The lateral temporomandibular ligament is the main intrinsic ligament of the TMJ, running from the zygomatic arch and articular tubercle obliquely to the lateral pole and posterior neck of the mandibular condyle. It consists of outer oblique and inner horizontal fibre bundles that guide and limit mandibular movement.
The outer oblique fibres limit the extent of mouth opening and guide the condyle's rotational and translational path. The inner horizontal fibres prevent posterior displacement of the condyle and articular disc, protecting the retrodiscal tissue and middle ear structures.
Laxity of the lateral TMJ ligament contributes to disc displacement disorders and condylar hypermobility. Clinical assessment involves palpation lateral to the condyle during opening. Ligamentous injury can follow mandibular trauma or prolonged dental procedures. Surgical tightening of the ligament is occasionally performed for chronic hypermobility.
Progressive ligamentous laxity allows the articular disc to displace anteromedially relative to the condyle, producing clicking on opening (with reduction) or restricted opening without clicking (without reduction), managed conservatively with splints or surgically with disc repositioning.
The condylar head translates anterior to the articular eminence and cannot return spontaneously due to masticatory muscle spasm, requiring manual reduction by downward traction on the posterior teeth.
