Percentage of Lateral Pterygoid Muscle Inserted in the Disc of Human Temporomandibular Joint

Abstract

Insertion of the upper head of the lateral pterygoid (UHLP) in the temporomandibular joint disc (TMJ) has been linked to anterior displacement of the disc and temporomandibular disfunction. The aim of this study was to determine in human adults, the percentage of muscle fiber in the upper head of the lateral pterygoid muscle inserted in the articular disc. A systematic review of the literature was designed beginning with articles published in Medline, Lilacs and Scielo data bases between the years 1990 and 2010. Key words "Lateral Pterygoid Muscle" and Pterygoid Lateral Muscle" were used, and the term MeSH "Pterygoid Muscle" with Boolean OR "Lateral Ptrerygoid Muscle" AND "Insertion" and the free terms "Pterygoid Lateral Muscle Disc Articular" and "Pterygoid lateral Muscle Meniscus". Of the 156 articles obtained and analyzed, 18 articles meeting eligibility criteria were selected. Based on those articles the percentage of insertion of the CSPL in the TMJ disc was evaluated, each one was subsequently assigned a level of evidence according to OCEBM Oxford Centre Evidence Based Medicine. Only four articles answered the research inquiry, three studies were histological and one used imaging techniques with cross section slices with an adequate evidence level (1B). However, results differed with insertion percentages from 2% to 69.8% being reported in the superior head of the lateral pterygoid muscle in the articular disc.