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Rosati R, Val M, Manfredini D, Carmagnola D, Fortunati C, Guarda-Nardini L, Dellavia C. Baseline masticatory muscles' performance may predict pain relief in temporomandibular disorders. Oral Dis 2024. [PMID: 38807477 DOI: 10.1111/odi.15011] [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: 10/09/2023] [Revised: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES To compare masticatory muscles' recruitment in patients with temporomandibular disorders and asymptomatic control subjects. To evaluate if the masticatory muscles' recruitment pattern may predict symptoms' improvement after temporomandibular disorders treatment. MATERIALS AND METHODS Standardized surface electromyography of anterior temporalis and superficial masseters muscles were recorded and compared at baseline in 26 patients with arthrogenous temporomandibular disorders (study group) and 26 asymptomatic subjects (control group). The study group was treated pharmacologically and by means of five arthrocentesis sessions. Pre-, during-, and post-treatment pain and mandibular function were assessed and compared among timepoints. Clinical improvement in terms of pain and mandibular function was correlated with pre-treatment standardized surface electromyography values. RESULTS Temporomandibular disorders patients showed improved maximum mouth opening and pain during and after treatment with arthrocentesis compared to baseline (T-test p < 0.01). Standardized surface electromyography values were significantly different in temporomandibular disorders subjects compared to controls (T-test p < 0.05). Improvement in pain at rest after treatment was inversely correlated with pre-treatment masseters standardized surface electromyography symmetry (R-coefficient 0.3936; p < 0.05). CONCLUSIONS Temporomandibular disorders patients showed a different muscular recruitment pattern compared to controls. The lesser the pre-treatment masseters symmetry, the greater the improvement of pain at rest after treatment.
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Affiliation(s)
- Riccardo Rosati
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Val
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, ASL 2 Marca Trevigiana, Treviso, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Daniela Carmagnola
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Claudia Fortunati
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Luca Guarda-Nardini
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, ASL 2 Marca Trevigiana, Treviso, Italy
| | - Claudia Dellavia
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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Saracutu OI, Pollis M, Cagidiaco EF, Ferrari M, Manfredini D. Repeatability of Teethan® indexes analysis of the masseter and anterior temporalis muscles during maximum clenching: a pilot study. Clin Oral Investig 2023; 27:5309-5316. [PMID: 37507600 PMCID: PMC10492765 DOI: 10.1007/s00784-023-05150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES The aim of this study is to assess the repeatability of a surface electromyographic (EMG) device (Teethan®, Teethan S.p.A., Milan, Italy), designed for the analysis of the masseter and anterior temporalis muscles. MATERIALS AND METHODS Tests were performed on a sample of 30 healthy fully dentate TMD-free individuals randomly selected. Each test consisted of two distinct recordings performed at 5-min intervals: (i) the patient is asked to clench with maximum voluntary contraction (MVC), with two cotton rolls interposed between the dental arches; (ii) the patient is asked to repeat the same clenching activity without the cotton rolls. The outcomes of the study were the EMG indices conceptualized by the manufacturing company, based on the differences between the two test conditions (i.e., clenching on cotton rolls and on dentition). Pairwise correlation analysis and ANOVA test were performed to assess the strength of correlation and the significance of differences between the results of the three trials. RESULTS Thirty TMD-free healthy individuals (20 females and 10 males; mean age 44 years, range 16-60 years) took part in the study. ANOVA test did not show any statistically significant difference between the three trials. The Global Index, which is the mean of the other EMG indices, showed the highest correlation values between the three trials, while some other indices showed a weak-to-medium correlation level. One out of five participants showed a coefficient of variation higher than 10%. CONCLUSIONS The statistical analysis showed that the indices provided by the device are quite repeatable. However, this does not necessarily imply a specific clinical application of the device, which was here used in fully controlled experimental conditions. CLINICAL RELEVANCE The clinical usefulness of the applied protocol remains questionable. Further studies should test the repeatability of EMG findings gathered with this device under various circumstances, in a more heterogeneous population.
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Affiliation(s)
- Ovidiu Ionut Saracutu
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy.
| | - Matteo Pollis
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Edoardo Ferrari Cagidiaco
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Marco Ferrari
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
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Kulchutisin P, Sowithayasakul T, Pumklin J, Piyapattamin T. Electromyographic Evaluations of Masticatory Muscle Activity between Patients with Skeletal Class I and III Relationships. Eur J Dent 2023; 17:910-916. [PMID: 36513336 PMCID: PMC10569853 DOI: 10.1055/s-0042-1758064] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the muscle activity of the masseter muscle (MM) and anterior temporal muscle (TA) of patients with skeletal Class I and III during maximum voluntary clenching (MVC) at the intercuspal position (ICP) and during chewing. MATERIALS AND METHODS Twenty patients were divided into Steiner's skeletal Class I and III groups. MM and TA activity during each task was measured by using surface electromyography. Averaged MM and TA activity during both tasks, symmetry of each muscle activity, synergy between ipsilateral MMs and TAs, and muscle effort were compared. STATISTICAL ANALYSIS Means and standard deviations of intergroup variables were compared by an independent sample t-test for parametric evaluations or by the Mann-Whitney U test for nonparametric evaluations. A probability value of p less than 0.05 was considered significant. RESULTS Averaged MM activity and muscle synergy during MVC at the ICP in skeletal Class III patients were lower than that in skeletal Class I patients. Neither symmetry nor muscle effort during both tasks was different. CONCLUSION Masticatory muscle performance of skeletal Class III patients was inferior to that of skeletal Class I patients.
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Affiliation(s)
- Pakwan Kulchutisin
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thanaporn Sowithayasakul
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Jittima Pumklin
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thosapol Piyapattamin
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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Akat B, Görür SA, Bayrak A, Eren H, Eres N, Erkcan Y, Kılıçarslan MA, Orhan K. Ultrasonographic and electromyographic evaluation of three types of occlusal splints on masticatory muscle activity, thickness, and length in patients with bruxism. Cranio 2023; 41:59-68. [PMID: 32936747 DOI: 10.1080/08869634.2020.1820685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate occlusal splint type differences in patients with bruxism. METHODS Seventeen controls and 51 patients were divided into three subgroups, each assigned to use a different occlusal splint (hard, soft, or semi-soft) for 3 months and assessed by ultrasonography and electromyography (EMG) before (BT) and 3 months after treatment (AT). RESULTS EMG values in all of the occlusal splint groups were significantly lower AT than BT (p < 0.05). BT and AT EMG values in the control group did not differ. Mean muscle thicknesses in bruxism patients was greater than in controls, and the greatest muscle thickness changes occurred with the hard occlusal splint (p < 0.05). DISCUSSION A decrease in EMG activity occurred with all three splint types and was most prominent in the hard occlusal splint group. Ultrasonographic measurements of muscle length and thickness should be used alongside EMG to measure muscle activity in bruxism patients.
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Affiliation(s)
- Bora Akat
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Sinem Atay Görür
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Ayben Bayrak
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Hakan Eren
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Necati Eres
- Department of Prosthodontics, Faculty of Dentistry, University of Lokman Hekim, Ankara, Turkey
| | - Yezdan Erkcan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Mehmet Ali Kılıçarslan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey
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Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Spagnuolo G, Woźniak K. Surface electromyography in the assessment of masticatory muscle activity in patients with pain-related temporomandibular disorders: a systematic review. Front Neurol 2023; 14:1184036. [PMID: 37206909 PMCID: PMC10188953 DOI: 10.3389/fneur.2023.1184036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Background Temporomandibular disorders (TMD) are a set of painful conditions affecting the orofacial region that are prevalent and constitute the most frequent type of non-dental pain complaint in the maxillofacial area. Pain-related TMD (TMD-P) is characterized by ongoing pain in the masticatory muscles, the temporomandibular joint, or surrounding structures. Due to the multiple factors that contribute to the development of this condition, it can be challenging to accurately diagnose. One of the useful method for assessing patients with TMD-P is surface electromyography (sEMG). The aim of this systematic review was to provide a comprehensive overview of the current scientific literature on the evaluation of masticatory muscle activity (MMA) in individuals diagnosed with TMD-P, through the utilization of sEMG. Methods To gather relevant information, electronic databases such as PubMed, Web of Science, Scopus, and Embase were searched using specific keywords including: "pain" AND ("temporomandibular disorder*" OR "temporomandibular dysfunction*") AND "surface electromyography" AND "masticatory muscle activity." The inclusion criteria were studies assessing MMA in patients with TMD-P using sEMG. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was utilized to evaluate the quality of the studies that were included in the review. Results The search strategy identified 450 potential articles. Fourteen papers met the inclusion criteria. Global quality rating for significant part of the articles was weak. Most studies showed greater sEMG activity of the masseter (MM) and temporal anterior (TA) muscles at rest in TMD-P subjects than in the asymptomatic controls, while the MM and TA muscles were less active in the pain-related TMD group compared to the non-TMD group during maximal voluntary clenching (MVC). Conclusion There were differences in MMA in the TMD-pain population compared to a healthy control group during various tasks. The diagnostic efficacy of surface electromyography in assessing individuals with TMD-P remains unclear.
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Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
- *Correspondence: Liliana Szyszka-Sommerfeld,
| | | | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Napoli, Italy
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
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Associations of Masticatory Muscles Asymmetry and Oral Health with Postural Control and Leg Injuries of Elite Junior Soccer Players. J Hum Kinet 2022; 84:21-31. [DOI: 10.2478/hukin-2022-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
The influence of asymmetry between masticatory muscles on postural control is still under debate and only few studies examined the impact of oral health on injury risk.
The present study investigated the relationships between masticatory muscles asymmetry, oral health, postural control and the prevalence of (non-contact or traumatic) leg injuries in a sample of 144 male elite junior soccer players. sEMG of the masseter and temporal muscles was performed during maximum teeth clenching, postural control was tested by measuring sway velocity during the unipedal stance with eyes closed, while oral health and the number of leg injuries were assessed using a questionnaire. The time-1 assessment was repeated in a subgroup of 69 players after one year. Pearson and partial correlation coefficients and adjusted odds ratios (OR) were used to assess associations. Asymmetry between the masseter and temporalis muscles (AMTM, quantified as anteroposterior coefficient, APC) was associated with higher sway velocity on the dominant leg (using time-1 data partial r = -0.24, p = 0.004, using longitudinal data partial r = -0.40, p = 0.005). Higher prevalence of two or more leg injuries throughout a competitive season was associated with poor oral health (adjusted OR (95%CI) using time-1 data = 2.14 (1.02–4.46), using longitudinal data = 4.47 (1.25–15.96)). These results indicate that AMTM has a negative influence on the sway velocity of the dominant leg only, possibly because frequent balancing exercises on the non-dominant leg may counteract negative influences of AMTM. The association of oral health with leg injuries underlines the need for oral health promotion and monitoring strategies in sports.
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Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized Controlled Trial. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083821] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Temporomandibular disorders (TMD) are primarily characterized by pain as well as issues concerning the proper functioning of individual elements of the stomatognathic system. The aim of the study was to assess the safety and efficacy of physical exercise, with or without radial Extracorporeal Shock Wave Therapy (rESWT), in patients with TMD. Eligible patients were adults (≥18 years) with diagnosed myofascial pain with or without mouth opening limitation (Group Ia, Ib) based on the Diagnostic Criteria for TMD (DC/TMD). Enrolled patients (n = 15) were randomly assigned 1:1 to receive physical exercise combined with rESWT (n = 8) or sham rESWT (n = 7) for four weeks. The primary endpoint was the pain intensity measured by a visual analogue scale (VAS). The secondary endpoints were muscle activity and function assessed through the surface electromyography evaluation of the anterior temporalis and the masseter muscles. The rESWT group (mean age: 28.50 ± 8.85 years) showed a statistically significant pain reduction (VAS Right side: ΔT0-T1 MD = −3.00; p = 0.023, Left side: ΔT0-T1, MD = 3.57, p = 0.021), whereas patients in the sham WBV group (mean age: 30.71 ± 8.98 years), did not reach statistical significance (VAS: Right side: ΔT0-T1 MD = 1.00, p = 0.155; Left side: ΔT0-T1 MD = 1.25 SE = 0.25, p = 0.094). Concurrently, muscle activity and performance significantly improved in the active rESWT group, with an improvement in the percentage of the overlapping coefficient (POC) compared to the control group. No dropouts and no side effects were recorded. Taken together, the findings of this pilot RCT suggested that rESWT combined with physical therapy could be effective in relieving pain and improving function in muscle-related TMD patients.
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Alessandri Bonetti A, Gallenzi P. Is there an association between EMG activity and temporomandibular disorders during orthotic mandibular advancement in sleep apnea patients undergoing DISE? Cranio 2022:1-6. [PMID: 35261324 DOI: 10.1080/08869634.2022.2047511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To detect whether myotatic reflex activation of masticatory muscles during drug-induced sleep endoscopy (DISE) can be an indirect marker for temporomandibular disorder (TMD) in patients suffering from obstructive sleep apnea (OSA). METHODS OSA patients were prospectively recruited and underwent a complete TMD examination prior to undergoing DISE with the addition of electrodes applied over masticatory muscles. A positive activation of myotatic reflex was considered in case of an increase in muscle tone of at least 50%. RESULTS Of the 41 patients included, 48.8% presented activation of myotatic reflex. Of these patients, 45% presented a TMD diagnosis, 40% presented pain at masticatory muscles palpation, and 15% did not report pain during clinical examination. CONCLUSION An increase in EMG activity during mandibular advancement is not associated with TMD presence, but it can be an indirect marker of pain in the orofacial area in OSA patients.
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Affiliation(s)
- Anna Alessandri Bonetti
- Institute of Dental Clinic and Maxillofacial Surgery, A. Gemelli University Policlinic IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Patrizia Gallenzi
- Institute of Dental Clinic and Maxillofacial Surgery, A. Gemelli University Policlinic IRCCS, Catholic University of Sacred Heart, Rome, Italy
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Accuracy of Surface Electromyography in the Diagnosis of Pain-Related Temporomandibular Disorders in Children with Awake Bruxism. J Clin Med 2022; 11:jcm11051323. [PMID: 35268414 PMCID: PMC8911396 DOI: 10.3390/jcm11051323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/20/2022] [Accepted: 02/26/2022] [Indexed: 12/27/2022] Open
Abstract
The study assessed masticatory muscle electromyographic (EMG) activity in both children diagnosed with pain-related temporomandibular disorders (TMD-P) and awake bruxism (AB) and in children without TMD, as well as the diagnostic value of surface electromyography (sEMG) in diagnosing TMD-P in subjects with AB. After evaluation based on the Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), 30 children diagnosed with myofascial pain were included in the myofascial pain group and 30 children without TMD diagnosis comprised the control group (mean age of 9.49 ± 1.34 years). The activity of the anterior temporal (TA) and masseter (MM) muscle was assessed bilaterally using a DAB-Bluetooth device (zebris Medical GmBH, Germany) at rest and during maximum voluntary clenching (MVC). The receiver operating characteristic (ROC) curve was used to determine the accuracy, sensitivity, and specificity of the normalized sEMG data. Statistically significant intergroup differences were observed in TA and MM muscle EMG activity at rest and during MVC. Moderate degree of sEMG accuracy in discriminating between TMD-P and non-TMD children was observed for TAmean, left MM, and MMmean EMG muscle activity at rest. sEMG can be a useful tool in assessing myofascial TMD pain in patients with AB.
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Ozturk G, Bal B, Oral K. Electromyographic evaluation of the effect of hard and soft stabilizing appliances on masseter and anterior temporalis muscles in asymptomatic individuals. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm20220812-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: Stabilization appliances have traditionally been used for the treatment of temporomandibular disorders and bruxism. The aim of this study was to evaluate the effect of two appliances (hard and soft) with different thicknesses on the electromyographic (EMG) activities of masseter and anterior temporalis muscles. Material and Methods: 30 healthy subjects have been divided into two groups of 15, according to the appliance material used (soft, hard). For each subject in both groups, two appliances have been prepared with 3 mm and 6 mm thickness. EMG recordings of bilateral masseter and anterior temporalis muscles were taken for each appliance. Results: The results showed that, the decrease in average EMG values during maximum voluntary clenching with a 3-mm and 6-mm-thick hard appliance was statistically significant compared with the average EMG of maximum voluntary clenching in the intercuspal position. The increase in average EMG values during maximum voluntary clenching with a soft appliance of 3 mm and 6 mm thickness was statistically significant. Conclusions: The hard stabilization appliances decrease the activity of the masseter and temporalis muscles, while the soft appliances increase the activity of the masseter and temporalis muscles.
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Sreekumar S, Janakiram C, Mathew A. Effects of Prosthetic Rehabilitation on Temporomandibular Disorders: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e33104. [PMID: 34951603 PMCID: PMC8742205 DOI: 10.2196/33104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/28/2021] [Accepted: 11/10/2021] [Indexed: 01/01/2023] Open
Abstract
Background Loss of teeth or occlusal imbalance is one of the proposed dental risk factors for temporomandibular disorders (TMDs). Losing some non–free-end teeth cause the original occluding tooth/teeth to supraerupt from the original upright position and causes neighboring tooth/teeth to shift in an angle, causing biomechanical imbalance on the mandible. Based on these sequelae, rehabilitation of missing teeth is the first step in managing TMD in edentulous patients. Even though the prevalence of TMD in association with edentulism and in rehabilitated patients has been increasing, proper guidelines for the management of such cases have not been established. This study describes the protocol to analyze the effect of prosthetic rehabilitation on patients with TMD. Objective This study aims to determine the effectiveness of prosthetic rehabilitation in the reduction of pain in edentulous patients with TMD and to determine the effect of the span of edentulism, the number of quadrants involved, pathological migration, the type of Kennedy classification, and the prosthetic status on temporomandibular joint dysfunction signs and symptoms. Methods In this randomized controlled trial, 300 patients diagnosed with TMD will be grouped into one of the three interventional groups based on the type of their edentulous state. The interventional groups are (1) partially edentulous arch: Kennedy Class I and II (prosthetic rehabilitation without splint); (2) partially edentulous arch: Kennedy Class III and IV (prosthetic rehabilitation with a splint); and (3) completely edentulous arches (prosthetic rehabilitation without splint). All three of the mentioned interventional groups have corresponding control groups that will receive symptomatic treatment and comprehensive counseling. The measured primary outcomes are pain and electromyogram, and the secondary outcomes include pain drawing, Graded Chronic Pain Scale, Jaw Functional Limitation Scale, Oral Behaviours Checklist, depression, physical symptoms, and anxiety. The outcome measurements will be recorded at baseline and at the end of 24 hours, 7 days, 28 days, and 3 months. Results Ethical approval was obtained from the Institutional Review Board of Amrita Institute of Medical Sciences, Kochi, India. Study participants’ recruitment began in May 2021 and is expected to conclude in March 2023. This clinical trial protocol was developed based on the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 Statement. Conclusions The purpose of this study is to gather data on prosthetic rehabilitation as a treatment for TMD. Obtaining this goal will aid in the development of evidence-based therapy protocols for prosthetic rehabilitation in TMD management. Trial Registration Clinical Trials Registry - India CTRI/2020/06/026169; http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=42381 International Registered Report Identifier (IRRID) DERR1-10.2196/33104
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Affiliation(s)
- Saranya Sreekumar
- Department of Prosthodontics and Implantology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kerala, India
| | - Chandrashekar Janakiram
- Department of Prosthodontics and Implantology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kerala, India
| | - Anil Mathew
- Department of Prosthodontics and Implantology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kerala, India
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Pinheiro M, Willaert R, Khan A, Krairi A, Van Paepegem W. Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions. Sci Rep 2021; 11:14034. [PMID: 34234245 PMCID: PMC8263622 DOI: 10.1038/s41598-021-93564-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/22/2021] [Indexed: 01/01/2023] Open
Abstract
Temporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies have shown that perturbations to the normal masticatory function can lead to morphological and functional changes in the craniomaxillofacial system. A clearer understanding of the biomechanical implications of TMJ replacement in masticatory function may help identify design shortcomings that hinder their long-term success. In this study, patient-specific finite element models of the intact and implanted mandible were developed and simulated under four different biting tasks. In addition, the impact of re-attaching of the lateral pterygoid was also evaluated. The biomechanics of both models was compared regarding both mandibular displacements and principal strain patterns. The results show an excessive mediolateral and anteroposterior displacement of the TMJ implant compared to the intact joint in three biting tasks, namely incisor (INC), left moral (LML), and right molar (RML) biting. The main differences in principal strain distributions were found across the entire mandible, most notably from the symphysis to the ramus of the implanted side. Furthermore, the re-attachment of the lateral pterygoid seems to increase joint anteroposterior displacement in both INC, LML and RML biting while reducing it during LGF. Accordingly, any new TMJ implant design must consider stabilising both mediolateral and anteroposterior movement of the condyle during biting activities and promoting a more natural load transmission along the entire mandible.
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Affiliation(s)
- Manuel Pinheiro
- Department of Materials, Textiles and Chemical Engineering, Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium.
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium
| | - Afaq Khan
- Materials Innovation Institute (M2i), Delft, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Anouar Krairi
- Materials Innovation Institute (M2i), Delft, The Netherlands
| | - Wim Van Paepegem
- Department of Materials, Textiles and Chemical Engineering, Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium
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Linsen SS, Schön A, Mercuri LG, Teschke M. Unilateral, Alloplastic Temporomandibular Joint Reconstruction, Biomechanically What Happens to the Contralateral Temporomandibular Joint?-A Prospective Cohort Study. J Oral Maxillofac Surg 2021; 79:2016-2029. [PMID: 33631133 DOI: 10.1016/j.joms.2021.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Unilateral alloplastic total temporomandibular joint reconstruction (TMJR) might influence the contralateral side joint function. This study's purpose was to estimate the risk for contralateral TMJR and the jaw function of the contralateral untreated temporomandibular joint (TMJ). PATIENTS AND METHODS A prospective cohort study design was used for patients who underwent unilateral alloplastic TMJR. The primary predictor was time after TMJR, and the secondary predictors were pre-TMJR mandibular angle resection, prior ipsilateral TMJ surgeries, and TMJR design (custom, stock). The primary outcome variable was the need for contralateral TMJR. The secondary outcome variables were the results of jaw function-jaw tracking, maximum voluntary clenching, surface electromyography, and pressure pain thresholds (PPT) and patient's quality-of-life (oral health-related quality-of-life [OHrQoL]). Data were collected preoperatively (T0), and 1 year (T1), 2-3 years (T2), and ≥ 4 years postoperatively (T4). Analysis of variance with post hoc Tukey -HSD test and multiple linear regression analysis were used for statistical analysis. P < .05 was considered significant. RESULTS Thirty-nine patients were enrolled, 15 males and 24 females, with an average age of 48.9 ± 16.2 years. Two patients (5.1%) required a contralateral TMJR. Contralateral condylar motion, incisal laterotrusion, and protrusion slightly decreased, while incisal opening (P = .003), rotation angle (P = .013), opening deflection, surface electromyography activity, maximum voluntary clenching (P = .01), PPTs, and OHrQoL all increased. Pre-TMJR mandibular angle resection had an impact on PPTs and subjective outcomes and prior ipsilateral TMJ surgeries on the opening rotation angle. CONCLUSIONS Based on this study, bilateral TMJR does not appear necessary when the contralateral TMJ is healthy. Unilateral alloplastic TMJR is associated with improved contralateral jaw function and OHrQoL.
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Affiliation(s)
- Sabine S Linsen
- Assistant Professor, Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany.
| | - Andreas Schön
- Assistant Professor, Department of Oral- and Maxillofacial Plastic Surgery, University Hospital Bonn, Bonn, Germany
| | - Louis G Mercuri
- Visiting Professor, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL; Adjunct Professor, Department of Bioengineering, University of Illinois Chicago, Chicago, IL; and Clinical Consultant, TMJ Concepts, Ventura, CA
| | - Marcus Teschke
- Private Practice, Praxis fuer Gesichtschirurgie und Kiefergelenkschirurgie, Hamburg, Germany
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Kim KY, Choi JY, Oh SH, Moon HW, Kim SH, Ahn HW, Kim KA, Nelson G. Computerized Assessment of Occlusion and Muscle Activity during Use of a Multilayer Clear Retainer: A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2021; 21:E541. [PMID: 33451097 PMCID: PMC7828563 DOI: 10.3390/s21020541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 11/17/2022]
Abstract
The aim of this preliminary study was to evaluate the short-term changes of occlusal contacts and muscle activity after orthodontic treatment during the use of a multi-layer clear retainer. Evaluation was done with the T-scan and BioEMG systems. A total of 18 subjects were included, who were evaluated at three time intervals-T0 at debonding, T1 at one month after retainer delivery, and T2 at four months after retainer delivery. The T-scan and electromyography (EMG) data were recorded simultaneously. The T-scan system recorded the occlusion time, disclusion time and force distribution. The EMG waves were quantified by calculating the asymmetry index and activity index. The time variables changed but not significantly. Occlusal force decreased in the anterior dentition and increased in the posterior dentition during T0-T2. There was no clear evidence of a relationship between unbalanced occlusal forces and muscle activity. In most subjects, the temporalis anterior muscle was more dominant than the masseter muscle. From this preliminary computerized study, there were no significant changes in the state of the occlusion or muscle activity during the short-term retention period.
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Affiliation(s)
- Kyoung Yeon Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul 02447, Korea; (K.Y.K.); (J.-Y.C.); (H.-W.M.); (H.-W.A.); (K.A.K.)
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul 02447, Korea; (K.Y.K.); (J.-Y.C.); (H.-W.M.); (H.-W.A.); (K.A.K.)
| | - Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Hyung-Wook Moon
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul 02447, Korea; (K.Y.K.); (J.-Y.C.); (H.-W.M.); (H.-W.A.); (K.A.K.)
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul 02447, Korea; (K.Y.K.); (J.-Y.C.); (H.-W.M.); (H.-W.A.); (K.A.K.)
| | - Hyo-Won Ahn
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul 02447, Korea; (K.Y.K.); (J.-Y.C.); (H.-W.M.); (H.-W.A.); (K.A.K.)
| | - Kyung A Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul 02447, Korea; (K.Y.K.); (J.-Y.C.); (H.-W.M.); (H.-W.A.); (K.A.K.)
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California San Francisco, San Francisco, CA 94143, USA;
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Kuć J, Szarejko KD, Gołębiewska M. Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9576. [PMID: 33371343 PMCID: PMC7767373 DOI: 10.3390/ijerph17249576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 01/08/2023]
Abstract
The aim of the study was functional evaluation of soft tissue mobilization in patients with temporomandibular disorder-myofascial pain with referral. The study group consisted of 50 individuals-37 females and 13 males. The average age was 23.36 ± 2.14 years. All subjects were diagnosed with myofascial pain with referral (diagnostic criteria for temporomandibular disorders). Soft tissue mobilization was applied three times. Electromyography of selected masticatory muscles was performed six times-before and after the treatment. After each mobilization, a decreasing tendency of muscular activity was observed in the entire study group. The Friedman test indicated that mobilization altered the activity of the right temporal muscle (p = 0.00010), both masseters (p = 0.0000), right sternocleidomastoid (p = 0.00251), left sternocleidomastoid (p = 0.00033), and right and left digastric muscles (p = 0.00045 and p = 0.00000, respectively). With respect to symmetry a statistically significant difference was noted in the case of the sternocleidomastoid muscles (p = 0.00729). In conclusion, soft tissue mobilization seems to be effective in the relaxation of masticatory muscles in patients with temporomandibular disorders. Our findings proved that soft tissue mobilization does not improve the symmetry and synergy of the masticatory muscles limited by dental occlusion.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 15-276 Bialystok, Poland
| | | | - Maria Gołębiewska
- Department of Dental Techniques, Medical University of Bialystok, 15-269 Bialystok, Poland;
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Surface Electromyography as a Method for Diagnosing Muscle Function in Patients with Congenital Maxillofacial Abnormalities. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8846920. [PMID: 33029337 PMCID: PMC7527883 DOI: 10.1155/2020/8846920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/24/2022]
Abstract
Electromyography (EMG) is the most objective and reliable method available for imaging muscle function and efficiency, which is done by identifying their electrical potentials. In global surface electromyography (sEMG), surface electrodes are located on the surface of the skin, and it detects superimposed motor unit action potentials from many muscle fibers. sEMG is widely used in orthodontics and maxillofacial orthopaedics to diagnose and treat temporomandibular disorders (TMD) in patients, assess stomatognathic system dysfunctions in patients with malocclusions, and monitor orthodontic therapies. Information regarding muscle sEMG activity in subjects with congenital maxillofacial abnormalities is limited. For this reason, the aim of this review is to discuss the usefulness of surface electromyography as a method for diagnosing muscle function in patients with congenital malformations of the maxillofacial region. Original papers on this subject, published in English between 1995 until 2020, are located in the MEDLINE/PubMed database.
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Electromyography as a Means of Assessing Masticatory Muscle Activity in Patients with Pain-Related Temporomandibular Disorders. Pain Res Manag 2020; 2020:9750915. [PMID: 32855751 PMCID: PMC7443041 DOI: 10.1155/2020/9750915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/28/2020] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to evaluate masticatory muscle electrical activity in patients with pain-related and pain-free temporomandibular disorders (TMDs) as well as in subjects with no TMD. Methods Ninety children with mixed dentition were recruited to the study. Of this total, 30 subjects were diagnosed with pain-related TMD (TMD-P), 30 with pain-free TMD (TMD-PF), and 30 without TMD. We used Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD) to assess the presence of TMD in the examined children. The electromyographical (EMG) potentials of the temporalis and masseter muscles were measured with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) at rest and during maximum voluntary clenching (MVC). Results An analysis of the EMG recordings showed statistically significant intergroup differences in masticatory muscle electrical activity at rest and during MVC. Significantly higher rest temporalis muscle activity was noted in pain-related TMD subjects compared with that children from the pain-free TMD and non-TMD groups, as well as in TMD-PF children in relation to those without TMD. The EMG potentials of the temporalis muscle during MVC were much lower in patients with TMD-P than in pain-free TMD and non-TMD subjects. Masseter muscle activity at rest in the TMD-pain group was significantly greater, and masseter muscle EMG potentials during clenching were markedly lower than in patients with no TMD diagnosis. Conclusion The use of electromyography to assess masticatory muscle function revealed alterations in the pattern of temporalis and masseter muscle activity in patients with pain-related TMD compared with the pain-free subjects.
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Melchior MDO, Valencise Magri L, Da Silva AMBR, Cazal MS, Da Silva MAMR. Influence of tongue exercise and orofacial myofunctional status on the electromyographic activity and pain of chronic painful TMD. Cranio 2019; 39:445-451. [PMID: 31431149 DOI: 10.1080/08869634.2019.1656918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To analyze the influence of tongue exercise and myofunctional status on the electromyographic activity (EMG) and pain perception in individuals with chronic painful TMDs.Methods: Twenty-four subjects diagnosed according to the DC/TMD (18-52 years old) were assessed: EMG on the masseter and anterior temporalis; myofunctional orofacial conditions underwent clinical assessment (OMES); and questionnaire for self-perception of TMD signs and symptoms (ProTMDMulti). The 50th percentile was calculated to establish a cutoff value based on OMES scores related to the functional variables of the tongue.Results: The compared groups showed no differences (p > 0.05) in self-perception of their TMD signs and symptoms or in the EMG activity during tongue exercises.Discussion: The myofunctional status of the tongue showed no impact on the painful TMD or on the activity of the masticatory muscles (captured during tongue exercise). The indication of tongue exercises in TMD cases is a safe and adequate possibility.
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Affiliation(s)
- Melissa De Oliveira Melchior
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Laís Valencise Magri
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Mateus Sgobi Cazal
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Valentino R, Cioffi I, Vollaro S, Cimino R, Baiano R, Michelotti A. Jaw muscle activity patterns in women with chronic TMD myalgia during standardized clenching and chewing tasks. Cranio 2019; 39:157-163. [DOI: 10.1080/08869634.2019.1589703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Roberta Valentino
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Iacopo Cioffi
- Faculty of Dentistry, University of Toronto Centre for the study of Pain, Toronto, ON, Canada
| | - Stefano Vollaro
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Roberta Cimino
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Roberta Baiano
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Ambrosina Michelotti
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
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Szyszka-Sommerfeld L, Machoy M, Lipski M, Woźniak K. The Diagnostic Value of Electromyography in Identifying Patients With Pain-Related Temporomandibular Disorders. Front Neurol 2019; 10:180. [PMID: 30891001 PMCID: PMC6411686 DOI: 10.3389/fneur.2019.00180] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/12/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Orofacial pain disorders can be divided into several subgroups. One of them is temporomandibular disorders (TMD) with recognizable signs such as joint noises, limitations in the range of motion, or mandibular deviation during function and symptoms-pain in the muscles or joint. Surface electromyography (sEMG) is a diagnostic tool that ensures reliable and valid evaluation of muscle activity. sEMG detects electrical potentials and on this account may conceivably be employed in the TMD recognition. The aim of this study was to assess the sensitivity, specificity, and accuracy of electromyography in diagnosing subjects with temporomandibular disorders, including pain-free TMD and pain-related TMD. Methods: The sample comprised 88 patients with cleft lip and palate and mixed dentition. TMD has been recognized on the grounds of Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). To evaluate the electrical activity of the temporal and masseter muscles in the rest position and during maximum voluntary contraction, a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) was used. The analysis of the receiver operating characteristic (ROC) curve gave information about accuracy, cut-off point value, sensitivity and specificity of the normalized sEMG data. Results: The highest diagnostic efficiency of sEMG in terms of identifying subjects with TMD and pain-related TMD was observed for the mean values of temporal and masseter muscle activity as well as the Asymmetry Index of the masseter muscles in a rest position. A moderate degree of EMG accuracy in differentiating between pain-related TMD and non-TMD children was observed for the mean values of masseter muscle activity and the Asymmetry Index of the masseter muscles at rest. Conclusion: An evaluation of electromyography exhibits its diagnostic usability in recognition of patients with pain-related TMD and it could be used as an adjunctive tool in the identification of this disorder. Clinical Trial Registration: This clinical research was registered in the ClinicalTrials.gov database under the number NCT03308266.
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Affiliation(s)
| | - Monika Machoy
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
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Ferreira MC, Porto de Toledo I, Dutra KL, Stefani FM, Porporatti AL, Flores-Mir C, De Luca Canto G. Association between chewing dysfunctions and temporomandibular disorders: A systematic review. J Oral Rehabil 2018; 45:819-835. [DOI: 10.1111/joor.12681] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. C. Ferreira
- Department of Speech Language Pathology; Federal University of Santa Catarina; Florianópolis Brazil
| | - I. Porto de Toledo
- Health Sciences Faculty; University of Brasilia; Brasilia Brazil
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - K. L. Dutra
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - F. M. Stefani
- Department of Speech Language Pathology; Federal University of Santa Catarina; Florianópolis Brazil
| | - A. L. Porporatti
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - C. Flores-Mir
- Department of Dentistry; Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
| | - G. De Luca Canto
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
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Electromyographic Analysis of Masticatory Muscles in Cleft Lip and Palate Children with Pain-Related Temporomandibular Disorders. Pain Res Manag 2018; 2018:4182843. [PMID: 29861801 PMCID: PMC5971269 DOI: 10.1155/2018/4182843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/16/2018] [Accepted: 04/12/2018] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to assess the electrical activity of temporalis and masseter muscles in children with cleft lip and palate (CLP) and pain-related temporomandibular disorders (TMD-P). Methods The sample consisted of 31 CLP patients with a TMD-P (mean age 9.5 ± 1.8 years) and 32 CLP subjects with no TMD (mean age 9.2 ± 1.7 years). The children were assessed for the presence of temporomandibular disorders (TMD) using Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the mandibular rest position and during maximum voluntary contraction (MVC). Results The rest activity of the temporalis and masseter muscles was significantly higher in TMD-P group compared with non-TMD children. A significant decrease in temporalis muscle activity during MVC was observed in TMD-P patients. There was a significant increase in the Asymmetry Index for temporalis and masseter muscle rest activity in the TMD-P group. Conclusion Cleft children diagnosed with TMD-P have altered masticatory muscle activity, and this can affect their muscle function.
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Abstract
INTRODUCTION Temporomandibular disease (TMD) etiology is multifactorial and is related to many perpetuating, predisposing, and initiating factors. The daytime parafunctions may have an important role in TMD pathogenesis. The most frequent parafunctions analyzed were the static parafunction (ie, clenching) and the dynamic parafunction (ie, grinding). In the present paper, the authors evaluated the swallowing (an oral function/parafunction) with the surface electromyography in patients with TMD. MATERIALS AND METHODS Twenty patients with TMD problems (nonhealthy patients, NHP) (mean age: 33 ± 1.994; 8 men and 12 women) and 20 healthy matched subjects (HP) (34.4 ± 2.782; 6 men and 14 women) were selected and examined. On each patient, an 8-channel surface electromyography was done during saliva swallowing. RESULTS Nonhealthy patients presented higher masseter and temporalis activation (P < 0.05) and an unbalancing of temporalis and submental muscles activation (P < 0.05) than the HP. DISCUSSION Nonhealthy patients presented a time of swallow higher than HP (P < 0.001). Nonhealthy patients presented a higher muscles activation and time of swallow than HP and a decrease of muscles balancing activation.
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da Silva FC, Palácio PRDC, Gomes AO, Politti F, Lima GRD, da Silva DDFT, Mesquita-Ferrrari RA, Fernandes KPS, Biasotto-Gonzalez DA, Deana AM, Bussadori SK. Electromyographic evaluation of masticatory muscles in individuals with hemiparesis and temporomandibular disorder. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1432159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Fernanda Cordeiro da Silva
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | - Andréa Oliver Gomes
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Fabiano Politti
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | | | - Raquel Agnelli Mesquita-Ferrrari
- Postgraduate Program in Rehabilitation Sciences and Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Rehabilitation Sciences and Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | - Alessandro Melo Deana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Rehabilitation Sciences and Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
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Salgueiro MDCC, Bortoletto CC, Horliana ACR, Mota ACC, Motta LJ, Motta PDB, MesquitaFerrari RA, Fernandes KPS, Bussadori SK. Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:391. [PMID: 28789647 PMCID: PMC5549372 DOI: 10.1186/s12906-017-1905-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022]
Abstract
BACKGROUND Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. METHODS The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey's test. DISCUSSION Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. TRIAL REGISTRATION NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0).
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Affiliation(s)
- Mônica da Consolação Canuto Salgueiro
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | | | - Anna Carolina RattoTempestini Horliana
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | - Ana Carolina Costa Mota
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | - Lara Jansiski Motta
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Management in Health Systems, Nove de Julho University, São Paulo, Brazil
| | | | - Raquel Agnelli MesquitaFerrari
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Kristianne Porta Santos Fernandes
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
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Chaves TC, Dos Santos Aguiar A, Felicio LR, Greghi SM, Hallak Regalo SC, Bevilaqua-Grossi D. Electromyographic ratio of masseter and anterior temporalis muscles in children with and without temporomandibular disorders. Int J Pediatr Otorhinolaryngol 2017; 97:35-41. [PMID: 28483248 DOI: 10.1016/j.ijporl.2017.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/06/2017] [Accepted: 03/16/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study investigated differences in surface electromyography (sEMG) activity of the masseter and anterior temporalis muscles in children with and without temporomandibular disorders (TMD). PARTICIPANTS Thirty-four children aged 8-12 years were recruited, comprising 17 children with TMD and 17 without TMD (control group [CG]). The children were quasi-matched for sex, age, weight, and height. sEMG data were obtained using Myosystem® Br-1 equipment with 12 channels to evaluate the bilateral masseter, anterior temporalis, and suprahyoid muscles. For sEMG analysis, raw and normalized root mean square (RMS) values were obtained at rest and during maximum clenching. The sEMG ratios of the raw RMS data of the bilateral masseter in relation to the anterior temporalis muscles (sEMG-M/AT ratio) were also assessed. Mann-Whitney tests (p ≤ 0.05) were used to compare sEMG ratio between TMD group and CG. RESULTS Significant prevalences of pain during chewing (53% vs. 0%, X2 = 5.87, p = 0.01), TMJ pain (58% vs. 0%, X2 = 6.67, p = 0.01), neck pain (58% vs. 18%, X2 = 3.77, p = 0.05) and pain in the temples (47% vs. 6%, X2 = 5.44, p = 0.02) were identified in the TMD group compared to CG. Our results revealed lower sEMG-M/AT ratios during maximum clenching (p = 0.01) in children with TMD compared to those in the asymptomatic CG. CONCLUSION The results showed that children with TMD preferentially used their temporalis muscles during maximum voluntary clenching, probably as a consequence of nociceptive inputs in order to obtain pain relief.
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Affiliation(s)
- Thaís Cristina Chaves
- Department of Neurosciences and Behavioral Sciences, Post Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto School of Medicine, University of São Paulo - USP, Brazil.
| | - Aroldo Dos Santos Aguiar
- Post-Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto School of Medicine, University of São Paulo - USP, Brazil
| | - Lilian Ramiro Felicio
- Physical Therapy Department, Post-graduate program in Physical Therapy, Federal University of Uberlândia, Brazil
| | - Stella Maris Greghi
- Post-Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto School of Medicine, University of São Paulo - USP, Brazil
| | - Simone Cecilio Hallak Regalo
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, Post-graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation at Ribeirão Preto School of Medicine, Post-graduate Program in Rehabilitation and Functional Performance, University of São Paulo-USP, Brazil
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Choi KH, Kwon OS, Jerng UM, Lee SM, Kim LH, Jung J. Development of electromyographic indicators for the diagnosis of temporomandibular disorders: a protocol for an assessor-blinded cross-sectional study. Integr Med Res 2017; 6:97-104. [PMID: 28462150 PMCID: PMC5395685 DOI: 10.1016/j.imr.2017.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/14/2016] [Accepted: 01/09/2017] [Indexed: 11/04/2022] Open
Abstract
Background Noninvasive and easy-to-use surface electromyography (EMG) is frequently utilized for the diagnosis of temporomandibular disorders (TMDs). However, few EMG parameters that consider TMDs in addition to the cranio-cervical-mandibular system have been regarded as important in traditional Korean medicine. Methods This clinical trial will be conducted as an assessor-blinded cross-sectional study. The participants will be classified based on the Diagnostic Criteria for TMDs Symptom Questionnaire (DC/TMD SQ) and 30 TMD patients and 30 healthy controls will be enrolled. The primary outcome will be the percentage overlapping coefficient (POC; %) in the masseter and sternocleidomastoid muscles between the patient group and healthy control group in clenching and cervical side flexion. The secondary outcomes include the score from temporomandibular joint-related questionnaires, the difference in the absolute values of EMG for the healthy group and TMD group before/after wearing intraoral appliances, and the change in the location of the temporomandibular joint as determined by X-ray imaging and 3D face photography. Discussion This study will provide information about the objective diagnostic method for TMD using surface EMG and will verify the effectiveness of surface EMG in diagnosing TMD. Furthermore, the method or device for diagnosis TMD will improve the expansion of treatment area to TMD by accumulating evidence for the efficacy of TKM treatment.
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Affiliation(s)
- Kwang-Ho Choi
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - O Sang Kwon
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Ui Min Jerng
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea.,Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - So Min Lee
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Lak-Hyung Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea.,Department of Neuropsychiatry, Woosuk University Oriental Medicine Hospital, Jeonju, Korea
| | - Jeeyoun Jung
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
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Pasinato F, Santos-Couto-Paz CC, Zeredo JLL, Macedo SB, Corrêa EC. Experimentally induced masseter-pain changes masseter but not sternocleidomastoid muscle-related activity during mastication. J Electromyogr Kinesiol 2016; 31:88-95. [DOI: 10.1016/j.jelekin.2016.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 07/30/2016] [Accepted: 09/26/2016] [Indexed: 11/24/2022] Open
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Fuentes AD, Sforza C, Miralles R, Ferreira CL, Mapelli A, Lodetti G, Martin C. Assessment of electromyographic activity in patients with temporomandibular disorders and natural mediotrusive occlusal contact during chewing and tooth grinding. Cranio 2016; 35:152-161. [PMID: 27101810 DOI: 10.1080/08869634.2016.1173312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study was to investigate whether the presence of a natural mediotrusive contact influences electromyographic (EMG) pattern activity in patients with temporomandibular disorders (TMDs). METHOD Bilateral surface EMG activity of the anterior temporalis (AT), masseter (MM), and sternocleidomastoid (SCM) muscles was recorded in 43 subjects during unilateral chewing and tooth grinding. Thirteen patients had TMD and a natural mediotrusive contact (Group 1), 15 had TMD without a natural mediotrusive contact (Group 2), and 15 were healthy subjects without mediotrusive contacts (Group 3). All subjects were examined according to the Research Diagnostic Criteria for TMD (RDC/TMD). All EMG values were standardized as the percentage of EMG activity recorded during maximum isometric contraction on cotton rolls. RESULTS EMG activity from all muscles measured showed no significant differences between groups during chewing and grinding. Overall, in all groups, the EMG activity during chewing was higher in the working side than the non-working side in AT and MM muscles. During grinding, these differences were only found in masseter muscles (mainly in eccentric grinding). SCM EMG activity did not show significant differences during chewing and grinding tasks. Symmetry, muscular balance, and absence of lateral jaw displacement were common findings in all groups. DISCUSSION EMG results suggest that the contribution of a natural mediotrusive occlusal contact to EMG patterns in TMD patients is minor. Therefore, the elimination of this occlusal feature for therapeutic purposes could be not indicated.
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Affiliation(s)
- Aler D Fuentes
- a Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile.,b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Chiarella Sforza
- c Functional Anatomy Research Center, Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italy
| | - Rodolfo Miralles
- b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Cláudia L Ferreira
- c Functional Anatomy Research Center, Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italy
| | - Andrea Mapelli
- c Functional Anatomy Research Center, Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italy.,d Department of Otorhinolaryngology, Ophthalmology, and Head and Neck Surgery , School of Medicine of Ribeirão Preto, University of São Paulo , São Paulo , Brazil
| | - Gianluigi Lodetti
- c Functional Anatomy Research Center, Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italy.,e Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, Dental Clinic , Università degli Studi di Brescia , Brescia , Italy
| | - Conchita Martin
- f Department of Stomatology IV, School of Dentistry , Complutense University of Madrid , Madrid , Spain
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Cazal MS, da Silva AMBR, Galo R, Junior WM, da Silva MAMR. Comparison of dynamic electromyographic analysis of masticatory capsules with materials of different textures. Cranio 2016; 34:105-11. [DOI: 10.1179/2151090315y.0000000003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Waheed El-Anwar M, Elsheikh E, Sweed AH, Ezzeldin N. Electromyography assessment in zygomaticomaxillary complex fractures. Oral Maxillofac Surg 2015; 19:375-379. [PMID: 25934247 DOI: 10.1007/s10006-015-0505-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/24/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this study was to assess the activity of the masseter and temporalis muscles using surface electromyography (EMG) in patients with zygomaticomaxillary complex (ZMC) fractures. PATIENTS AND METHODS This prospective study was carried out on 25 patients who had ZMC fractures. Fifteen patients were managed by open reduction and rigid fixation (ORIF) using titanium miniplates. This study, using surface electromyography, analyzed the activity of the masseter and temporalis muscles of 25 patients with ZMC fractures; 15 of them were surgically treated under general anesthesia (GA). Evaluations were made before surgery and 6 weeks after surgery by recording the mean of muscle contraction of 20 motor unit action potential (MUAP) against resistance, and statistical analyses were performed. RESULTS A significant EMG difference between the normal and ZMC fracture sides was found (P < 0.0001) for both masseter and temporalis muscles and was significantly improved after ORIF. However, postoperative EMV values of the repaired side was significantly less than measured postoperatively in the normal side (P < 0.0001) for both muscles. CONCLUSION ZMC fractures significantly diminish muscular activity of the masseter and temporalis and even though significant recovery of muscle activity was revealed after 6 weeks, it is still less than normal activity, highlighting the importance of postoperative rehabilitation.
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Affiliation(s)
- Mohammad Waheed El-Anwar
- Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Ezzeddin Elsheikh
- Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Hassan Sweed
- Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nillie Ezzeldin
- Rheumatology and Rehabilitation department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Dalewski B, Chruściel-Nogalska M, Frączak B. Occlusal splint versus modified nociceptive trigeminal inhibition splint in bruxism therapy: a randomized, controlled trial using surface electromyography. Aust Dent J 2015; 60:445-54. [DOI: 10.1111/adj.12259] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- B Dalewski
- Department of Prosthodontics; Pomeranian Medical University in Szczecin; Szczecin Poland
| | - M Chruściel-Nogalska
- Department of Prosthodontics; Pomeranian Medical University in Szczecin; Szczecin Poland
| | - B Frączak
- Department of Prosthodontics; Pomeranian Medical University in Szczecin; Szczecin Poland
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Pitta NC, Nitsch GS, Machado MB, de Oliveira AS. Activation time analysis and electromyographic fatigue in patients with temporomandibular disorders during clenching. J Electromyogr Kinesiol 2015; 25:653-7. [DOI: 10.1016/j.jelekin.2015.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 04/14/2015] [Accepted: 04/15/2015] [Indexed: 11/25/2022] Open
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Accuracy of the surface electromyography RMS processing for the diagnosis of myogenous temporomandibular disorder. J Electromyogr Kinesiol 2015; 25:596-602. [DOI: 10.1016/j.jelekin.2015.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/23/2022] Open
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Effect of different dental articulating papers on SEMG activity during maximum clenching. J Electromyogr Kinesiol 2015; 25:612-8. [DOI: 10.1016/j.jelekin.2015.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 04/12/2015] [Accepted: 04/14/2015] [Indexed: 11/18/2022] Open
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Grillo CM, Canales GDLT, Wada RS, Alves MC, Barbosa CMR, Berzin F, de Sousa MDLR. Could Acupuncture Be Useful in the Treatment of Temporomandibular Dysfunction? J Acupunct Meridian Stud 2014; 8:192-9. [PMID: 26276455 DOI: 10.1016/j.jams.2014.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 11/16/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022] Open
Abstract
In this study, the effects of acupuncture in comparison with flat occlusal plane appliance were evaluated in patient with myogenic temporomandibular dysfunction (TMD). The sample consisted of 40 women with TMD and unbalanced energy predominance of Yang Liver Ascension, selected using the Renying and Cunkou pulses, randomly divided into two groups: acupuncture and splint. The effect of treatments on the masseter and anterior temporal muscles was evaluated after 4 weeks of treatment, by means of electromyographic activity (root mean square) and pain pressure threshold. Pain intensity was measured using the visual analog scale, and range of mouth opening was evaluated using a millimeter ruler. All evaluations were performed at the beginning and end of the treatment. Visual analog scale score was reduced equally in the two groups (p < 0001), and the increase in range of mouth opening was significant in both groups. A significant difference was detected only in pain pressure threshold of the left masseter in the acupuncture group (p < 0.05). Only root mean square in the at rest position of the right temporal muscle diminished in the final stage of the splint group (p < 0.05). Both treatments reduced the pain intensity of myogenic TMD in the short term and may be considered strategies for control of chronic pain related to TMD.
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Affiliation(s)
- Cássia Maria Grillo
- Department Community Dentistry, Piracicaba Dental School, University of Campinas, Campinas, Brazil.
| | | | - Ronaldo Seichi Wada
- Department Community Dentistry, Piracicaba Dental School, University of Campinas, Campinas, Brazil
| | - Marcelo Corrêa Alves
- Superior School of Agriculture "Luiz de Queiroz", University of Sao Paulo, Sao Paulo, Brazil
| | | | - Fausto Berzin
- Department of Morphology, Piracicaba Dental School, University of Campinas, Campinas, Brazil
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Cooper BC, Adib F. An assessment of the usefulness of Kinesiograph as an aid in the diagnosis of TMD: a review of Manfredini et al.'s studies. Cranio 2014; 33:46-66. [PMID: 25115950 DOI: 10.1179/2151090314y.0000000010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM Performing a literature review of publications by Dr. Manfredini et al. related to their temporomandibular joint (TMJ) injection therapy outcome with conclusions on the clinical utility of computerized measurement devices used in the management of temporomandibular disorders (TMDs). In addition, reviewing their published opinion on an occlusion: TMD versus a biopsychosocial paradigm for TMD. Manfredini et al. authored an article published in the Journal of the American Dental Association (JADA) 2013, "An Assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders," the most recent of 12 articles. In all studies, subjects received TMJ injections with an objective measurement outcome criterion; increased maximum mouth opening (MMO) and subjective symptom improvement of pain and chewing function. In the 2013 JADA article, the Mandibular Kinesiograph, referred to as KG, measured MMO before and after therapy. In 11 prior articles, all subject groups with limited mouth opening exhibited very significant increased MMO post-treatment, documenting treatment success using the same 2013 protocol. The 2013 study showed a 1·1 mm improved MMO, described as insignificant. The authors did not critique or explain the aberrant, skewed 2013 outcome data contrasted with their prior studies, which showed overwhelmingly significant increased MMO. Instead, they concluded that the MMO recording device was clinically useless. This motivated a literature review of the authors' TMD publications. CONCLUSION The publications by Manfredini et al. recognized proponents of the psychosocial model of TMD, including the 2013 article, appear to be part of a campaign denying an occlusion: TMD relationship and disparaging the specific computerized measurement devices and the dentists using them in the management of their TMD patients using neuromuscular occlusion dental treatment.
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Lodetti G, Marano G, Fontana P, Tartaglia GM, Maria de Felício C, Biganzoli E, Sforza C. Surface electromyography and magnetic resonance imaging of the masticatory muscles in patients with arthrogenous temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:248-56. [DOI: 10.1016/j.oooo.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
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Calixtre LB, Grüninger BLDS, Chaves TC, Oliveira ABD. Is there an association between anxiety/depression and temporomandibular disorders in college students? J Appl Oral Sci 2014; 22:15-21. [PMID: 24626244 PMCID: PMC3908760 DOI: 10.1590/1678-775720130054] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 10/07/2013] [Indexed: 11/21/2022] Open
Abstract
Objective Considering the high incidence of Temporomandibular Disorders (TMD) in the
population aged 15-30 years and the fact that students are exposed to stressful
psychosocial factors, the purposes of this study were: to verify clinical symptoms
and jaw functionality in college students with TMD according to the
anxiety/depression (A/D) level and to evaluate the correlation between A/D and
functionality, maximum mouth opening (MMO) and pain and muscle activity. Material and Methods Nineteen students with TMD diagnosed according to the Research Diagnostic Criteria
for Temporomandibular Disorders underwent two assessments during an academic
semester. The evaluations were based on questionnaires (MFIQ - Mandibular Function
Impairment Questionnaire; HADS - Hospital Anxiety and Depression Scale), clinical
measurements (MMO without pain, MMO and assisted MMO; palpation of joint and
masticatory muscles), and electromyography. The HADS scores obtained in the two
assessments were used to classify all data as either "high" or "low" A/D. Data
normality, differences and correlations were tested with the Shapiro-Wilk test,
Student's t-test (or the Wilcoxon test), and Spearman test, respectively. The
alpha level was set at 0.05. Results None of the clinical variables were significantly different when comparing low and
high A/D data. In low A/D there was a significant correlation between HADS score
and: MFIQ (P=0.005, r=0.61), and MMO without pain (P=0.01, r=-0.55). Conclusions Variation in A/D level did not change clinical symptoms or jaw functionality in
college students with TMD. Apparently, there is a correlation between TMJ
functionality and A/D level, which should be further investigated, taking into
account the source of the TMD and including subjects with greater functional
limitation.
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Affiliation(s)
- Letícia Bojikian Calixtre
- Federal University of São Carlos, Department of Physical Therapy, São CarlosSP, Brazil, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Bruno Leonardo da Silva Grüninger
- Federal University of São Carlos, Department of Physical Therapy, São CarlosSP, Brazil, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Thais Cristina Chaves
- University of São Paulo, FMRP, Department of Neurosciences and Behavioral Sciences, Ribeirão PretoSP, Brazil, Department of Neurosciences and Behavioral Sciences, University of São Paulo (FMRP/USP), Ribeirão Preto, SP, Brazil
| | - Ana Beatriz de Oliveira
- Federal University of São Carlos, Department of Physical Therapy, São CarlosSP, Brazil, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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Machado MB, Nitsch GS, Pitta NC, Oliveira ASD. Tempo de ativação muscular em portadoras de disfunção temporomandibular durante a mastigação. AUDIOLOGY - COMMUNICATION RESEARCH 2014. [DOI: 10.1590/s2317-64312014000200016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Comparar, entre portadoras de disfunção temporomandibular (DTM) e controles, o tempo de ativação do músculo masseter e do músculo temporal anterior, em diferentes faixas de amplitude eletromiográfica de superfície, durante a mastigação. Métodos Foram avaliadas 22 voluntárias, com idades entre 18 e 48 anos, divididas em Grupo DTM (n=14) do tipo “Ia”, de acordo com o Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TDM) e Grupo Controle (n=8), assintomáticas. Foram registrados, por meio de eletromiografia de superfície, a amplitude e o tempo de ativação dos músculos masseter e temporal anterior, durante mastigação bilateral de Parafilm M® por dez segundos. Os sinais eletromiográficos foram categorizados em três faixas percentuais, 0-39%, 40-74% e 75-100%, relativas ao valor médio de amplitude de três contrações máximas de apertamento dentário. As porcentagens dos tempos totais de ativação (duty factor), em cada uma das faixas de amplitude, foram comparadas entre os grupos pelo teste t-Student, para dados não pareados. Resultados Não houve diferenças significativas do duty factor na comparação entre os grupos controle e DTM. Conclusão A variável eletromiográfica testada não se mostrou útil como ferramenta diagnóstica na prática clínica, o que será possível apenas quando em conjunto com a história clínica e exame físico do indivíduo.
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Schmidt KC, Briesemeister M, Ries LGK. Alterações no controle motor mandibular e cervical de crianças com paralisia cerebral. REVISTA CEFAC 2014. [DOI: 10.1590/1982-0216201412812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Objetivo: analisar a atividade elétrica dos músculos Temporal e Masseter e o padrão de postura e movimento de cabeça e mandíbula de crianças com Paralisia Cerebral (PC).Métodos: a amostra deste estudo compreendeu 32 voluntários com PC espástica e com Desenvolvimento Típico, com a faixa etária de 7 a 13 anos de idade, caracterizados com base na Classificação de Angle e Critério de Diagnóstico para Pesquisa das Disfunções Temporomandibulares (RDC/TMD). De forma simultânea, foram avaliadas a postura e movimentação da cabeça e mandíbula e a atividade elétrica dos músculos Temporal e Masseter por meio da cinemática e eletromiografia.Resultados: a PC não foi associada a presença de DTM ou com a alteração da oclusão dentária. No grupo PC, foi observada maior assimetria do músculo temporal (p<0.05), maior extensão da cabeça na máxima abertura da boca (p<0.05), maior amplitude de extensão da cabeça (p<0.01) e maior amplitude de projeção anterior da cabeça (p<0.05).Conclusão: a maior assimetria na atividade muscular, a maior extensão e projeção anterior da cabeça durante o ciclo mastigatório podem ser causas das desordens da função motora oral das crianças com PC.
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Wirianski A, Deall S, Whittle T, Wong M, Murray GM, Peck CC. Isotonic resistance jaw exercise alters jaw muscle coordination during jaw movements. J Oral Rehabil 2014; 41:353-66. [PMID: 24612288 DOI: 10.1111/joor.12153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2014] [Indexed: 11/28/2022]
Abstract
The aim was to investigate the effects of isotonic resistance exercise on the electro-myographic (EMG) activity of the jaw muscles during standardised jaw movements. In 12 asymptomatic adults surface EMG activity was recorded from the anterior temporalis and masseter muscles bilaterally and the right anterior digastric muscle during right lateral jaw movements that tracked a target. Participants were randomly assigned to a Control group or an Exercise group. Jaw movement and EMG activity were collected (i) at baseline, before the exercise task (pre-exercise); (ii) immediately after the exercise task (isotonic resistance at 60% MVC against right lateral jaw movements); (iii) after 4 weeks of a home-based exercise programme; and, (iv) at 8-weeks follow-up. There were no significant within-subject or between-group differences in the velocity and amplitude of the right lateral jaw movements either within or between data collection sessions (P > 0.05). However, over the 8 weeks of the study, three of the tested EMG variables (EMG Duration, Time to Peak EMG from EMG Onset, and Time to Peak EMG activity relative to Movement Onset) showed significant (P < 0.05) differences in the five tested muscles. Many of the significant changes occurred in the Control group, while the Exercise group tended to maintain the majority of the tested variables at pre-exercise baseline values. The data suggest a level of variability between recording sessions in the recruitment patterns of some of the muscles of mastication for the production of the same right lateral jaw movement and that isotonic resistance exercise may reduce this variability.
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Affiliation(s)
- A Wirianski
- Jaw Function and Orofacial Pain Research Unit, Westmead Hospital Centre for Oral Health, Faculty of Dentistry, University of Sydney, Professorial Unit, Level 2, Westmead, NSW, Australia
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de Felício CM, Melchior MDO, da Silva MAMR. Effects of Orofacial Myofunctional Therapy on Temporomandibular Disorders. Cranio 2014; 28:249-59. [DOI: 10.1179/crn.2010.033] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Botelho AL, Gentil FHU, Sforza C, da Silva MAMR. Standardization of the Electromyographic Signal Through the Maximum Isometric Voluntary Contraction. Cranio 2014; 29:23-31. [PMID: 21370766 DOI: 10.1179/crn.2011.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- André Luís Botelho
- Faculty of Odontology of Ribeirão Preto, University of São Paulo, Dept. of Odontology Restoration, Avenida do Café, s/n, Monte Alegre Ribeirão Preto, SP, Brazil.
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Maria de Felicio C, de Oliveira Melchior M, Rodrigues Da Silva MAM. Clinical Validity of the Protocol for Multi-Professional Centers for the Determination of Signs and Symptoms of Temporomandibular Disorders. Part II. Cranio 2014; 27:62-7. [DOI: 10.1179/crn.2009.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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El Hage Y, Politti F, Herpich CM, de Souza DFM, de Paula Gomes CAF, Amorim CF, de Oliveira Gonzalez T, Biasotto-Gonzalez DA. Effect of facial massage on static balance in individuals with temporomandibular disorder - a pilot study. Int J Ther Massage Bodywork 2013; 6:6-11. [PMID: 24298296 PMCID: PMC3838310 DOI: 10.3822/ijtmb.v6i4.208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. Purpose The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Methods Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). Results No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. Conclusions While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD.
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Affiliation(s)
- Yasmin El Hage
- Postgraduate Program in Rehabilitation Sciences, Laboratório de Biodinâmica do Movimento Humano, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil ; Department of Physical Therapy, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
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Lauriti L, Silva PFDC, Politti F, Biasotto-Gonzalez DA, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. Pattern of electromyographic activity in mastication muscles of adolescents with temporomandibular disorder. J Phys Ther Sci 2013; 25:1303-7. [PMID: 24259781 PMCID: PMC3820197 DOI: 10.1589/jpts.25.1303] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 05/29/2013] [Indexed: 01/26/2023] Open
Abstract
UNLABELLED [Purpose] The aim of the present study was to assess the behavior of the mean and median frequencies of the electromyography signal of the mastication muscles of adolescents with different degrees of TMD severity. [Subjects] Forty-two adolescents aged 14 to 18 years. [Methods] The adolescents were classified according to severity using the Helkimo Index. The control group consisted of 14 subjects with no signs or symptoms of TMD. Three readings were taken in during maximum intercuspation and mandibular rest, with each reading lasting 10 seconds. [Results] Significant differences (p=0.0001) were found in the mean frequency (Hz) between the control group (CG), mild TMD group (MG) and moderate/severe TMD group (MSG), especially during mandibular rest, for all muscles evaluated: right temporal: CG (137.5), MG (194.2), MSG (291.7); left temporal: CG (106.9), MG (200.6), MSG (294.2); right masseter: CG (155.7), MG (242.8), MSG (278.3); left masseter: CG (125.0), MG (214.6), MSG (316.7). Greater differences among groups were found under the condition of mandibular rest. CONCLUSIONS Adolescents with TMD especially those with more severe symptoms exhibit hyperactivity of the mastication muscles.
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Affiliation(s)
- Leandro Lauriti
- Rehabilitation Sciences, Nove de Julho University (UNINOVE), Brazil
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Shimada A, Hara S, Svensson P. Effect of experimental jaw muscle pain on EMG activity and bite force distribution at different level of clenching. J Oral Rehabil 2013; 40:826-33. [PMID: 23992609 DOI: 10.1111/joor.12096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 11/30/2022]
Abstract
Bite force at different levels of clenching and the corresponding electromyographic (EMG) activity in jaw-closing muscles were recorded in 16 healthy women before, during and after painful stimulation of the left masseter muscle. Experimental pain was induced by infusion of 5·8% hypertonic saline (HS), and 0·9% isotonic saline (IS) was infused as a control. EMG activity was recorded bilaterally from the masseter and temporalis muscles, and static bite force was assessed by pressure-sensitive films (Dental Pre-scale) at 5, 50 and 100% of maximal voluntary contraction (MVC) during each session. Visual feedback was applied by showing EMG activity to help the subject perform clenching at 5, 50 and 100% MVC, respectively. EMG activity at 100% MVC in left and right masseter decreased significantly during painful HS infusion (1·7-44·6%; P < 0·05). EMG activity at 5% and 50% MVC was decreased during HS infusion in the painful masseter muscle (4·8-18·6%; P < 0·05); however, EMG activity in the other muscles increased significantly (18·5-128·3%; P < 0·05). There was a significant increase in bite force in the molar regions at 50% MVC during HS infusion and in the post-infusion condition (P < 0·05). However, there were no significant differences in the distribution of forces at 100% MVC. In conclusion, experimental pain in the masseter muscle has an inhibitory effect on jaw muscle activity at maximal voluntary contraction, and compensatory mechanisms may influence the recruitment pattern at submaximal efforts.
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Affiliation(s)
- A Shimada
- Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark
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Woźniak K, Piątkowska D, Lipski M, Mehr K. Surface electromyography in orthodontics - a literature review. Med Sci Monit 2013; 19:416-23. [PMID: 23722255 PMCID: PMC3673808 DOI: 10.12659/msm.883927] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Electromyography is the most objective and reliable technique for evaluating muscle function and efficiency by detecting their electrical potentials. It makes it possible to assess the extent and duration of muscle activity. The main aim of surface electromyography is to detect signals from many muscle fibers in the area of the detecting surface electrodes. These signals consist of a weighted summation of the spatial and temporal activity of many motor units. Hence, the analysis of the recordings is restricted to an assessment of general muscle activity, the cooperation of different muscles, and the variability of their activity over time. This study presents the main assumptions in the assessment of electrical muscle activity through the use of surface electromyography, along with its limitations and possibilities for further use in many areas of orthodontics. The main clinical uses of sEMG include the diagnostics and therapy of temporomandibular joint disorders, an assessment of the extent of stomatognathic system dysfunctions in subjects with malocclusion, and the monitoring of orthodontic therapies.
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Affiliation(s)
- Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University of Szczecin, Szczecin, Poland
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Farronato G, Giannini L, Galbiati G, Grillo E, Maspero C. Occlus-o-Guide® versus Andresen activator appliance: neuromuscular evaluation. Prog Orthod 2013; 14:4. [PMID: 24325935 PMCID: PMC3847849 DOI: 10.1186/2196-1042-14-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 04/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to assess the muscular variations at the electromyography (EMG) level for the anterior temporalis muscles and masseter muscles during treatment with Occlus-o-Guide® and Andresen activator appliances. METHODS Eighty-two patients (35 males and 47 females) aged between 8 and 12 years (mean age, 10.5±0.8 years) participated in the study. Fifty patients underwent treatment with an Occlus-o-Guide® and 32 patients with an Andresen activator. All patients underwent EMG examination using a Freely EMG (De Gotzen, Legnano, Italy) and surface bipolar electrodes when the appliances were worn for the first time (T0), and after 6 months (T1) and after 12 months (T2) of appliance use. RESULTS Statistical analysis showed that both at T0 and T2, the percent overlapping coefficient (POC) of the anterior temporalis muscles was not statistically different between the appliance groups. At T0, the POC of the masseter muscles was significantly lower for the Andresen appliance as compared to the Occlus-o-Guide® (p=0.02), while at T2 this significance was lost. CONCLUSIONS At insertion of an appliance, all patients show neuromuscular balance that does not correspond to orthognathic occlusion. Both appliances work by creating muscular imbalance. With the appliances in situ, EMG responses were generally analogous for the Occlus-o-Guide® and the Andresen activator; however, the imbalance was greater and the recovery of the orthological muscular balance was slower in patients under treatment with the Andresen activator as compared to those with the Occlus-o-Guide®.
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Affiliation(s)
- Giampietro Farronato
- Department of Orthodontics, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, University of Milan, Milan 20122, Italy.
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