Indications

Mandibular joint dysfunctions

Pressure sensitivity of the masticatory muscles

Mandibular joint clicking

Restricted mouth opening

Differential Diagnoses

Arthritis of the mandibular joint

Inflammation of dental roots

Osseous processes of the jaw

Parotitis

Material

Local anesthetic: 3 mL

Needle: 0.4 × 20 mm

Technique

Depending on pain projection, the injectable is administered to myofascial trigger points of a superficial or a deep layer of the masseter.

If pain is present in the area of the cheeks, para-nasal sinuses, and upper jaw, the myofascial trigger point is found in the cranial superficial layer of the masseter. If pain extends toward the lower molars and the lower jaw, the injection sites are located in the deep layers of the central muscle belly of the masseter. Pain projected to the temples, above the eyebrow, and into the lower jaw originates in trigger points located in superficial caudal aspects of the masseter. Pain projected to the preauricular aspect of the ear and to the jaw angle is connected to a trigger point of the deep layer of the masseter, near its attachment to the zygomatic arch.