DOI:

10.37988/1811-153X_2023_3_90

Musculofascial pain and dysfunction with unilateral spasm of the lateral pterygoid muscle

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Authors

  • N.M. Didenko 1, PhD in Medical Sciences, assistant professor of the Prosthetic dentistry Department
    ORCID: 0000-0003-1440-2484
  • T.A. Gaidarova 1, PhD in Medical Sciences, professor of the Prosthetic dentistry Department
    ORCID: 0000-0002-6415-0767
  • E.V. Mokrenko 1, PhD in Medical Sciences, head of the Prosthetic dentistry Department
    ORCID: 0000-0002-4286-3993
  • O.V. Klushnikov 1, PhD in Medical Sciences, associate professor of the Prosthetic dentistry Department
    ORCID: 0000-0001-6411-8639
  • 1 Irkutsk State Medical University, 664003, Irkutsk, Russia

Abstract

Due to the peculiarities of the anatomy and the complexity of the function of the pterygoid muscle we decided to investigate the state of the lateral pterygoid muscle function when examining patients in the clinic of orthopaedic dentistry. Objective: to investigate the manifestations of the lateral pterygoid muscle spasm in adult patients in the clinic of orthopaedic dentistry.
Materials and methods.
The study was carried out in 78 patients aged 18 to 35 years with unilateral hypertonicity of the lateral pterygoid muscle, which was revealed during a consultative appointment at the clinic of orthopaedic. The muscle tone of the lateral pterygoid muscle was assessed by the presence of trigger points. Diagnostic methods included taking medical history, examination of the face and oral cavity, X-ray examination, assessment of the condition and function of the musculoskeletal system. To provide first aid for pain and symptoms associated with the temporomandibular joint dysfunction, manual treatment of masticatory muscles was performed in the clinic of orthopaedic dentistry in a dental chair.
Results.
The patients examined complained of pain in the area of the TMJ, the face, the ear, noise and ringing in the ear, clicks in the TMJ area. A special group consisted of patients experiencing pain caused by compression of the branches of the trigeminal and facial nerves. These patients noted numbness and tingling on one side of the cheek, involuntary twitching of the lower eyelid. We identified trigger points in the upper head of the LPM in 79% of the examined patients, in the lower head in 100%, in the temporal muscle — in 96%, in the medial pterygoid muscle — in 90% of patients and in 96% of patients — in the masticatory muscle itself. We noted that if pain or tenderness was detected in the upper head of the lateral pterygoid muscle on one side, then pain and shortening of the lower head of the lateral pterygoid muscle were detected on the other side. In these cases, patients chewed more on the opposite side. The study of occlusal relationships showed a significantly greater number of disorders in the transverse direction. X-ray examination of the temporomandibular joint in all patients revealed no bone pathology. A posturological examination showed that all the examined patients had signs of disorders of the postural system and functions of the musculoskeletal system of varying degrees of severity, mostly in the frontal plane. After manual treatment of all masticatory muscles, these complaints and signs disappeared.
Conclusion.
Pain syndrome in LPM spasm is due to: trigger points in the LPM itself; neuropathic pain or muscle dysfunction caused by compression of the branches of the trigeminal facial nerves. Pain and LPM dysfunction can cause: musculofascial pain; hearing problems — pain, noise and ringing in the ear; chewing disorders; violation of occlusion in the transversal direction. Also, when planning the treatment of transversal malocclusion, the functional state of the musculoskeletal system should be taken into account.

Key words:

lateral pterygoid muscle, trigger points, musculofascial pain syndrome, hypertonicity, manual treatment, musculoskeletal system

For Citation

[1]
Didenko N.M., Gaidarova T.A., Mokrenko E.V., Klushnikov O.V. Musculofascial pain and dysfunction with unilateral spasm of the lateral pterygoid muscle. Clinical Dentistry (Russia).  2023; 26 (3): 90—99. DOI: 10.37988/1811-153X_2023_3_90

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Received

July 7, 2023

Accepted

August 27, 2023

Published on

September 24, 2023