Occlusal adjustment as treatment for tenderness in the muscles of mastication in category 1 patients.

When a lateral pterygoid muscle is more tender to palpation than the other muscles of mastication, and a stress test is positive, an occlusal cause should be suspected. Patients with lateral pterygoid tenderness are divided into three categories according to two criteria: the position of the condyles in their glenoid fossae and the degree of dysfunction in the articulation. Only patients in category 1, those with a centered condylar position and without dysfunction, are discussed in this article. Occlusal adjustment is executed on the basis of information gathered from radiographs of the temporomandibular joint, diagnostic casts, and leaf gauge measurements of unequal bilateral occlusal contact. The amount of tooth structure requiring removal can be determined by using leaf gauges of differing thicknesses. Occlusal adjustments are performed without mandibular manipulation until the tenderness of the lateral pterygoid muscle is relieved.