Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey.
J Stomatol Oral Maxillofac Surg. 2024 Sep;125(5S1):101989. doi: 10.1016/j.jormas.2024.101989. Epub 2024 Jul 30.
TMD is a multifaceted condition with various contributing factors, but the actual impact of the lateral pterygoid plate on the development of TMD remains uncertain. This research aims to investigate the relationship between anatomical variations of the lateral pterygoid plate (LPP), including its angle and proximity to the condyle, and the prevalence of temporomandibular disorders (TMD), to improve diagnostic accuracy and therapeutic approaches for TMD.
MATERIALS & METHODS: A retrospective analysis was conducted on 189 Cone Beam Computed Tomography (CBCT) images of individuals aged 18 to 45. Inclusion criteria were based on definitive diagnoses of degenerative joint disease, excluding individuals with orthodontic treatments, injuries, or craniofacial disorders.Participants were divided into TMD and control groups using standardized DC/TMD protocols for assessment. A radiologist, blinded to the patient's clinical status, then analyzed the CBCT images. LPP dimensions, angles, and condyle distances were measured using OnDemand 3D Imaging Software.
The study found a statistically significant higher average LPP length in females compared to males (right LPP p < 0,001, left LPP p = 0,004), with no significant differences in LPP-condyle distances and angles between genders. Comparing the TMD and control groups revealed a positive correlation between lateral plate angles and TMJ disorders (p = 0,044), suggesting a potential biomechanical linkage.
Conclusively, the study challenges the assumption that LPP anatomical variations significantly impact TMD while underscoring a potential link between LPP angle and TMD. The novel insight into the potential role of the LPP angle in TMD provides a new direction for research and clinical practice, emphasizing the importance of considering subtle anatomical differences in the management of TMD.
TMD 是一种多方面的病症,有多种致病因素,但翼外板的实际影响 TMD 的发展仍不确定。本研究旨在探讨翼外板(LPP)解剖变异与 TMD 发生率之间的关系,包括其角度和与髁突的接近程度,以提高 TMD 的诊断准确性和治疗方法。
对 189 名 18 至 45 岁个体的锥形束 CT(CBCT)图像进行回顾性分析。纳入标准基于退行性关节病的明确诊断,排除接受正畸治疗、受伤或颅面畸形的个体。使用 DC/TMD 标准协议对患者进行评估,将参与者分为 TMD 和对照组。一位放射科医生在不了解患者临床状况的情况下对 CBCT 图像进行分析。使用 OnDemand 3D 成像软件测量 LPP 尺寸、角度和髁突距离。
研究发现女性的 LPP 平均长度明显高于男性(右侧 LPP p<0.001,左侧 LPP p=0.004),但男女之间的 LPP-髁突距离和角度无显著差异。比较 TMD 和对照组发现,外侧板角度与 TMJ 紊乱呈正相关(p=0.044),提示可能存在生物力学联系。
综上所述,本研究挑战了 LPP 解剖变异对 TMD 有显著影响的假设,同时强调了 LPP 角度与 TMD 之间可能存在联系。LPP 角度在 TMD 中的潜在作用的新见解为研究和临床实践提供了新的方向,强调在 TMD 管理中考虑细微解剖差异的重要性。