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基于锥形束计算机断层扫描(CBCT)测量颞下颌关节功能紊乱中翼外肌的长度

CBCT-Based measurement of lateral pterygoid muscle length in TMJ dysfunction.

作者信息

Öncü Esra, Kuzey Nida, Baltaş Emin, Çağlayan Fatma

机构信息

Department of Oral Dental and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, 25240, Turkey.

出版信息

BMC Oral Health. 2025 Sep 26;25(1):1463. doi: 10.1186/s12903-025-06841-2.

Abstract

BACKGROUND

The lateral pterygoid muscle (LPM) plays a pivotal role in maintaining the stability of the temporomandibular joint (TMJ), especially the articular disc. A considerable number of patients afflicted with TMJ dysfunction may also experience LPM spasms, which can be challenging to discern through direct clinical examination. The objective of this study was to evaluate LPM length by measuring the distance between the origin and insertion points of the LPM with CBCT slices, a novel approach in the literature.

MATERIALS AND METHODS

The study encompassed a total of 498 TMJs and LPMs from 249 patients, including 59 males and 190 females. LPM lengths were measured on CBCT slices between the lateral pterygoid plate and fovea pterygoidea. Additionally TMJ movements were evaluated on conventional TMJ radiographs taken with the mouth open and closed.

RESULTS

In all TMJs, the LPM length was found to be greater in males than in females (p < 0.0001). LPM length exhibited a significant increase in hypermobile joints, while it demonstrated a decrease in normal and hypomobile joints. In individuals with unilateral hypomobility, the LPM length on the hypomobile side was lower than the contralateral side (p < 0.05).

CONCLUSION

While the muscle itself cannot be visually identified using CBCT due to its obscurity, the origins and insertions of the muscle can be clearly delineated. This allows for the measurement of distances between these points, thereby providing insight into the length of the muscle. The reduced length of the LPM in cases of hypomobile TMJs suggests the presence of LPM spasm.

TRIAL REGISTRATION

The study was conducted retrospectively on CBCT slices of individuals with TMJ dysfunction. No clinical interventions were performed on human participants within the scope of the study.

摘要

背景

翼外肌在维持颞下颌关节(TMJ)尤其是关节盘的稳定性方面起着关键作用。相当一部分患有颞下颌关节功能障碍的患者也可能出现翼外肌痉挛,而通过直接临床检查很难辨别。本研究的目的是通过使用CBCT切片测量翼外肌起点和止点之间的距离来评估翼外肌长度,这是文献中的一种新方法。

材料与方法

该研究共纳入了来自249例患者的498个颞下颌关节和翼外肌,其中男性59例,女性190例。在CBCT切片上测量翼外肌在翼突外侧板和翼肌凹之间的长度。此外,在张口和闭口时拍摄的传统颞下颌关节X线片上评估颞下颌关节的运动。

结果

在所有颞下颌关节中,发现男性的翼外肌长度大于女性(p < 0.0001)。翼外肌长度在活动度过大的关节中显著增加,而在正常和活动度减小的关节中则减小。在单侧活动度减小的个体中,活动度减小侧的翼外肌长度低于对侧(p < 0.05)。

结论

虽然由于翼外肌位置较深,使用CBCT无法直接观察到该肌肉本身,但其起点和止点可以清晰显示。这使得能够测量这些点之间的距离,从而了解肌肉的长度。活动度减小的颞下颌关节病例中翼外肌长度缩短表明存在翼外肌痉挛。

试验注册

本研究是对患有颞下颌关节功能障碍个体的CBCT切片进行的回顾性研究。在研究范围内未对人类参与者进行临床干预。

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