The role of the inferior head of the human lateral pterygoid muscle in the generation and control of horizontal mandibular force

Threshold variations of medial pterygoid single motor units during vertical or horizontal force tasks

OBJECTIVES

To test the hypotheses that (a) the force thresholds at onset of medial pterygoid muscle single motor unit (SMU) activity do not decrease with an increase in the rate of force generation in standardised vertical or horizontal jaw-force tasks, and (b) there is evidence for functional heterogeneity within the medial pterygoid muscle.

METHODS

In 14 healthy participants, electromyographic recordings of the right medial pterygoid muscle were performed with intramuscular fine-wire electrodes during four isometric force tasks: vertical, horizontal contralateral, horizontal protrusion and horizontal ipsilateral, performed at two rates of force development (slow ramp, fast ramp). Computer tomography scans confirmed electrode location within the muscle, which was divided into medial and lateral parts. Force thresholds of onset of discriminated SMUs were compared between rates in each task; significance accepted at p < 0.05.

RESULTS

Of 45 SMU force thresholds studied in one or more tasks, there was no significant difference between slow and fast ramp within each force task, except slow ramp thresholds from the lateral part during the vertical force task were significantly higher than fast ramp thresholds. Reversals of recruitment order between tasks provided evidence for functional heterogeneity within the muscle. Force thresholds of the vertical tasks (range: 1-292.6 N) were mostly higher than for the horizontal tasks (range: 0.1-12.5 N).

CONCLUSION

The data are consistent with the proposal that the medial pterygoid muscle stabilises the jaw in the vertical plane during isometric force generation in the jaw closing, as well as horizontal directions.

Evaluating temperature increase during the polymerization of dental acrylic resin materials used for the direct fabrication of anterior deprogramming devices

STATEMENT OF PROBLEM

The polymerization of acrylic resin materials used for the direct fabrication of anterior deprogramming devices results in a temperature increase because of the exothermic reaction. This heat release might cause thermal trauma to the pulp, compromising the tooth's vitality.

PURPOSE

The purpose of this in vitro study was to compare the temperature increase and the timing of the maximum temperature recording obtained inside the pulp chamber of a maxillary central incisor during the polymerization of different resins materials used for the direct fabrication of anterior deprogramming devices.

MATERIAL AND METHODS

The exothermic reaction was examined during the polymerization of 4 different polymethyl methacrylate resin products: Pattern Resin LS; GC America, DuraLay inlay pattern resin; Reliance Dental, Kallocryl CPGM red; Speiko, and mega-Model Resin NF; Megadental. A polymeric matrix was fabricated to simulate the anterior deprogramming device. A freshly extracted intact maxillary central incisor was fixed in an acrylic resin mold, and a thermal probe was inserted into the pulp chamber to transmit the temperature recordings. The resin materials were mixed as per the manufacturer's instructions and an equal volume of each was inserted into the plastic matrix, which was then positioned on the tooth. The temperature increase and the time needed to obtain the maximum temperature were recorded. The temperature and time recordings were performed initially for the intact tooth and repeated after the tooth was prepared for a metal-ceramic restoration. The data were analyzed with descriptive statistics, 1-way analysis of variance, and the Tukey Honestly Significant Difference tests (α=.05).

RESULTS

In accordance with the 1-way ANOVA, there was a statistically significant difference both in temperature increase (F [7,72] = 3.72, P=.002) and in the recorded time (F [7,72] = 160.80, P<.001). The mean temperature inside the pulp chamber ranged from 40.1 °C for the Pattern Resin LS to 41.4 °C for the DuraLay inlay pattern resin material. The mean time recordings ranged from 133 seconds for the Kallocryl CPGM red material to 266 seconds for the DuraLay inlay pattern resin material.

CONCLUSIONS

The Pattern Resin LS revealed the lowest exothermic reaction (P<.05) when compared with the other materials tested in this study, whereas Kallocryl CPGM red had the shortest time increase without being statistically significantly different.

Single motor units from the medial pterygoid muscle can be active during isometric horizontal and vertical forces

OBJECTIVES

To determine (a) whether the medial pterygoid muscle is active in an isometric vertical force task and in isometric horizontal force tasks in the contralateral, protrusion and ipsilateral directions; (b) whether the same single motor units (SMUs) could be active across different directions of isometric force generation; and (c) whether different regions of the medial pterygoid muscle exhibit different patterns of SMU activation during the generation of any one direction of isometric force.

METHODS

Intramuscular electromyographic (EMG) recordings were made from the right medial pterygoid muscle in 15 healthy participants during isometric force tasks: vertical and horizontal contralateral, protrusion and ipsilateral. A computed tomography scan divided the EMG recording site into a medial or lateral part in each participant. Single motor units were discriminated in each task.

RESULTS

Medial pterygoid SMU activity was recorded in 100% of participants for the vertical biting tasks, 86% of participants for the horizontal contralateral and horizontal protrusion tasks and 57% of the horizontal ipsilateral tasks. Of the 72 SMUs that were discriminated, 36% were active in all tasks; 18% were active only in the vertical tasks and 17% were active in the vertical, horizontal contralateral and horizontal protrusion tasks. The proportion of SMUs that was active in at least 1 horizontal task in the lateral part (33/39) was significantly higher than the proportion (21/33) in the medial part (Chi-Square, P < 0.05).

CONCLUSION

The data are consistent with a stabilisation role for the medial pterygoid muscle in isometric jaw forces in the vertical and horizontal planes.

Functional Activity of Superior Head of Human Lateral Pterygoid Muscle during Isometric Force

There is controversy as to the jaw tasks for which the superior head of the human lateral pterygoid muscle (SHLP) becomes active. The aim was to describe the functional activities of SHLP single motor units (SMUs) during horizontal isometric force tasks. In 11 subjects, 48 SMUs were recorded from computer-tomography-verified SHLP sites during generation of horizontal isometric force in the contralateral (CL), protrusive (P), and ipsilateral (IL) directions and intermediate directions (CL-P, IL-P). In eight subjects, SHLP SMUs were active in CL, CL-P, and P. Qualitatively, SHLP EMG activity increased with increased isometric force. Forty-two SMUs were active in directions other than IL; 6 exhibited activity at IL and other directions. The similarity of these data to previous human lateral pterygoid (IHLP) data supports the notion that SHLP and IHLP should be regarded as a single muscle, with activities shaded according to the biomechanical demands of the task.

Isotonic resistance jaw exercise alters jaw muscle coordination during jaw movements

The aim was to investigate the effects of isotonic resistance exercise on the electro-myographic (EMG) activity of the jaw muscles during standardised jaw movements. In 12 asymptomatic adults surface EMG activity was recorded from the anterior temporalis and masseter muscles bilaterally and the right anterior digastric muscle during right lateral jaw movements that tracked a target. Participants were randomly assigned to a Control group or an Exercise group. Jaw movement and EMG activity were collected (i) at baseline, before the exercise task (pre-exercise); (ii) immediately after the exercise task (isotonic resistance at 60% MVC against right lateral jaw movements); (iii) after 4 weeks of a home-based exercise programme; and, (iv) at 8-weeks follow-up. There were no significant within-subject or between-group differences in the velocity and amplitude of the right lateral jaw movements either within or between data collection sessions (P > 0.05). However, over the 8 weeks of the study, three of the tested EMG variables (EMG Duration, Time to Peak EMG from EMG Onset, and Time to Peak EMG activity relative to Movement Onset) showed significant (P < 0.05) differences in the five tested muscles. Many of the significant changes occurred in the Control group, while the Exercise group tended to maintain the majority of the tested variables at pre-exercise baseline values. The data suggest a level of variability between recording sessions in the recruitment patterns of some of the muscles of mastication for the production of the same right lateral jaw movement and that isotonic resistance exercise may reduce this variability.

Reliability of electromyographic activity vs. bite-force from human masticatory muscles

The reproducibility of electromyographic (EMG) activity in relation to static bite-force from masticatory muscles for a given biting situation is largely unknown. Our aim was to evaluate the reliability of EMG activity in relation to static bite-force in humans. Eighty-four subjects produced five unilateral static bites of different forces at different biting positions on molars and incisors, at two separate sessions, and the surface EMG activities were recorded from temporalis, masseter, and suprahyoid muscles bilaterally. Intraclass correlation coefficients (ICCs) were determined, and an ICC of ≥ 0.60 indicated good reliability of these slopes. The ICCs for jaw-closing muscles during molar biting were: temporalis muscles, ipsilateral 0.58-0.93 and contralateral 0.88-0.91; and masseter muscles, ipsilateral 0.75-0.86 and contralateral 0.69-0.88. The ICCs for jaw-closing muscles during incisor biting were: temporalis muscles, ipsilateral 0.56-0.81 and contralateral 0.34-0.86; and masseter muscles, ipsilateral 0.65-0.78 and contralateral 0.59-0.80. For the suprahyoid muscles the 95% CIs were mostly wide and most included zero. The slopes of the EMG activity vs. bite-force for a given biting situation were reliable for temporalis and masseter muscles. These results support the use of these outcome measurements for the estimation and validation of mechanical models of the masticatory system.

Quantitative analysis of masticatory activity during unilateral mastication using muscle fMRI

OBJECTIVE

Quantitative analysis of the activities of all masticatory muscles is required to elucidate the mechanism of stomatognathic dysfunction. Electromyography can be used to record the activity of masticatory muscles, but quantification of the overall activity of every masticatory muscle has not been accomplished because of methodological limitations. In this study, we used muscle functional magnetic resonance imaging for simultaneous quantification of the overall activities of the masseter, medial pterygoid and lateral pterygoid muscles during unilateral gum chewing.

METHODS

Seven healthy male volunteers participated in the study. We evaluated changes in the mean proton transverse relaxation time in the bilateral masseter, medial pterygoid and lateral pterygoid muscles before and after unilateral gum chewing, and to quantify the overall activity of these muscles simultaneously during unilateral gum chewing.

RESULTS

After 5 min of chewing, the activity of the ipsilateral masseter was highest among the six muscles, followed by the ipsilateral medial pterygoid, contralateral lateral pterygoid and contralateral masseter muscles.

CONCLUSION

These results affirm the importance of the ipsilateral masseter muscle and quantitatively demonstrate the important contribution of the ipsilateral medial pterygoid and contralateral lateral pterygoid muscles during unilateral mastication.

Superior head of human lateral pterygoid muscle: Single motor unit firing rates during isometric force

The superior head of the human lateral pterygoid muscle (SHLP) has been classically considered to have functions that are independent of the inferior head of the lateral pterygoid (IHLP). Recent evidence however suggests that some of the functional properties of the SHLP are similar to those of the IHLP. The aim was to determine whether the functional properties in terms of single motor unit (SMU) firing rates within the SHLP vary with horizontal isometric force (400-800gwt) and direction (i.e., contralateral (CL), protrusive (P), ipsilateral (IL) and intermediate directions, CL-P, IL-P) in a manner similar to those identified for the IHLP, and as would be expected if both SHLP and IHLP should be regarded as one muscle. In eight subjects, the firing rates of 40 SMUs were recorded from computer tomography (CT)-verified SHLP sites while each subject exerted horizontal isometric forces with their lower jaw onto a force transducer in the five directions. Firing rates increased significantly with horizontal isometric force from 400 to 800gwt. Firing rates also changed significantly (p<0.01) with direction with CL, CL-P and P having comparable firing rates (13.3, 12.6 and 12.6impulses/s, respectively) which were significantly higher than IL-P. The similarity of these data to previous IHLP data, provide additional support for the hypothesis that the SHLP and the IHLP should be regarded as two parts of one muscle.

Activity of superior head of human lateral pterygoid increases with increases in contralateral and protrusive jaw displacement

The hypothesis was that the superior head of human lateral pterygoid muscle (SHLP) plays a similar role in jaw movement as the inferior head of human lateral pterygoid muscle (IHLP). The aims were to determine the functional properties of SHLP single motor units (SMUs) and root mean square activity (RMS) of the SHLP during contralateral and protrusive jaw movement tasks and to compare these features with those identified previously for the IHLP. In 22 human subjects, SMUs were recorded intramuscularly from computer tomography-verified sites within the SHLP during standardized contralateral and protrusive jaw movement tasks recorded by a jaw-tracking device. Of the 50 SMUs discriminated, 39 were active during contralateral and 29 during protrusive jaw movements. The firing rates and RMS of the SHLP motor units increased with an increase in jaw displacement. The RMS activity across the entire trial during contralateral jaw movement was significantly greater than that during protrusion. Similarly to conclusions previously identified for the IHLP, the data are consistent with an important role for the SHLP in the control of contralateral and protrusive jaw movements. The similarities in SHLP and IHLP functional properties support the proposal that both heads should be regarded as a system of fibers acting as one muscle.

Threshold properties of single motor units in superior head of human lateral pterygoid muscle

The superior head of the human lateral pterygoid muscle (SHLP) may play a similar role in jaw movement as the inferior head (IHLP).

OBJECTIVE

The aim was to determine whether threshold properties of single motor units (SMUs) within SHLP during jaw tasks were comparable to those identified for IHLP.

DESIGN

In 24 human subjects, SMUs were recorded intramuscularly from computer-tomography verified sites within SHLP during standardised jaw tasks recorded by a jaw-tracking device.

RESULTS

Of the 69 SMUs discriminated, 54 were active during contralateral, 52 during protrusive and 8 during ipsilateral jaw movements. The thresholds, at which SMUs commenced firing, decreased (p<0.05) as speed of contralateral or protrusive tasks increased. The data suggest an important role for SHLP in generation and control of contralateral and protrusive jaw movements. A number of lines of evidence were consistent with functional heterogeneity within SHLP.

CONCLUSIONS

The similarities in SHLP and IHLP functional properties support the proposal that both heads should be regarded as a system of fibers acting as one muscle.

The human lateral pterygoid muscle

One of the jaw muscles particularly implicated in temporomandibular disorders (TMD), a common form of non-dental chronic orofacial pain, is the human lateral pterygoid muscle. The precise role of this muscle in TMD is unclear as is the nature of the interaction between pain and motor function particularly involving this muscle. This research group has adopted a two-stage approach to studying the effects of pain on motor function. The first is to study normal orofacial motor function through recordings of jaw movement and electromyographic (EMG) activity from a number of jaw muscles (including recordings from the lateral pterygoid muscle; verification of electrode location achieved through computer tomography imaging) during a number of standardised jaw movements. These studies have defined the detailed functional properties of, in particular, the lateral pterygoid muscle, whose physiology and function is not well understood. In summary, the data are consistent with the hypothesis previously proposed that the lateral pterygoid should be regarded as a system of fibres that acts as one muscle, with varying amounts of evenly graded activity throughout its entire range, and with the distribution of activity within the muscle being determined by the biomechanical demands of the task. Our second approach has been to study the effects of experimental masseter muscle pain on the detailed functional properties (e.g., root-mean-square EMG activity) of the jaw muscles, especially the lateral pterygoid muscle. Preliminary data from these pain studies point towards significant effects of human experimental muscle pain on jaw muscle activity and jaw movement.

A working-side change to lateral tooth guidance increases lateral pterygoid muscle activity

The inferior head of lateral pterygoid (IHLP) is thought to play a critical role in the generation and control of lateral jaw movements.

AIM

The aim was to test the hypothesis that a change to the lateral tooth guidance (working-side occlusal alteration, OA) results in a significant change in the electromyographic (EMG) activity of the IHLP during standardised lateral jaw movements (laterotrusion) tracked by a jaw-tracking system.

METHODS

Ten trials of right laterotrusion were repeated under: control 1 (before occlusal alteration), OA (after occlusal alteration placement), and control 2 (after occlusal alteration removal) conditions in 14 subjects while recording left IHLP, bilateral anterior and posterior temporalis, masseter and submandibular muscles.

RESULTS

IHLP activity was significantly (p<0.05) increased with the occlusal alteration during the outgoing (movement from intercuspal position to approximately 5mm right) and return phases of laterotrusion. The other muscles demonstrated no change or a significant decrease in activity.

CONCLUSIONS

These findings suggest that a change to the occlusion on the working-side in the form of a steeper guidance necessitates an increase in IHLP activity to move the mandible down the steeper guidance. It must be emphasised that these data cannot be used as justification for occlusal therapy.

Fatigue-related changes in discharge patterns of motor units in the inferior head of the lateral pterygoid muscle in humans

OBJECTIVE

To investigate single motor unit (SMU) firing patterns of the inferior head of the human lateral pterygoid muscle (IHLP) during sustained isometric contractions, and to examine IHLP fatigability.

DESIGN

In 5 subjects, EMG was recorded from the right IHLP during generation of horizontal isometric mandibular force towards left side. Subjects tracked a target on an oscilloscope, slowly increasing the force to 25% of maximum voluntary contraction, and then maintained that force for 120 s (endurance task). Subjects rested for 30 s after each test, and three 10s recovery tests were performed every 30 s (recovery task). Fatigue data were obtained from 23 SMUs.

RESULTS

Twelve of 23 SMUs (52.2%) continued to fire throughout the 120 s, and each subject had at least one of these units. These units were classified as tonic pattern (T-unit). The firing rate of 6 of the 12 T-units (50.0%) decreased gradually with time. Comparison of the mean firing rate and coefficient of variance (CV) of interspike interval (ISI) of the 12 T-units between pre-fatigue, post-fatigue and the three recovery tasks showed that the mean firing rate decreased and CV of ISI increased after fatigue. Mean firing rate and CV of ISI recovered after 30 s of rest after the endurance task.

CONCLUSIONS

The firing patterns of IHLP units changed with the passing of time during sustained isometric contractions leading to fatigue.

Activity of inferior head of human lateral pterygoid muscle during standardized lateral jaw movements

OBJECTIVE

(a) To describe the changes in electromyographic (EMG) activity from selected jaw muscles during a standardized lateral jaw movement with the teeth together, and (b) to investigate the effects on jaw muscle activity of changes in both the rate of lateral jaw movement and the relative magnitude of jaw-closing force.

DESIGN

In 16 healthy volunteers, recordings were made using a jaw-tracking system, of mid-incisor point (MIPT) movements, as well as EMG activity from the contralateral inferior head of the lateral pterygoid muscle (IHLP), and bilateral anterior and posterior temporalis, masseter and submandibular muscles, during lateral jaw movement tasks at two speeds and two closing force levels with the teeth together.

RESULTS

The IHLP was the only muscle to show a consistent increase in activity in association with the outgoing phase of the task and a decrease during the return phase. Under high closing force at slow speed, the EMG activities of the IHLP and bilateral anterior temporalis and masseter muscles were significantly (p < 0.05) higher than those under a low closing force, while there was no significant change (p > 0.05) in bilateral posterior temporalis and submandibular muscles. The change from slow to fast lateral movement at low force did not significantly (p > 0.05) alter the mean activity except for the IHLP (increase in activity) and the contralateral anterior temporalis (decrease in activity).

CONCLUSIONS

The data suggest that the IHLP is one of the principal jaw muscles involved in a lateral jaw movement with the teeth together while the other jaw muscles may play a contributory or facilitatory role.

The human lateral pterygoid muscle: A review of some experimental aspects and possible clinical relevance

The clinical notion that some disturbance to the activity of the lateral pterygoid muscle plays a role in the aetiology of temporomandibular disorders (TMD) is still widely accepted and influences management strategies. However, there is no rigorous scientific evidence to support this clinical notion and the role of the lateral pterygoid muscle in normal function is still controversial. The classically defined functions of each head of the muscle are that the superior head is active on closing, retrusion, and ipsilateral jaw movements, while the inferior head is active on opening, protrusion and contralateral jaw movements. However, recent data indicate that these concepts are too simplistic. For example, recent evidence suggests that parts of the superior head may also be active on opening, protrusion and contralateral jaw movements, and that the superior head may consist of three mediolaterally arranged functional zones. Given these complexities, the proposal that clicking and/or locking conditions arise in the temporomandibular joint through some form of lack of co-ordination between the two heads of the muscle needs re-evaluation. Despite earlier reports to the contrary, both heads of the lateral pterygoid muscle appear to be electrically silent at the postural or resting jaw position, and therefore appear to play no role in the anteroposterior positioning of the jaw at the postural position. An important role has also been demonstrated electromyographically for progressive changes in activity in the inferior head as the direction of horizontal jaw force shifts from one side to the other. This suggests an important role for the lateral pterygoid muscle in the generation of side-to-side and protrusive jaw forces. The lateral pterygoid muscle is likely therefore to play an important role in parafunctional excursive jaw movements and also possibly a role in influencing jaw position in patients where the maxillomandibular relationship records change from session to session. The above data provide new insights into the normal function of the lateral pterygoid muscle. The proposal that the lateral pterygoid muscle plays some role in the aetiology of TMD needs now to be rigorously tested.

Activity in the inferior head of the human lateral pterygoid muscle with different directions of isometric force

The aim was to test the hypothesis that this head of the muscle plays a part in the generation and fine control of horizontal mandibular forces in a range of directions. Electromyographic activity was recorded from the inferior head of the lateral pterygoid of eight individuals during the generation such forces to a target in contralateral, ipsilateral and protrusive directions, and in two intermediate directions (contralateral-protrusive, ipsilateral-protrusive). The mean electromyographic activity and the mean firing rates of 21 single-motor units were significantly affected by direction, with the highest activity being contralateral, and graded decreases occurring as the direction shifted to the ipsilateral. Firing rates were significantly correlated with force magnitude. The data suggest that the inferior head of the human lateral pterygoid is involved in the creation and fine control of mandibular forces in different horizontal directions.

Functional properties of single motor units in the inferior head of human lateral pterygoid muscle: task firing rates

The precise function of the inferior head of the human lateral pterygoid muscle (IHLP) is unclear. The aim of this study was to clarify the normal function of the IHLP. The hypothesis was that an important function of the IHLP is the generation and fine control of horizontal (i.e., anteroposterior and mediolateral) jaw movements. The activities of 50 single motor units (SMUs) were recorded from IHLP (14 subjects) during two- or three-step contralateral movement (n = 36) and/or protrusion (n = 33). Most recording sites were identified by computer tomography. There was a statistically significant overall increase in firing rate as the magnitude of jaw displacement increased between the holding phases (range of increments: 0.3-1.6 mm). The firing rates during the dynamic phases for each unit were significantly greater than those during the previous holding phases but less than those during the subsequent holding phases. For the contralateral step task at the intermediate rate, the cross-correlation coefficients between jaw displacement in the mediolateral axis and the mean firing rate of each unit ranged from r = 0.29 to 0.77; mean +/- SD; r = 0.49 +/- 0.13 (protrusive step task: r = 0.12-0.74, r = 0.44 +/- 0.14 for correlation with anterior-posterior axis). The correlation coefficients at the fast rate during the contralateral step task and the protrusive step task were significantly higher than those at the slow rate. The firing rate change of the SMUs per unit displacement between holding phases was significantly greater for the lower-threshold than for the higher-threshold units during contralateral movement and protrusion. After dividing IHLP into four regions, the SMUs recorded in the superior part exhibited significantly greater mean firing rate changes per unit displacement during protrusion than for the SMUs recorded in the inferior part. Significantly fewer units were related to the protrusive task in the superior-medial part. These data support previously proposed notions of functional heterogeneity within IHLP. The present findings provide further evidence for an involvement of the IHLP in the generation and fine control of horizontal jaw movements.