The lateral temporomandibular ligament is the primary intrinsic capsular ligament of the TMJ, running from the articular tubercle of the zygomatic arch obliquely downward and backward to the posterior surface of the mandibular condyle neck. It consists of outer oblique and inner horizontal bands that resist different directions of condylar displacement.
Limits mandibular depression, retraction, and lateral displacement; the outer oblique band guides the rotation-translation movement of the condyle during jaw opening.
The lateral TMJ ligament is the first structure to fail in TMJ dislocation, where extreme mandibular opening allows the condyle to pass anterior to the articular eminence. Its laxity in hypermobility syndromes (Ehlers-Danlos, Marfan) predisposes to recurrent TMJ dislocation. Surgical ligament plication and eminectomy address recurrent dislocation. Prolotherapy injections target the lateral ligament in chronic TMJ hypermobility.
Anterior condylar displacement beyond the articular eminence from lateral TMJ ligament failure during wide opening, producing open-lock with inability to close the mouth, reduced by downward and backward mandibular pressure under conscious sedation.
Lateral ligament laxity allowing excessive condylar translation producing recurrent subluxation and joint noise, managed with prolotherapy, botulinum toxin to the masseter, or surgical eminectomy.
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