Thesis (doctoral)--Universiteit van Amsterdam, 1970.

Thesis (doctoral)--Universiteit van Amsterdam, 1970.

Abstract The fact that the lateral pterygoid muscle (LPM) and related symptoms play an important role in temporomandibular disorders (TMD) is widely recognized. In the study reported here, the LPM was investigated by magnetic resonance imaging (MRI) of patients with TMD. The visibility of the LPM in MRI with different projections was analyzed and a new imaging projection, condyle-the lateral pterygoid muscle projection (CLPM), for the LPM in MRI was introduced. Normal and abnormal findings of the LPM was compared with clinical symptoms of TMD. Compared with sagittal imaging of temporomandibular joint (TMJ), CLPM images and most of the oblique sagittal imaging were able to show the LPM clearly. Hypertrophy, atrophy and contracture of the LPM were found in TMJs either with disc in normal position or with disc displacements. Pathological changes of the superior belly and hypertrophy of the inferior belly combined with various pathological changes of the superior belly were the most frequently observed abnormal imaging findings of the LPM in TMD. The pathological changes of the LPM were associated with the main clinical symptoms of TMD. In patients with symptomatic condyle hypermobility, the pathological changes of the LPM and related symptoms were associated with the clinical symptoms of TMJs with disc in normal position. The imaging abnormalities of the LPM were common in TMJs with disc displacements and seemed to be fewer in condyle hypomobility cases in TMJs with anterior disc displacement with non-reduction (ADDnr). However, normal imaging of the LPM was also found in TMJs with severe osteoarthritic changes and disc displacement. The recognition of muscle alterations may lead to a more specific diagnosis and improve the understanding of the clinical symptoms and disease pathophysiology of TMD.

Objective: The purpose of this study was to establish a baseline database consisting of the morphometry of the South African neonatal pterygoid hamulus. Methods: Cone Beam Computed Tomography (CBCT) scans were conducted on 74 formalin-fixed neonatal cadavers and displayed on the Planmeca Romexis 4.6.0.R program for quantitative data measurement. The length, width and angle of inclination in the coronal and sagittal planes of the pterygoid hamulus and the inter-hamular distance were measured. Additionally, the distance from the pterygoid hamulus to the posterior nasal spine was measured. Statistical analysis was performed to compare sides, population groups and weight classes and to establish correlations between measurements. Results: Weight was found to be a determining factor in the morphometrics of the pterygoid hamulus, the exception being the inclination in the sagittal plane, results were therefore separated according to weight class. For neonates weighing less than or equal to 1 kg, the length of the pterygoid hamulus was 2.23 (SD 0.377) mm, the width of the pterygoid hamulus in the coronal plane was 0.938 (SD 0.162) mm and in the sagittal plane was 1.68 (SD 0.373) mm. For neonates weighing more than 1 kg, the length was 2.74 (SD 0.438) mm, the width in the coronal plane was 1.12 (SD 0.226) mm and in the sagittal plane was 1.87 (SD 0.446) mm. The regression formula between the inter-hamular distance and the distance between the pterygoid hamulus and posterior nasal spine was determined to be y=2.44+0.52x. No significant difference between right and left sides, sex or population group was found. Conclusion: Understanding how the neonatal pterygoid hamulus differs from the adult structure is important when surgery in the oropharyngeal area of infants is concerned. The correlations established in this study between biometrics and morphometrics allows for extrapolation of the morphometrics to be made in the absence of proper scanning equipment. / Dissertation (MSc) University of Pretoria, 2020. / Anatomy / MSc (Clinical Anatomy) / Unrestricted

O Músculo Pterigóideo Lateral (MPL) desempenha um papel importante nas Desordens Temporomandibulares (DTM), devido à íntima relação deste músculo com a Articulação Temporomandibular (ATM). No entanto, evidências de alterações patológicas dos músculos mastigatórios ainda parecem faltar nas pesquisas da DTM. Este estudo investigou o MPL por meio de Ressonância Magnética (RM) de 50 indivíduos com e sem DTM. Neste trabalho, das 100 ATM analisadas, 35 pacientes com DTM (70 ATM), prevalecendo o gênero feminino e 15 indivíduos sem sinais e sintomas clínicos de DTM (30 ATM) foram incluídos. O MPL foi observado e analisado em diferentes projeções. As imagens sagitais oblíquas e axiais da ATM foram capazes de mostrar os MPL claramente. Hipertrofia, atrofia e contratura do MPL foram as anomalias encontradas. Sinais de DTM, como hipermobilidade, hipomobilidade e deslocamento do disco articular puderam ser observados nas imagens de ATM. Com relação aos sintomas clínicos como dor, sons articulares, cefaléia e limitação nos movimentos mandibulares, foi possível observar que todos os pacientes com DTM apresentavam pelo menos um destes sintomas, sendo as queixas mais presentes dor e estalo; e os pacientes sem DTM também puderam mostrar alterações nas imagens de RM da ATM, como atrofia e contratura muscular, as mais observadas. O reconhecimento das alterações no MPL, podem levar a um diagnóstico mais específico e aumentar o entendimento dos sintomas clínicos e da fisiopatologia da DTM. Estudos futuros são necessários para se continuar avaliando o MPL por meio de RM. / The Lateral Pterygoid Muscle (LPM) plays an important role in Temporomandibular Disorders (TMD), due to the close relation of this muscle with the Temporomandibular Joint (TMJ). However, evidence of pathological changes of the masticatory muscles still seems to be lacking in the TMD research. This study investigated the LPM by Magnetic Resonance Imaging (MRI) of 50 subjects with and without TMD. In this work, 100 Temporomandibular joints were analyzed, 35 subjects with TMD (70 TMJs), with the prevalence of female and 15 subjects without clinical signs and symptoms (30 TMJs) were included. The LPM was visible in different projections and analyzed. The oblique sagital and axial images of the TMJ were able to show the LPM clearly. Hipertrophy, atrophy and contracture of the LPM were the abnormalities found. TMD signs, such as hipermobility, hipomobility, disc displacement could be seem in the TMJ images. Related to clinical symptoms like pain, articular sounds, headache, and limitation of mandibular movements, it was possible to observed that all patients with TMD had at least one of these symptoms, pain and click being the most frequent complaint. Patients without TMD could also show alterations in the TMJ MRI, such as atrophy and contracture as the most common. The recognition of LPM alterations may lead to a more specific diagnosis and improvement of understanding of the clinical symptoms and pathophysiology of TMD. Further studies should be necessary to continue evaluating the LPM by MRI.

O Músculo Pterigóideo Lateral (MPL) desempenha um papel importante nas Desordens Temporomandibulares (DTM), devido à íntima relação deste músculo com a Articulação Temporomandibular (ATM). No entanto, evidências de alterações patológicas dos músculos mastigatórios ainda parecem faltar nas pesquisas da DTM. Este estudo investigou o MPL por meio de Ressonância Magnética (RM) de 50 indivíduos com e sem DTM. Neste trabalho, das 100 ATM analisadas, 35 pacientes com DTM (70 ATM), prevalecendo o gênero feminino e 15 indivíduos sem sinais e sintomas clínicos de DTM (30 ATM) foram incluídos. O MPL foi observado e analisado em diferentes projeções. As imagens sagitais oblíquas e axiais da ATM foram capazes de mostrar os MPL claramente. Hipertrofia, atrofia e contratura do MPL foram as anomalias encontradas. Sinais de DTM, como hipermobilidade, hipomobilidade e deslocamento do disco articular puderam ser observados nas imagens de ATM. Com relação aos sintomas clínicos como dor, sons articulares, cefaléia e limitação nos movimentos mandibulares, foi possível observar que todos os pacientes com DTM apresentavam pelo menos um destes sintomas, sendo as queixas mais presentes dor e estalo; e os pacientes sem DTM também puderam mostrar alterações nas imagens de RM da ATM, como atrofia e contratura muscular, as mais observadas. O reconhecimento das alterações no MPL, podem levar a um diagnóstico mais específico e aumentar o entendimento dos sintomas clínicos e da fisiopatologia da DTM. Estudos futuros são necessários para se continuar avaliando o MPL por meio de RM. / The Lateral Pterygoid Muscle (LPM) plays an important role in Temporomandibular Disorders (TMD), due to the close relation of this muscle with the Temporomandibular Joint (TMJ). However, evidence of pathological changes of the masticatory muscles still seems to be lacking in the TMD research. This study investigated the LPM by Magnetic Resonance Imaging (MRI) of 50 subjects with and without TMD. In this work, 100 Temporomandibular joints were analyzed, 35 subjects with TMD (70 TMJs), with the prevalence of female and 15 subjects without clinical signs and symptoms (30 TMJs) were included. The LPM was visible in different projections and analyzed. The oblique sagital and axial images of the TMJ were able to show the LPM clearly. Hipertrophy, atrophy and contracture of the LPM were the abnormalities found. TMD signs, such as hipermobility, hipomobility, disc displacement could be seem in the TMJ images. Related to clinical symptoms like pain, articular sounds, headache, and limitation of mandibular movements, it was possible to observed that all patients with TMD had at least one of these symptoms, pain and click being the most frequent complaint. Patients without TMD could also show alterations in the TMJ MRI, such as atrophy and contracture as the most common. The recognition of LPM alterations may lead to a more specific diagnosis and improvement of understanding of the clinical symptoms and pathophysiology of TMD. Further studies should be necessary to continue evaluating the LPM by MRI.

Thesis (M.S.)--University of Michigan, 1987.

Thesis (M.S.)--University of Michigan, 1987.

M.Tech. (Chiropractic) / Headache is the most common type of pain and is one of the most frequent reasons for medical consultation (Rasmussen, 1995). Tension-type headaches cause substantial levels of disability for the patient as well as the global society because of its high prevalence in the general population (Stovner, Hagen, Jensen, 2007). Tension-Type headache is a primary headache commonly found in three forms: infrequent episodic, frequent episodic and chronic with or without pericranial tenderness (International Headache Society, 2009). The aim of this study was to determine the effectiveness of chiropractic manipulation of the temporomandibular joint in conjunction with ischemic compression of the lateral pterygoid muscle as a treatment protocol for tension-type headache. Method: This study consisted of three groups of sixteen participants each with tension-type headaches. The participants were between the ages of 18 and 25 years of age. Potential participants were examined and selected based on the inclusion and exclusion criteria. Group one received chiropractic manipulation of the temporomandibular joint. Group two received ischemic compression of the lateral pterygoid muscle. Group three received a combination treatment of chiropractic manipulation of the temporomandibular joint and ischemic compression of the lateral pterygoid muscle. Objective and subjective finding were based on the treatment sessions. Procedure: All participants received a total of six treatments over two weeks followed by a seventh visit which consisted of data gathering only. The subjective data collected was in the form of a TMJ symptom questionnaire completed at visit one and seven and a Headache Disability Index (HDI) completed at visits one, three and seven. TMJ motion was measured by means of a vernier caliper.

Orientadores: Eliane Maria Ingrid Amstalden, Edson Aparecido Liberti / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T00:17:07Z (GMT). No. of bitstreams: 1 Benigno_MariaIvoneMendes_D.pdf: 2199405 bytes, checksum: 7460327535443e71e135d559be319402 (MD5) Previous issue date: 2014 / Resumo: Introdução: A atividade mastigatória é uma sincronia entre os músculos da mastigação e articulação temporomandibular (ATM). A perda de dentes é um importante fator que contribui para as disfunções do Sistema Estomatognático e consequentes danos aos músculos mastigadores. Considerando os poucos trabalhos sobre o assunto, a necessidade de maior compreensão e detalhamento quanto às alterações das fibras desta musculatura, especialmente na disfunção pela perda dentária, este estudo teve como objetivos: investigar as alterações morfológicas e ultraestruturais do músculo Pterigoideo Medial (PTM) e Masseter, pós exodontia em modelo experimental. Material e Métodos: Foram utilizados 24 ratos wistar para microscopia de luz (ML) e 12 para microscopia eletrônica de transmissão (MET), divididos em três grupos experimentais: GI -15, GII-30 e GIII-60 dias, pós exodontia de molares inferiores esquerdos. Contendo 5 animais experimentais e três controles por grupo para ML e 3 ratos para MET, com 1 controle por grupo. Sob microscopia de luz foram realizados estudos morfométricos e sob luz polarizada, dos músculos PTM e Masseter. A análise morfométrica baseou-se na medida da área das fibras, em cortes transversais, corados pelo H&E (40x.objetiva), com programa digital (software AXION¿vision). Realizadas 240 medidas por animal/ total de 1200 por grupo experimental e 200 medidas por animal/ total de 600 por grupo controle. Análise qualitativa das fibras colágenas foi obtida sob luz polarizada. Também foram observadas, qualitativamente, alterações ultraestruturais destes músculos, ipsilateral às exodontias. Teste ANOVA foi aplicado para a análise dos dados. Resultados: A morfometria da área das fibras do músculo PTM, mostrou redução significante, nos animais submetidos à exodontia, tanto ipsi quanto contralateral. Não foram detectadas diferenças quanto aos quesitos interação entre lados direito e esquerdo e grupos (GI, II e III), nem quando se comparou os lados entre si. Diferenças foram notadas quando se comparou o grupo experimental, nos distintos períodos evolutivos, detectando-se aumento progressivo das áreas das fibras musculares, sendo a média maior no Grupo GIII. Apesar do crescimento progressivo da área das fibras, elas não se tornam hipertróficas nesse estágio avaliatório, uma vez que, a média dos valores obtidos é semelhante à do grupo controle. As fibras do músculo PTM parecem adaptar-se às mudanças. Nenhuma diferença foi detectada quanto à análise morfométrica do músculo Masseter. Ultraestruturalmente, observou-se assimetria e desorganização da linha Z e banda I, apenas no grupo experimental GII, do músculo PTM. A análise das fibras colágenas mostrou que os fascículos musculares são revestidos por uma delicada rede de fibras colágenas do tipo I e do tipo III, com predomínio deste último (fibras reticulares), nos Masseteres, nos diferentes períodos evolutivos. Conclusão: A disfunção temporomandibular, promovida pela exodontia unilateral de molares inferiores em ratos, pode levar a alterações morfométricas ipsi e contralaterais, com redução de áreas de fibras, particularmente no PTM. Entretanto as fibras musculares parecem se adaptar às novas condições, ao longo do experimento. A linha Z e banda I são as mais sensíveis a essa disfunção, no músculo PTM, contudo efêmera, uma vez que foi observada apenas no grupo GII. O músculo PTM mostrou-se mais vulnerável, provavelmente pelas suas características funcionais próprias e maior participação na dinâmica dos movimentos mastigatórios, comparadas às do Masseter. As fibras colágenas do tipo I e do tipo III são os constituintes principais das estruturas fibro conjuntivas desses músculos, com predomínio do tipo III no Masseter e parecem não ser afetadas nesse procedimento / Abstract: The loss of dental elements is an important factor in stomatognathic system dysfunctions and consequential damage to the masticatory muscles. The aim of this study was to analyze the morphometric and ultrastructural changes of the pterygoid medial(PTM) and masseter muscle, under occlusal defects, induced by unilateral left molar extraction, of Wistar rats. Thirty-six male rats were used: 24 for light microscopy (LM) and 12 for transmission electron microscopy analysis (TEM), divided into three experimental groups (GI-15; GII-30 and GIII-60 days), containing 5 animals each for LM with 3 control and 3 for TEM with one animal control for each period. Morphometric studies were made measuring the area of PTM and Masseter muscle fibers ipsi and contralateral to dental extraction, using a digital program. A qualitative analysis was performed to evaluate the ultrastructural findings and of the PTM and Masseter muscle. The results were compared using ANOVA test. There was a reduction of area of PTM of animals undergoing tooth extraction, both ipsi as contralateral. Both sides were similar when compared with each other, as assessed in the various evolutive periods. Differences were observed in the fiber area, especially in the first group and these showed progressive increase, reaching their highest average in GIII. No difference was detected regarding the morphometric analysis of the masseter muscle. For ultrastructure observed asymmetry and disorganization of Z line and I band, only the experimental group GII, muscle PTM. The analysis of the collagen fibers showed that the muscle fascicles are lined by a delicate network of collagen type I and type III, with a predominance of the latter (reticular fibers), in the masseter, in different evolutionary periods. Temporomandibular joint dysfunction, promoted by unilateral molar extraction in wistar rats, can lead to morphometric changes ipsi and contralateral with reduction of areas, particularly in the PTM. However seem to adapt to new conditions throughout the experiment. The band Z and the ith row of the muscle cytoskeleton are the most sensitive to this, dysfunction in muscle PTM, however ephemeral, since it was observed only in the Group (GII) with 30 days of the experiment. The muscle PTM proved to be more vulnerable in this experimental model, probably for its own functional features and greater participation in the dynamics of the masticatory movements, compared to the Masseter. The collagen fibers of type I and type III are the major constituents of the connective fibrous tissue structures of these muscles, with a predominance of type III in the Masseter and doesn't seem to be affected, to this procedure / Doutorado / Ciencias Biomedicas / Doutora em Ciências Médicas