Relationship Between Lateral Pterygoid Pain, Disc Displacement and Mandibular Movements

Objectives: Pain in the lateral pterygoid area (LPA) is a common finding during examination of patients with temporomandibular disorders (TMDs). The purpose of this study was to evaluate the relationship between mouth opening and protrusion range and disc dislocation diagnoses of TMD patients with and without pain on palpation of the LPA.

Methods: Clinical examination was performed on 70 patients (13 males, 57 females) by a calibrated examiner using the Hungarian version of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Examination Protocol. In addition, patients completed the Symptom Questionnaire. The LPA was palpated on each side, as specified in the DC/TMD Clinical Examination Protocol. Maximum assisted opening (MAO), protrusion and TMJ noises were recorded. Diagnostic algorithms for intra-articular disorders were completed to provide diagnosis for disc displacement. Data was analyzed with Chi-squared tests or Fisher tests and independent sample t-test (α=0.05).

Results: 32 patients (45.7%) indicated pain in the LPA on one or both sides. We observed correlation between pain in the LPA and disc displacement with reduction (p=0.006) and disc displacement without reduction (p=0.020) on the right side. Results show similar tendency on the left side, however, statistically significant correlation was not found. Mean values of MAO and protrusion were lower in patients with palpation pain in the LPA, but significant correlation was not stated.

Conclusions: Our results suggest that there may be a correlation between pain in the LPA and disc displacements. However, results of this study could not clearly prove a relationship between LPA pain and mandibular movements.