The Role of the Lateral Pterygoid Muscles in TMJ Disorders During Static Conditions

Abstract

ABSTRACTIntramuscular EMG of the lateral pterygoid muscles (LPM), surface EMG of the temporalis and masseter muscles and force measurements of the temporomandibular joint (TMJ) were synchronously used to investigate the biomechanical role of the two heads of the LPM in relation to internal derangement (ID) of the TMJ. EMG and kinetic analysis of five static conditions (resting, protraction, opening, molar and incisor clenching) and three maximum isometric masticatory forces (opening, molar and incisor clenching) were done to compare forces and muscular activity between TMJ ID and control subjects. The analysis of variance results of the integrated linear envelope (LE) EMG showed no significant differences between the two groups for the masseter and temporalis muscles. Therefore, there is no apparent reason to believe that these muscles are hyperactive in TMJ ID. The integrated LE EMG of the SLP was significantly lower in the TMJ group during molar clenching (104μV+60.0 over 159μV+68.8 for a p =.020). The superior head of the lateral pterygoid muscle (SLP) seemed to have lost its diskal stabilizing function. The integrated LE EMG signals of the ILP were significantly higher in the TMJ ID group during rest, resisted protraction and incisor clenching (p =.029, p =.046, p =.031 respectively). The ILP muscle has probably adapted to control the inner joint instability while continuing its own actions. The ILP muscle seemed to have lost its functional specificity. The results of the isometric forces showed that TMJ ID subjects exhibited significantly lower molar bite forces (297.1 N over 419N, p =.042) confirming that they have less muscle strength and tissue tolerance than subjects with healthy masticatory muscle systems. A neuromuscular adaptation could be occurring in the TMJ ID masticatory system affecting muscular actions and forces.