Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지
DOI QR코드

DOI QR Code

Relationship between Temporomandibular Joint Disorders and Horizontal Morphology of Lateral Pterygoid Muscle

외측 익돌근의 수평적 형태와 측두하악관절장애 간의 상관성

  • Jung, Jae-Kwang (Department of Oral Medicine, School of Dentistry, Kyungpook National University Daegu) ;
  • Kwon, Choonik (Department of Oral Medicine, School of Dentistry, Kyungpook National University Daegu) ;
  • Byun, Jin-Seok (Department of Oral Medicine, School of Dentistry, Kyungpook National University Daegu) ;
  • Choi, Jae-Kap (Department of Oral Medicine, School of Dentistry, Kyungpook National University Daegu)
  • 정재광 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 권춘익 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 변진석 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 최재갑 (경북대학교 치의학전문대학원 구강내과학교실)
  • Received : 2013.04.18
  • Accepted : 2013.05.15
  • Published : 2013.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate the relationship between horizontal morphology of lateral pterygoid muscle and onset of temporomandibular joint disorders. Randomly selected 150 subjects, assigned with equal number in terms of gender and age group, were included. The axial and sagittal images in their magnetic resonance images of the temporomandibular joints were used to measure the morphologic characteristics of lateral pterygoid muscles and temporomandibular joints. The measurement variables were maximal horizontal width and insertion angle to the condyle, position of the articular disc, condylar deformity, and joint effusion. In addition, presence or absence of the temporomandibular joint pain was examined through history and palpation of the joints. The relationships among measurement variables were analyzed and the results were as follow. The insertion angle of the lateral pterygoid muscle to the condyle was higher in the joint of anterior disc displacement without reduction than that in the joint of normal disc position. In addition, the maximal horizontal width of the lateral pterygoid muscle was significantly increased in joints with pain than those without pain. Also, the insertion angle was significantly higher in younger age group and the maximal width was significantly greater in male than in female. These results suggest that high insertion angle of lateral pterygoid muscle might be an important anatomic predisposing factor for anterior disc displacement in temporomandibular joint and muscular activity of lateral pterygoid muscle might be affected by preauricular pain. In conclusion, there might be a bi-directional interaction between lateral pterygoid muscle and joint in the progression of anterior disc displacement in temporomandibular joint.

이 연구의 목적은 측두하악관절장애와 외측 익돌근의 수평적 형태 간의 연관성을 조사하는 것이다. 이를 위해 10대에서 50대까지 연령군별로 각 남녀 15명씩 임의로 선정한 총 150명의 측두하악관절장애 환자에서 자기공명영상의 수평면 및 시상면상에서 나타난 외측 익돌근 및 측두하악관절의 형태적 특성을 조사하였다. 조사한 해부학적 특성은 외측 익돌근의 최대폭경, 수평 부착각도, 관절원판의 위치, 과두의 변형여부, 관절 삼출액 여부 등이며, 또한 전이부의 통증여부, 과두 주변의 압통 유무와 같은 임상적 소견이 포함되었다. 이들 해부학적 특성 및 임상적 소견의 상호 간 관련성을 분석한 결과, 비정복성 관절원판 변위를 가진 경우 외측 익돌근의 부착각도가 유의하게 높았으며 전이부에 통증이 있는 경우에는 최대 폭경이 유의하게 큰 것으로 나타났다. 뿐만 아니라 연령이 낮을수록 부착각도가 유의하게 높았으며 남성에서 최대 폭경이 더 큰 것으로 나타났다. 위의 결과를 통해 외측 익돌근 수평 부착각도가 관절원판 변위와 유의한 관련성이 있으며 전이부의 통증이 최대 폭경을 증가시키는 것으로 생각된다. 결론적으로 외측 익돌근의 높은 수평 부착각도가 관절원판 변위 발생의 중요한 해부학적 기여요인이 될 수 있으며, 측두하악관절의 통증은 외측 익돌근의 활성에 영향을 줄 수 있을 것으로 추정된다.

Keywords

References

  1. Wang MQ, Yan CY, Yuan YP. Is the superior belly of the lateral pterygoid primarily a stabilizer? An EMG study. J Oral Rehabil. 2001;28:507-10. https://doi.org/10.1046/j.1365-2842.2001.00703.x
  2. Finden SG, Enochs WS, Rao VM. Pathologic changes of the lateral pterygoid muscle in patients with derangement of the temporomandibular joint disk: objective measures at MR imaging. AJNR Am J Neuroradiol. 2007;28:1537-1539. https://doi.org/10.3174/ajnr.A0590
  3. Taskaya-Yilmaz N, Ceylan G, Incesu L, Muglali M. A possible etiology of the internal derangement of the temporomandibular joint based on the MRI observations of the lateral pterygoid muscle. Surg Radiol Anat. 2005;27:19-24. https://doi.org/10.1007/s00276-004-0267-6
  4. Yang X, Pernu H, Pyhtinen J, Tiilikainen PA, Oikarinen KS, Raustia AM. MR abnormalities of the lateral pterygoid muscle in patients with nonreducing disk displacement of the TMJ. Cranio. 2002;20: 209-221.
  5. Okeson JP, Management of temporomandibular disorders and occlusion, 6th ed., St. Louis, Mosby., pp. 113.
  6. Filho HP, Suazo GI, Zavando D, Guimaraes AS. Anterior disc displacement and the superior head of lateral pterygoid muscle. A case-control study. Int. J. Morphol. 2010;28:365-368.
  7. Dergin G, Kilic C, Gozneli R, Yildirim D, Garip H, Moroglu S. Evaluating the correlation between the lateral pterygoid muscle attachment type and internal derangement of the temporomandibular joint with an emphasis on MR imaging findings. J Craniomaxillofac Surg. 2012;40:459-463. https://doi.org/10.1016/j.jcms.2011.08.002
  8. D'Ippolito SM, Borri Wolosker AM, D'Ippolito G, Herbert de Souza B, Fenyo-Pereira M. Evaluation of the lateral pterygoid muscle using magnetic resonance imaging. Dentomaxillofac Radiol. 2010;39: 494-500. https://doi.org/10.1259/dmfr/80928433
  9. Grünheid T, Langenbach GE, Korfage JA, Zentner A, van Eijden TM. The adaptive response of jaw muscles to varying functional demands. Eur J Orthod. 2009;31:596-612. https://doi.org/10.1093/ejo/cjp093
  10. Hather BM, Tesch PA, Buchanan P, Dudley GA. Influence of eccentric actions on skeletal muscle adaptations to resistance training. Acta Physiol Scand. 1991;143:177-185. https://doi.org/10.1111/j.1748-1716.1991.tb09219.x
  11. Staron RS, Karapondo DL, Kraemer WJ et al. Skeletal muscle adaptations during early phase of heavy-resistance training in men and women. Appl Physiol. 1994;76:1247-1255.
  12. Premkumar S, Textbook of craniofacial growth, New Delhi India, 2011, Jaypee Brothers Medical Publishers Ltd., pp. 238.
  13. Castelo PM, Gavião MB, Pereira LJ, Bonjardim LR. Evaluation of changes in muscle thickness, bite force and facial asymmetry during early treatment of functional posterior crossbite. J Clin Pediatr Dent. 2010;34:369-374. https://doi.org/10.17796/jcpd.34.4.656rh557093373k4
  14. Buchner R, Van der Glas HW, Brouwers JE, Bosman F. Electromyographic parameters related to clenching level and jaw-jerk reflex in patients with a simple type of myogenous cranio-mandibular disorder. J Oral Rehabil. 1992;19:495-511. https://doi.org/10.1111/j.1365-2842.1992.tb01113.x
  15. Svensson P, Wang K, Sessle BJ, Arendt-Nielsen L. Associations between pain and neuromuscular activity in the human jaw and neck muscles. Pain. 2004;109:225-232. https://doi.org/10.1016/j.pain.2003.12.031
  16. Svensson P, Graven-Nielsen T, Matre D, Arendt- Nielsen L. Experimental muscle pain does not cause long-lasting increases in resting electromyographic activity. Muscle Nerve. 1998;21:1382-1389. https://doi.org/10.1002/(SICI)1097-4598(199811)21:11<1382::AID-MUS4>3.0.CO;2-5
  17. Murray GM, Phanachet I, Uchida S, Whittle T. The human lateral pterygoid muscle: a review of some experimental aspects and possible clinical relevance. Aust Dent J. 2004;49:2-8. https://doi.org/10.1111/j.1834-7819.2004.tb00042.x
  18. Phanachet I, Whittle T, Wanigaratne K, Klineberg IJ, Sessle BJ, Murray GM. Functional heterogeneity in the superior head of the human lateral pterygoid. J Dent Res. 2003;82:106-111. https://doi.org/10.1177/154405910308200206
  19. Poveda Roda R, Bagan JV, Díaz Fernández JM, Hernández Bazán S, Jiménez Soriano Y. Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors. Med Oral Patol Oral Cir Bucal. 2007;12:E292-298.
  20. Buescher JJ. Temporomandibular joint disorders. Am Fam Physician. 2007;76:1477-1482.
  21. Newton JP, Abel EW, Robertson EM, Yemm R. Changes in human masseter and medial pterygoid muscles with age: a study by computed tomography. Gerodontics. 1987;3:151-154.
  22. Newton JP, Yemm R, Abel RW, Menhinick S. Changes in human jaw muscles with age and dental state. Gerodontology. 1993;10:16-22. https://doi.org/10.1111/j.1741-2358.1993.tb00074.x
  23. Palinkas M, Nassar MS, Cecílio FA et al. Age and gender influence on maximal bite force and masticatory muscles thickness. Arch Oral Biol. 2010;55:797-802. https://doi.org/10.1016/j.archoralbio.2010.06.016
  24. Monemi M, Eriksson PO, Eriksson A, Thornell LE. Adverse changes in fibre type composition of the human masseter versus biceps brachii muscle during aging. J Neurol Sci. 1998;154:35-48. https://doi.org/10.1016/S0022-510X(97)00208-6
  25. Monemi M, Thornell L, Eriksson P. Diverse changes in fibre type composition of the human lateral pterygoid and digastric muscles during aging. J Neurol Sci. 1999;171:38-48. https://doi.org/10.1016/S0022-510X(99)00244-0
  26. Waltimo A, Kemppainen P, Könönen M. Maximal contraction force and endurance of human jaw-closing muscles in isometric clenching. Scand J Dent Res. 1993;101:416-421.
  27. Kiliaridis S, Georgiakaki I, Katsaros C. Masseter muscle thickness and maxillary dental arch width. Eur J Orthod. 2003;25:259-263. https://doi.org/10.1093/ejo/25.3.259
  28. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997;8: 291-305. https://doi.org/10.1177/10454411970080030401
  29. Magnusson T, Egermark I, Carlsson GE. Treatment received, treatment demand, and treatment need for temporomandibular disorders in 35-year-old subjects. Cranio. 2002;20:11-17.
  30. Falkner F, Tanner JM, Human growth: part 2. Postnatal growth, New York, 1978, Plenum 273- 294;381-412.
  31. Schmolke C. The relationship between the temporomandibular joint capsule, articular disc and jaw muscles. J Anat. 1994;184:335-345.
  32. van Eijden TM, Koolstra JH, Brugman P. Architecture of the human pterygoid muscles. J Dent Res. 1995;74:1489-1495. https://doi.org/10.1177/00220345950740080901