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A possible etiology of the internal derangement of the temporomandibular joint based on the MRI observations of the lateral pterygoid muscle

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Abstract

The purpose of this study was to evaluate the relationship of the temporomandibular joint (TMJ) internal derangement and lateral pterygoid muscle (LPM) by magnetic resonance imaging (MRI). In this study, 115 subjects with TMJ internal derangement (total 230 TMJs) and 21 subjects without clinical symptoms (total 42 TMJs) were included. TMJ disc position and LPM were evaluated using MRI. LPM attachments were categorized into two different types: type 1, where fibers of the superior head of the LPM (SLPM) were attached to the disc and fibers of the inferior head of the LPM (ILPM) were attached to condyle, and type 2, where fibers of the SLPM were attached to the disc and condyle, and fibers of the ILPM were attached to condyle. The presence of muscle atrophy and degeneration were also evaluated. LPM attachments were observed in two different parts. Disc displacements were common in the muscle attachments of both types. Type 1 muscle attachments were seen in 85.9% of all the anterior disc displacement without reduction (ADD) TMJs (total 64 TMJs). Atrophy was seen in a higher proportion (43.7%) in TMJs with ADD (28/64) than in TMJs with normal and anterior disc displacement with reduction (ADDR). Out of 74 TMJs with atrophy, 68 had type 1 muscle attachment. Four TMJs had atrophy in both superior and inferior heads of the lateral pterygoid. However, atrophy was not present only in the ILPM. It has been concluded that since the SLPM only attached to the disc in type 1, the disc may displace anteriorly very easily. Therefore, this situation will reduce the function of the SLPM. Reduced muscle function may cause muscle atrophy. The activity of the SLPM may be more reduced since the disc permanently dislocated in TMJs with ADD. Finally, spasm of the LPM causes disc displacement and atrophy and then the degeneration of the LPM may follow disc displacement.

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References

  1. Aziz MA, Cowie RJ, Skinner CE, Abdi TS, Orzame G (1998) Are the two heads of the human lateral pterygoid separate muscles? A perspective based on their nerve supply. J Orofac Pain 12:226–238

    CAS  PubMed  Google Scholar 

  2. Bertorini T, Woodhouse C, Horner L (1994) Muscle hypertrophy secondary to the tethered cord syndrome. Muscle Nerve 17:331–335

    CAS  PubMed  Google Scholar 

  3. Dulcic N, Panduric J, Kraljevic S, Badel T, Celic R (2003) Incidence of temporomandibular disorders at tooth loses in the supporting zones. Coll Antropol 27(suppl 12):61–67

    Google Scholar 

  4. Fujita S, Iizuka T, Dauber W (2001) Variation of heads of lateral pterygoid muscle and morphology of articular disc of human temporomandibular joint: anatomical and histological analysis. J Oral Rehabil 28:560–571

    Article  CAS  PubMed  Google Scholar 

  5. Juniper RP (1981) The superior pterygoid muscle. Br J Oral Surg 19:121–128

    CAS  PubMed  Google Scholar 

  6. Juniper RP (1984) Temporomandibular joint dysfunction: a theory based upon electromyographic studies of the lateral pterygoid muscle. Br J Oral Maxillofac Surg 22:1–8

    Article  CAS  PubMed  Google Scholar 

  7. Katzberg RW, Bessette RW, Tallents RH, et al (1986) Normal and abnormal temporomandibular joint: MR imaging with surface coil. Radiology 158:183–189

    CAS  PubMed  Google Scholar 

  8. Kim HJ, Kwak HH, Hu KS, Park HD, Kang HC, Koh KS, Jung HS (2003) Topographic anatomy of the mandibular nerve branches distributed on the two heads of the lateral pterygoid. Int J Oral Maxillofacial Surg 32:408–413

    Article  CAS  Google Scholar 

  9. Klineberg (1991) The lateral pterygoid muscle: some anatomical, physiological and clinical considerations. Ann R Aust Coll Dent Surg 11:96–108

    CAS  Google Scholar 

  10. Lafreniere CM, Lamontagne M, el-Sawy R (1997) The role of the lateral pterygoid muscles in TMJ disorders during static conditions. Cranio 15:38–52

    CAS  PubMed  Google Scholar 

  11. Laskin D (1994) Etiology and pathogenesis of internal derangement of the temporomandibular joint: current controversies in surgery for internal derangement of the temporomandibular joint. Oral Maxillofac Surg Clin North Am 6:217

    Google Scholar 

  12. Liu ZJ, Wang HV, Pu WY (1989) A comparative electromyography of the lateral pterygoid muscle and arthrography in patients with TMJ disturbance syndrome sounds. J Prosthet Dent 62:229–233

    CAS  PubMed  Google Scholar 

  13. Loughner BA, Gremillion HA, Larkin LH, Mahan PE, Watson RE (1996) Muscle attachment to the lateral aspect of the articular disk of the human temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:139–144

    CAS  PubMed  Google Scholar 

  14. Mahan PE, Wilkinson TM, Gibbs CH, Mauderli A, Brannon LS (1983) Superior and inferior bellies of the lateral pterygoid muscle EMG activity at basic jaw positions. J Prosthet Dent 50:710–718

    CAS  PubMed  Google Scholar 

  15. Manfredini D, Landi N, Romagnoli M, Cantini E, Bosco M (2003) Etiopathogenesis of parafunctional habits of the stomatognathic system. Minerva Stomatol 52:339–345

    CAS  PubMed  Google Scholar 

  16. Naidoo LCD (1996) The lateral pterygoid muscle and its relationship to the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:4–9

    CAS  PubMed  Google Scholar 

  17. Naidoo LCD, Juniper RP (1997) Morphometric analysis of the insertion of the upper head of the lateral pterygoid muscle. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83:441–446

    CAS  PubMed  Google Scholar 

  18. Osborn JW (1985) The disc of the human temporomandibular joint: design, function and failure. J Oral Rehabil 12:279–293

    CAS  PubMed  Google Scholar 

  19. Quemar JC, Ravalec X, Akoka S (1993) Parasagittal magnetic resonance imaging of the lateral pterygoid muscle: a preliminary study. J Orofac Pain 7:169–174

    CAS  PubMed  Google Scholar 

  20. Schellhas KP (1989) MR imaging of the muscles of mastication. Am J Roentgenol 153:847–855

    CAS  Google Scholar 

  21. Sicher H (1960) Oral anatomy, 3rd edn. Mosby, St. Louis, p 142

  22. Thyagarajan D, Kompoliti K, Ford B (1998) Post-traumatic shoulder ‘dystonia’: persistent abnormal postures of the shoulder after minor trauma. Neurology 51:1205–1207

    CAS  PubMed  Google Scholar 

  23. Toller MÖ, Juniper RP (1993) The embryologic development of the human lateral pterygoid muscle and its relationships with the temporomandibular joint disc and Meckel’s cartilage. J Oral Maxillofac Surg 51:772–778

    PubMed  Google Scholar 

  24. Troiano MF (1967) New concept of the insertion of the lateral pterygoid muscle. J Oral Surg 25:337–340

    CAS  PubMed  Google Scholar 

  25. Van Spronsen PH, Weijs WA, Valk J, Prahl-Andersen B, van Ginkel PC (1989) Comparison of jaw-muscle bite-force cross-sections obtained by means of magnetic resonance imaging and high-resolution CT scanning. J Dent Res 68:1765–1770

    PubMed  Google Scholar 

  26. Wanman A, Agerberg G (1990) Etiology of craniomandibular disorders: evaluation of some occlusal and psychosocial factors in 19-year-olds. J Craniomandibular Disorders: Facial Oral Pain 5:35–44

    Google Scholar 

  27. Wilkes CH (1989) Internal derangement of the temporomandibular joint: pathologic variations. Arch Otolaryngol Head Neck Surg 115:469–477

    CAS  PubMed  Google Scholar 

  28. Wilkinson TM (1988) The relationship between the disc and the lateral pterygoid muscle in the human TMJ. J Prosthet Dent 60:715–724

    CAS  PubMed  Google Scholar 

  29. Yang X, Pernu H, Pyhtinen J, Tiilikainen PA, Oikarinen KS, Raustia AM (2001) MRI findings concerning the lateral pterygoid muscle in patients with symptomatic TMJ hypermobility. J Craniomandibular Practice 19:260–268

    CAS  Google Scholar 

  30. Yang X, Pernu H, Pyhtinen J, Tiilikainen PA, Oikarinen KS, Raustia AM (2002) MR abnormalities of the lateral pterygoid muscle in patients with non-reducing disc displacement of the TMJ. J Craniomandibular Practice 20:209–221

    Google Scholar 

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Acknowledgements

The authors would like to thank Associate Professor Cihad Dündar, MD, Department of Public Health, Medical Faculty of Ondokuz Mayıs University, Samsun, for his invaluable support in this project.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Dental Faculty of Ondokuz Mayıs University, Samsun, Turkey

    N. Taskaya-Yılmaz & M. Muglali

  2. Department of Prosthetic Dentistry, Dental Faculty of Ondokuz Mayıs University, Samsun, Turkey

    G. Ceylan

  3. Department of Radiology, Faculty of Medicine of Ondokuz Mayıs University, Samsun, Turkey

    L. Incesu

Authors
  1. N. Taskaya-Yılmaz
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  2. G. Ceylan
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  3. L. Incesu
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  4. M. Muglali
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Correspondence to N. Taskaya-Yılmaz.

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Taskaya-Yılmaz, N., Ceylan, G., Incesu, L. et al. A possible etiology of the internal derangement of the temporomandibular joint based on the MRI observations of the lateral pterygoid muscle. Surg Radiol Anat 27, 19–24 (2005). https://doi.org/10.1007/s00276-004-0267-6

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  • DOI: https://doi.org/10.1007/s00276-004-0267-6

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