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Imaging Sci Dent. 2015 Mar;45(1):1-5. English. Original Article.
Lopes SL , Costa AL , Gamba TD , Flores IL , Cruz AD , Min LL .
Department of Diagnosis and Surgery, Sao Jose dos Campos Dental School, UNESP, Sao Paulo, Brazil.
Department of Pediatric Dentistry and Orthodontics, University of Sao Paulo City, UNICID, Sao Paulo, Brazil.
Department of Oral Diagnosis, School of Dentistry, UNICAMP, Piracicaba, Sao Paulo, Brazil.
Department of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil.
Laboratory of Neuroimaging, Department of Neurology, Faculty of Medical Sciences, UNICAMP, Campinas, Sao Paulo, Brazil.

PURPOSE: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. MATERIALS AND METHODS: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. RESULTS: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. CONCLUSION: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

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