring with an Orthodontic Mini-Screw for Chronic Meniscocondylar Dislocation of TMJ

Dimensional changes in lateral pterygoid muscles and disc position during mandibular movement using magnetic resonance imaging

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

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