1
|
Nozad Mojaver Y, Tawadros P, Moura Ferreira P, Whittle T, Murray GM. Threshold variations of medial pterygoid single motor units during vertical or horizontal force tasks. J Oral Rehabil 2021; 48:1314-1326. [PMID: 34510487 DOI: 10.1111/joor.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yalda Nozad Mojaver
- Faculty of Medicine and Health, Sydney Dental School, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, Australia
| | - Paul Tawadros
- Faculty of Medicine and Health, Sydney Dental School, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, Australia
| | - Polyana Moura Ferreira
- Faculty of Medicine and Health, Sydney Dental School, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, Australia
| | - Terry Whittle
- Faculty of Medicine and Health, Sydney Dental School, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, Australia
| | - Greg M Murray
- Faculty of Medicine and Health, Sydney Dental School, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, Australia
| |
Collapse
|
2
|
Yamaguchi S, Watanabe M, Hattori Y. Statistical parametric mapping of three-dimensional local activity distribution of skeletal muscle using magnetic resonance imaging (MRI). Sci Rep 2021; 11:4808. [PMID: 33637801 PMCID: PMC7910551 DOI: 10.1038/s41598-021-84247-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 02/15/2021] [Indexed: 11/23/2022] Open
Abstract
Analysis of the internal local activity distribution in human skeletal muscles is important for managing muscle fatigue/pain and dysfunction. However, no method is established for three-dimensional (3D) statistical analysis of features of activity regions common to multiple subjects during voluntary motor tasks. We investigated the characteristics of muscle activity distribution from the data of ten healthy subjects (29 ± 1 year old, 2 women) during voluntary teeth clenching under two different occlusal conditions by applying spatial normalization and statistical parametric mapping (SPM) to analysis of muscle functional magnetic resonance imaging (mfMRI) using increase in transverse relaxation time (T2) of the skeletal muscle induced by exercise. The expansion of areas with significant T2 increase was observed in the masticatory muscles after clenching with molar loss comparing with intact dentition. The muscle activity distribution characteristics common to a group of subjects, i.e., the active region in the temporal muscle ipsilateral to the side with the molar loss and medial pterygoid muscle contralateral to the side with the molar loss, were clarified in 3D by applying spatial normalization and SPM to mfMRI analysis. This method might elucidate the functional distribution within the muscles and the localized muscular activity related to skeletal muscle disorders.
Collapse
Affiliation(s)
- Satoshi Yamaguchi
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Makoto Watanabe
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Institute of Living and Environmental Sciences, Miyagi Gakuin Women's University, 9-1-1 Sakura-ga-oka, Aoba-ku, Sendai, Miyagi, 981-8557, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| |
Collapse
|
3
|
Nozad Mojaver Y, Tawadros PB, Moura Ferreira P, Whittle T, Murray GM. Single motor units from the medial pterygoid muscle can be active during isometric horizontal and vertical forces. J Oral Rehabil 2019; 46:998-1008. [PMID: 31206789 DOI: 10.1111/joor.12831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/30/2019] [Accepted: 06/09/2019] [Indexed: 12/27/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yalda Nozad Mojaver
- Jaw Function and Orofacial Pain Research Unit, Sydney Dental School, Faculty of Medicine and Health, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Paul B Tawadros
- Jaw Function and Orofacial Pain Research Unit, Sydney Dental School, Faculty of Medicine and Health, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Polyana Moura Ferreira
- Jaw Function and Orofacial Pain Research Unit, Sydney Dental School, Faculty of Medicine and Health, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Terry Whittle
- Jaw Function and Orofacial Pain Research Unit, Sydney Dental School, Faculty of Medicine and Health, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Greg M Murray
- Jaw Function and Orofacial Pain Research Unit, Sydney Dental School, Faculty of Medicine and Health, Westmead Hospital Centre for Oral Health, The University of Sydney, Westmead, New South Wales, Australia
| |
Collapse
|
4
|
Malik B, Whittle T, Ogawa T, Murray GM. Reorganization of motor unit activity at different sites within the human masseter muscle during experimental masseter pain. Eur J Oral Sci 2018; 126:400-410. [PMID: 30059170 DOI: 10.1111/eos.12561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2018] [Indexed: 12/01/2022]
Abstract
The aims were to test the hypotheses that experimental masseter muscle pain leads to recruitment and/or derecruitment of motor units at different sites within the masseter and that the patterns of change in motor unit activity differ between sites. Single motor unit (SMU) activity was recorded at two sites within the right masseter [superior/anterior, inferior/posterior (IP)] during isometric biting tasks (ramp, step level) on an intraoral force transducer in 17 participants during three experimental blocks comprising no infusion (baseline), 5% hypertonic saline infusion (pain), or isotonic saline infusion (control). A visual analog scale (VAS) was used to score pain intensity. The VAS scores were statistically significantly greater during infusion of hypertonic saline than during infusion of isotonic saline. No significant differences in force levels and rates of force change were found between experimental blocks. In comparison with isotonic saline infusion, SMUs could be recruited and derecruited at both sites during hypertonic saline infusion. The frequency of recruitment or derecruitment, in comparison with no change, was statistically significantly greater at the IP site than at the superior/anterior site. Experimental noxious masseter stimulation results in a reorganization of motor unit activity throughout the muscle, and the pattern of reorganization may be different in different regions of the muscle.
Collapse
Affiliation(s)
- Bushra Malik
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, Australia
| | - Terry Whittle
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, Australia
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Greg M Murray
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, Australia
| |
Collapse
|
5
|
MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:74-87. [DOI: 10.1016/j.oooo.2017.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/24/2017] [Accepted: 09/30/2017] [Indexed: 11/20/2022]
|
6
|
Expression of MyHC isoforms mRNA transcripts in different regions of the masseter and medial pterygoid muscles in chimpanzees. Arch Oral Biol 2017; 83:63-67. [DOI: 10.1016/j.archoralbio.2017.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 06/27/2017] [Accepted: 07/06/2017] [Indexed: 11/22/2022]
|
7
|
Chen H, Whittle T, Gal JA, Murray GM, Klineberg IJ. The medial pterygoid muscle: a stabiliser of horizontal jaw movement. J Oral Rehabil 2017; 44:779-790. [PMID: 28664577 DOI: 10.1111/joor.12542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2017] [Indexed: 11/30/2022]
Abstract
There is limited information of the normal function of the human medial pterygoid muscle (MPt). The aims were to determine whether (i) the MPt is active throughout horizontal jaw movements with the teeth apart and (ii) whether single motor units (SMUs) are active during horizontal and opening-closing jaw movements. Intramuscular electrodes were placed in the right MPt of 18 participants who performed five teeth-apart tasks: (i) postural position, (ii) ipsilateral (i.e. right) jaw movement, (iii) contralateral movement, (iv) protrusive movement and (v) opening-closing movement. Movement tasks were guided by a target and were divided into BEFORE, OUT, HOLDING, RETURN and AFTER phases according to the movement trajectories recorded by a jaw tracking system. Increased EMG activity was consistently found in the OUT, HOLDING and RETURN phases of the contralateral and protrusive movement tasks. An increased RETURN phase activity in the ipsilateral task indicates an important role for the MPt in the contralateral force vector. Of the 14 SMUs active in the opening-closing task, 64% were also active in at least one horizontal task. There were tonically active SMUs at the postural jaw position in 44% of participants. These new data point to an important role for the MPt in the fine control of low forces as required for stabilisation of vertical mandibular position not only to maintain postural position, but also throughout horizontal jaw movements with the teeth apart. These findings provide baseline information for future investigations of the possible role of this muscle in oro-facial pain conditions.
Collapse
Affiliation(s)
- H Chen
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - T Whittle
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - J A Gal
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - G M Murray
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - I J Klineberg
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| |
Collapse
|
8
|
Hasanoglu Erbasar GN, Alpaslan C, Eroglu Inan G. Can an NTI-tss device be effective as a first-line therapy in patients with TMD myofascial pain? J Oral Rehabil 2017; 44:589-593. [DOI: 10.1111/joor.12524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2017] [Indexed: 11/26/2022]
Affiliation(s)
- G. N. Hasanoglu Erbasar
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Ankara Yıldırım Beyazıt University; Ankara Turkey
| | - C. Alpaslan
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - G. Eroglu Inan
- Department of Statistics; Faculty of Science; Ankara University; Ankara Turkey
| |
Collapse
|
9
|
Digitale Palpation des M. pterygoideus lateralis. MANUELLE MEDIZIN 2016. [DOI: 10.1007/s00337-016-0158-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Scarr G, Harrison H. Resolving the problems and controversies surrounding temporo-mandibular mechanics. J Appl Biomed 2016. [DOI: 10.1016/j.jab.2016.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
|
11
|
Takahashi M, Yamaguchi S, Fujii T, Watanabe M, Hattori Y. Contribution of each masticatory muscle to the bite force determined by MRI using a novel metal-free bite force gauge and an index of total muscle activity. J Magn Reson Imaging 2016; 44:804-13. [PMID: 26970439 DOI: 10.1002/jmri.25223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 02/22/2016] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To develop a metal-free bite force gauge that can monitor the bite force in a strong magnetic field and to analyze the correlations between bite-force and total T2 shift of the mastication muscles. MATERIALS AND METHODS The gauge used a micro-pressure sensor made of optical fiber. Ten subjects performed a 60-s isometric bite task at 40% of maximum clenching in various occlusal support conditions (intact dentition, right molar loss, or left molar loss). Spin-echo images were taken with a 1.5 Tesla scanner before and immediately after the task to correlate the bite force with the mean voxel count, mean shift in transverse relaxation time (ΔT2), and total T2 shift of each masticatory muscle. RESULTS Measurements of total T2 shift identified significant correlations between the bite force and activities of the superficial layer of the bilateral masseter muscle, regardless of the occlusion condition (intact dentition: left, P = 0.007 and right, P < 0.001; right molar loss: left, P = 0.02 and right, P = 0.021; and left molar loss: left, P = 0.022 and right, P = 0.049). In contrast, significant correlations were not detected between the bite force and mean ΔT2 (intact dentition: left, P = 0.102 and right, P = 0.053; right molar loss: left, P = 0.393 and right, P = 0.868; and left molar loss: left, P = 0.531 and right, P = 0.92). CONCLUSION Measurement of total T2 shift using a metal-free bite force gauge is a more sensitive index of individual muscle activity than mean ΔT2 during a bite task. J. MAGN. RESON. IMAGING 2016;44:804-813.
Collapse
Affiliation(s)
- Minoru Takahashi
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Satoshi Yamaguchi
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Tsuyoshi Fujii
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Makoto Watanabe
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Kansei Fukushi Research Center, Tohoku Fukushi University, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|
12
|
Stelzenmueller W, Umstadt H, Weber D, Goenner-Oezkan V, Kopp S, Lisson J. Evidence - The intraoral palpability of the lateral pterygoid muscle - A prospective study. Ann Anat 2015; 206:89-95. [PMID: 26706107 DOI: 10.1016/j.aanat.2015.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Abstract
The intraoral palpability of the inferior caput of the lateral pterygoid muscle has been a matter of ambiguity because of its topography. Thus, none of the recently published studies has provided reliable proof of the possibility of digital intraoral palpation, although palpation of the muscle is part of most of the examination catalogs for clinical functional analysis and functional therapy. Digital muscle palpation was performed intraorally on five preparations after exposure of the infratemporal fossa and visualization of the lateral pterygoid muscle. Direct digital palpation of the lateral pterygoid muscle was seen in all five cases. The successful palpation was carried out and approved during laterotrusion to the examined side (relaxation). While opening and closing the mouth (contraction) the muscle is palpable. In real-time kinematic measurements (MRI) an impression of the lateral caput of the left lateral pterygoid muscle of a 30-year-old control male person was found up to 6mm. Electromyographic detection by direct signal conduction with concomitant palpation is possible. The injection electrode tested in situ in the muscle was felt transorally with the palpating finger. The intraoral palpability of the inferior caput of the lateral pterygoid muscle is verified. The basic requirement for successfully palpating the lateral pterygoid muscle is the exact knowledge of muscle topography and the intraoral palpation pathway. After documented palpation of the muscle belly in cadaverous preparations, MRI and EMG also visualized palpation of the lateral pterygoid muscle in vivo. The palpation technique seems to be essential and basically feasible.
Collapse
Affiliation(s)
- Wolfgang Stelzenmueller
- Universität des Saarlandes, Klinik für Kieferorthopädie, Campus Homburg, Homburg/Saar, Germany.
| | - Horst Umstadt
- CMF-Care GmbH, Practice for Oral and Cranio-Maxillofacial Surgery, Weinheim, Germany
| | - Dominic Weber
- Deutsches Zentrum für Dentaldiagnostik DZD, Frankfurt am Main, Germany
| | | | - Stefan Kopp
- Goethe-Universität Frankfurt, Zentrum der Zahn-, Mund- und Kieferheilkunde (Carolinum), Poliklinik für Kieferorthopädie, Frankfurt am Main, Germany
| | - Jörg Lisson
- Universität des Saarlandes, Klinik für Kieferorthopädie, Campus Homburg, Homburg/Saar, Germany
| |
Collapse
|
13
|
Cortes ARG, Jin Z, Morrison MD, Arita ES, Song J, Tamimi F. Mandibular Tori Are Associated With Mechanical Stress and Mandibular Shape. J Oral Maxillofac Surg 2014; 72:2115-25. [DOI: 10.1016/j.joms.2014.05.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 05/21/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
|
14
|
The influence of different registration positions on condyle displacement in symptomatic patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:312-8. [PMID: 24528791 DOI: 10.1016/j.oooo.2013.11.498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/13/2013] [Accepted: 11/18/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate effects of different registration positions on the condyle-disk position changes in the mandibular fossa in symptomatic individuals. STUDY DESIGN Vertical and sagittal condyle position and thickness of the bilaminar zone were measured by magnetic resonance imaging during maximal intercuspation (MI) and with jigs in Gothic arch tracing guided centric relation (DIR method [Dynamics and Intraoral Registration]) and retruded contact position (RCP). Participants were 26 patients seeking treatment for temporomandibular disorders. Condyle and disk position in the fossa were calculated in the parasagittal plane. RESULTS Significant differences were found for MI, DIR, and RCP for thickness of bilaminar zone and sagittal condyle position, dependent on diagnosis and registration position for vertical and sagittal condyle position and thickness of bilaminar zone. CONCLUSIONS DIR position ensures the widest posterior space for the retrodiskal tissues and the slightest sagittal difference between condyle zenith and glenoid fossa.
Collapse
|
15
|
Reichardt G, Miyakawa Y, Otsuka T, Sato S. The mandibular response to occlusal relief using a flat guidance splint. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2013; 6:134-139. [PMID: 24273617 PMCID: PMC3835921 DOI: 10.1007/s12548-013-0093-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 08/05/2013] [Indexed: 12/03/2022]
Abstract
Background The mechanism of action of occlusal splints used for the successful treatment of temporomandibular disorders (TMD) remains unclear and controversial. Aim The aim of this study was to observe the mandibular response during sleep bruxism (SB) on the elimination of occlusal influences by using a flat anterior and lateral guidance splint (FGS). Material and method Any changes in mandibular movement patterns and condylar position with the introduction of this tool were measured. Current SB activity on the natural dentition was evaluated using a Brux Checker® (BC) and compared with the activity after insertion of an FGS in 153 subjects. Result The spatial mandibular position changed individually with a tendency toward forward and downward movement. The insertion of an FGS led to a change in the topographical condyle-fossa relationship and seemed to create an “unloading” condition for the temporomandibular joint. It was found that increased angulation of the maxillar incisors was responsible for altered muscular activity during sleep. Conclusion The masticatory organ appears to self-regulate and to provide an oral behavior modification, which may be more physiological using the FGS as a compensating factor. In this context, it is assumed that sleep bruxism in terms of parafunctional activity is a physiological function of the masticatory organ. The results of this study indicate the importance of controlling anterior guidance in the functional reconstruction of human occlusion.
Collapse
Affiliation(s)
- G Reichardt
- Private Dental Office "Ihre Zahnärzte", Landhausstrasse 74, 70190 Stuttgart, Germany ; Department of Craniofacial Growth and Developmental Dentistry, Kanagawa Dental University, 82 Inaoka-cho, 238-8580 Yokosuka, Kanagawa Japan
| | | | | | | |
Collapse
|
16
|
Ficnar T, Middelberg C, Rademacher B, Hessling S, Koch R, Figgener L. Evaluation of the effectiveness of a semi-finished occlusal appliance--a randomized, controlled clinical trial. Head Face Med 2013; 9:5. [PMID: 23351923 PMCID: PMC3562212 DOI: 10.1186/1746-160x-9-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 01/16/2013] [Indexed: 11/10/2022] Open
Abstract
Introduction Painful temporomandibular disorders (TMDs) are usually treated with physiotherapy, self-exercises, medication-based therapy and splint therapy. For splint therapy different types of splints are available. Therefore this randomized controlled study compared the effectiveness of a semi-finished occlusal appliance (SB) with a laboratory-made occlusal appliance (SS) in myofascial pain patients. Method The trial subjects allocated to the experimental groups with the (SB) occlusal appliance and those provided with a laboratory-made occlusal appliance (SS) did, in addition, receive conservative treatment (self-exercises, drug-based and manual therapy). The control group was given conservative therapy (CO) only. Overall, a total of 63 patients participated in the study with each group consisting of 21 subjects. Results When the first follow-up examination took place (14 days after splint insertion) mouth opening within the SB group was significantly enlarged. When the second examination was conducted (2.5 months after splint insertion) mouth opening was significantly enlarged in both splint groups when compared with the initial value. In the control group, no significant enlargement of mouth opening was detected. At no point there was a significant reduction in the number of pressure-sensitive areas of the TMJ. On palpation of the masticatory muscles however, a significant reduction in the number of pressure-sensitive areas could be observed within the CO group and the SS group after 2.5 months. When comparing pain reduction (muscle/joint pain) and mouth opening, no significant differences could be detected between the treatments. Conclusion The results suggest that TMD should be treated conservatively. In cases of restricted mouth opening, the additional use of occlusal appliances can eliminate the patient’s discomfort more quickly. In this context, the tested, semi-finished occlusal appliance appears to offer an immediately available, temporary alternative to laboratory-made splints.
Collapse
Affiliation(s)
- Tobias Ficnar
- Department of Prosthetic Dentistry and Biomaterials, University Hospital Münster, Alber-Schweitzer-Campus 1, Building W 30, 48149, Münster, Germany.
| | | | | | | | | | | |
Collapse
|
17
|
Hellmann D, Giannakopoulos NN, Schmitter M, Lenz J, Schindler HJ. Anterior and posterior neck muscle activation during a variety of biting tasks. Eur J Oral Sci 2012; 120:326-34. [DOI: 10.1111/j.1600-0722.2012.00969.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel Hellmann
- Department of Prosthodontics; University of Heidelberg; Heidelberg; Germany
| | | | - Marc Schmitter
- Department of Prosthodontics; University of Heidelberg; Heidelberg; Germany
| | - Jürgen Lenz
- Research Group Biomechanics; Institute for Mechanics; Karlsruhe Institute of Technology (KIT); Karlsruhe; Germany
| | | |
Collapse
|
18
|
Türp JC, Schindler H. The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. J Oral Rehabil 2012; 39:502-12. [PMID: 22486535 DOI: 10.1111/j.1365-2842.2012.02304.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The relationship between the dental occlusion and temporomandibular disorders (TMDs) has been one of the most controversial topics in the dental community. In a large epidemiological cross-sectional survey - the Study of Health in Pomerania (Germany) - associations between 15 occlusion-related variables and TMD signs or symptoms were found. In other investigations, additional occlusal variables were identified. However, statistical associations do not prove causality. By using Hill's nine criteria of causation, it becomes apparent that the evidence of a causal relationship is weak. Only bruxism, loss of posterior support and unilateral posterior crossbite show some consistency across studies. On the other hand, several reported occlusal features appear to be the consequence of TMDs, not their cause. Above all, however, biological plausibility for an occlusal aetiology is often difficult to establish, because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either, because the amelioration may be due to the change of the appliance-induced intermaxillary relationship. In addition, symptoms often abate even in the absence of therapy. Although patients with a TMD history might have a specific risk for developing TMD signs, it appears more rewarding to focus on non-occlusal features that are known to have a potential for the predisposition, initiation or perpetuation of TMDs.
Collapse
Affiliation(s)
- J C Türp
- Dental School, University of Basel, Basel, Switzerland.
| | | |
Collapse
|
19
|
HELLMANN D, GIANNAKOPOULOS NN, BLASER R, EBERHARD L, RUES S, SCHINDLER HJ. Long-term training effects on masticatory muscles. J Oral Rehabil 2011; 38:912-20. [DOI: 10.1111/j.1365-2842.2011.02227.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Schindler HJ, Turp JC. Letters to the Editor. Eur J Orthod 2010; 32:228-9; author reply 229. [DOI: 10.1093/ejo/cjq001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
21
|
Ettlin D, Mang H, Colombo V, Palla S, Gallo L. Stereometric Assessment of TMJ Space Variation by Occlusal Splints. J Dent Res 2008; 87:877-81. [DOI: 10.1177/154405910808700903] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Occlusal splints are used for the management of temporomandibular disorders, although their mechanism of action remains controversial. This study investigated whether insertion of an occlusal splint leads to condyle-fossa distance changes, and to mandibular rotation and/or translation. By combining magnetic resonance images with jaw tracking (dynamic stereometry), we analyzed the intra-articular distances of 20 human temporomandibular joints (TMJs) before and after insertion of occlusal splints of 3 mm thickness in the first molar region. For habitual closure, protrusion, and laterotrusion in the contralateral joint, occlusal splints led to minor—yet statistically significant—increases of global TMJ space and to larger increases at defined condylar areas. Condylar end rotation and translation in habitual closure were reduced. Hence, the insertion of a 3-mm-thick occlusal splint led to a change in the topographical condyle-fossa relationship, and therefore to a new distribution of contact areas between joint surfaces.
Collapse
Affiliation(s)
- D.A. Ettlin
- Clinic for Masticatory Disorders, Removable Prosthodontics and Special Care Dentistry, Center for Oral Medicine, Dental and Maxillo-Facial Surgery, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032 Zürich, Switzerland
| | - H. Mang
- Clinic for Masticatory Disorders, Removable Prosthodontics and Special Care Dentistry, Center for Oral Medicine, Dental and Maxillo-Facial Surgery, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032 Zürich, Switzerland
| | - V. Colombo
- Clinic for Masticatory Disorders, Removable Prosthodontics and Special Care Dentistry, Center for Oral Medicine, Dental and Maxillo-Facial Surgery, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032 Zürich, Switzerland
| | - S. Palla
- Clinic for Masticatory Disorders, Removable Prosthodontics and Special Care Dentistry, Center for Oral Medicine, Dental and Maxillo-Facial Surgery, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032 Zürich, Switzerland
| | - L.M. Gallo
- Clinic for Masticatory Disorders, Removable Prosthodontics and Special Care Dentistry, Center for Oral Medicine, Dental and Maxillo-Facial Surgery, University of Zürich, Switzerland, Plattenstrasse 11, CH-8032 Zürich, Switzerland
| |
Collapse
|
22
|
Stapelmann H, Türp JC. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache - where do we stand? A qualitative systematic review of the literature. BMC Oral Health 2008; 8:22. [PMID: 18662411 PMCID: PMC2583977 DOI: 10.1186/1472-6831-8-22] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Accepted: 07/29/2008] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. METHODS We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. RESULTS Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavakli 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. CONCLUSION Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The NTI-tss bite splint may be justified when a reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding) is desired, or as an emergency device in patients with acute temporomandibular pain and, possibly, restricted jaw opening.
Collapse
Affiliation(s)
- Henrike Stapelmann
- Clinic for Reconstructive Dentistry and Temporomandibular Disorders, Dental School, Hebelstrasse 3, 4056 Basel, Switzerland
| | - Jens C Türp
- Clinic for Reconstructive Dentistry and Temporomandibular Disorders, Dental School, Hebelstrasse 3, 4056 Basel, Switzerland
- Interuniversity College for Health and Development Graz/Castle of Seggau, Austria
| |
Collapse
|
23
|
Schindler HJ, Türp JC, Sommer C, Kares H, Nilges P, Hugger A. Therapie bei Schmerzen der Kaumuskulatur. Schmerz 2007; 21:102-15. [PMID: 17123054 DOI: 10.1007/s00482-006-0514-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Myalgias of the masticatory muscles are the most frequent noninfectious complaints in the orofacial region. After summarizing the current knowledge on the physiology, etiology, pathophysiology, diagnosis, and differential diagnosis of masticatory muscle pain, we specifically focus on management recommendations. Results of an extensive literature search show that for the majority of patients pain reduction or pain relief can be achieved with noninvasive reversible methods. Longitudinal short- and long-term studies have revealed that different therapeutic measures are similarly effective. In patients with chronic masticatory myalgias associated with psychosocial impairment, however, additional involvement of a psychotherapist is crucial.
Collapse
Affiliation(s)
- H J Schindler
- Bundesforschungsanstalt für Ernährung, Hirschstr. 105, 76137 , Karlsruhe, Deutschland.
| | | | | | | | | | | |
Collapse
|