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Accurate Diagnosis and Treatment of Painful Temporomandibular Disorders: A Literature Review Supplemented by Own Clinical Experience. Pain Res Manag 2023; 2023:1002235. [PMID: 36760766 PMCID: PMC9904928 DOI: 10.1155/2023/1002235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/04/2022] [Accepted: 01/21/2023] [Indexed: 02/04/2023]
Abstract
Introduction Temporomandibular disorders (TMD) is a multifactorial group of musculoskeletal disorders often with combined etiologies that demand different treatment plans. While pain is the most common reason why patients decide to seek help, TMD is not always painful. Pain is often described by patients as a headache, prompting patients to seek the help of neurologists, surgeons, and ultimately dentists. Due to the unique characteristics of this anatomical area, appropriate diagnostic tools are needed, as well as therapeutic regimens to alleviate and/or eliminate the pain experienced by patients. Aim of the Study. The aim of this study is to collect and organize information on the diagnosis and treatment of pain in TMD, through a review of the literature supplemented by our own clinical experience. Material and Methods. The study was conducted by searching scientific databases PubMed, Scopus, and Google Scholar for documents published from 2002-2022. The following keywords were used to build the full list of references: TMD, pain, temporomandibular joint (TMJ), TMJ disorders, occlusal splint, relaxing splints, physiotherapy TMD, pharmacology TMD, natural therapy TMD, diagnostic criteria for TMD, and DC/TMD. The literature review included 168 selected manuscripts, the content of which was important for pain diagnosis and clinical treatment of TMD. Results An accurate diagnosis of TMD is the foundation of appropriate treatment. The most commonly described treatments include physiotherapy, occlusal splints therapy, and pharmacological treatment tailored to the type of TMD. Conclusions Based on the literature review and their own experience, the authors concluded that there is no single ideal form of pain therapy for TMD. Treatment of TMD should be based on a thorough diagnostic process, including the DC/TMD examination protocol, psychological evaluation, and cone beam computer tomography (CBCT) imaging. Following the diagnostic process, once a diagnosis is established, a treatment plan can be constructed to address the patient's complaints.
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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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Effat KG. Chronic craniomandibular pain after craniotomy: A long-term clinical study. Cranio 2022:1-8. [PMID: 36503374 DOI: 10.1080/08869634.2022.2154930] [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: 12/15/2022]
Abstract
OBJECTIVE Chronic craniomandibular/cervical pain and temporomandibular disorders have not been studied in patients who had a craniotomy several years previously. The aim of the current clinical work was to address these issues. METHODS A total group of 150 ambulant patients who had a previous craniotomy was subclassified according to whether or not the temporalis muscle was manipulated. RESULTS The average incidence of multiple subsite regional head and neck pain was 69.3% a number of years after a craniotomy. Evidence of internal derangement of the temporomandibular joint was significantly higher in the group that required manipulation of the temporalis muscle during the procedure. CONCLUSION The pattern of chronic craniomandibular/cervical pain experienced years after a craniotomy supports the brain neuromatrix theory of pain.
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Affiliation(s)
- Kamal G Effat
- Department of Otolaryngology, El- Sahel Teaching Hospital, Cairo, Egypt
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Ullah H, Wahab MA, Will G, Karim MR, Pan T, Gao M, Lai D, Lin Y, Miraz MH. Recent Advances in Stretchable and Wearable Capacitive Electrophysiological Sensors for Long-Term Health Monitoring. BIOSENSORS 2022; 12:bios12080630. [PMID: 36005025 PMCID: PMC9406032 DOI: 10.3390/bios12080630] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 05/27/2023]
Abstract
Over the past several years, wearable electrophysiological sensors with stretchability have received significant research attention because of their capability to continuously monitor electrophysiological signals from the human body with minimal body motion artifacts, long-term tracking, and comfort for real-time health monitoring. Among the four different sensors, i.e., piezoresistive, piezoelectric, iontronic, and capacitive, capacitive sensors are the most advantageous owing to their reusability, high durability, device sterilization ability, and minimum leakage currents between the electrode and the body to reduce the health risk arising from any short circuit. This review focuses on the development of wearable, flexible capacitive sensors for monitoring electrophysiological conditions, including the electrode materials and configuration, the sensing mechanisms, and the fabrication strategies. In addition, several design strategies of flexible/stretchable electrodes, body-to-electrode signal transduction, and measurements have been critically evaluated. We have also highlighted the gaps and opportunities needed for enhancing the suitability and practical applicability of wearable capacitive sensors. Finally, the potential applications, research challenges, and future research directions on stretchable and wearable capacitive sensors are outlined in this review.
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Affiliation(s)
- Hadaate Ullah
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu 610054, China
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Md A. Wahab
- Institute for Advanced Study, Chengdu University, Chengdu 610106, China
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, George St Brisbane, GPO Box 2434, Brisbane, QLD 4001, Australia
| | - Geoffrey Will
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, George St Brisbane, GPO Box 2434, Brisbane, QLD 4001, Australia
| | - Mohammad R. Karim
- Center of Excellence for Research in Engineering Materials (CEREM), Deanship of Scientific Research (DSR), King Saud University, Riyadh 11421, Saudi Arabia
- K.A. CARE Energy Research and Innovation Center, Riyadh 11451, Saudi Arabia
| | - Taisong Pan
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu 610054, China
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Min Gao
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu 610054, China
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Dakun Lai
- Biomedical Imaging and Electrophysiology Laboratory, School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yuan Lin
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu 610054, China
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu 610054, China
- Medico-Engineering Corporation on Applied Medicine Research Center, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Mahdi H. Miraz
- School of Computing and Data Science, Xiamen University Malaysia, Bandar Sunsuria, Sepang 43900, Malaysia
- School of Computing, Faculty of Arts, Science and Technology, Wrexham Glyndŵr University, Wrexham LL112AW, UK
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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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Meng H, Dai J, Li Y. Quantitative sensory testing in patients with the muscle pain subtype of temporomandibular disorder: a systemic review and meta-analysis. Clin Oral Investig 2021; 25:6547-6559. [PMID: 34487241 DOI: 10.1007/s00784-021-04171-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/28/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES This meta-analysis aimed to evaluate quantitative sensory testing (QST) evidence for pain processing in patients with the muscle pain subtype of temporomandibular disorders (mTMD). MATERIALS AND METHODS A comprehensive systematic electronic search strategy was performed in online literature databases. All full-text observational studies published up to July 2021 with the aim of investigating pain sensitization in humans with mTMD using QST measures were eligible for inclusion. Meta-analysis of QST data was performed using a random effects model, which included results comparing patients with mTMD to healthy controls, and standard mean difference (SMD) results were analyzed. RESULTS Twelve studies with 732 participants (371 patients with mTMD and 361 healthy controls) were analyzed following screening and quality appraisal. Compared with healthy controls, patients with mTMD had significantly lower pressure pain threshold (SMD - 1.10, 95% confidence interval [CI] - 1.52 to - 0.68) with high heterogeneity (Tau2 = 0.61, I2 = 86%), and significantly lower mechanical pain threshold (SMD - 0.64, 95% CI - 0.95 to - 0.32) with no heterogeneity (Tau2 = 0.00, I2 = 0%). No difference was observed in the cold pain threshold (SMD 0.16, 95% CI - 0.13 to 0.45), heat pain threshold (SMD - 0.13, 95% CI - 0.40 to 0.15), and wind-up ratio (SMD 0.63, 95% CI - 0.11 to 1.38) between patients with mTMD and healthy controls. Other QST parameters were also discussed. CONCLUSIONS The study results suggest that the pain processing of deep tissues is likely sensitized in mTMD and calls for more QST studies with standard procedures to reduce inter-study heterogeneity. CLINICAL RELEVANCE The major findings of this meta-analysis support using PPT to examine the pain processing in patients with mTMD in clinical scenario.
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Affiliation(s)
- He Meng
- Department of Stomatology, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, Guangdong, China
| | - Juan Dai
- Department of Stomatology, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, Guangdong, China
| | - Yuzhou Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, Chongqing, China.
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Barone M, Imaz F, Converso G, Bordachar D, Barbero A, Trucco M, Intelangelo L. Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain, mouth opening and electromyographic activity in patients with temporomandibular disorders. J Bodyw Mov Ther 2021; 28:563-569. [PMID: 34776197 DOI: 10.1016/j.jbmt.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/05/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Rhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD. MATERIALS AND METHODS This was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package. RESULTS A statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85-1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49). CONCLUSION In this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.
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Affiliation(s)
- M Barone
- Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina.
| | - F Imaz
- Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina
| | - G Converso
- University of Gran Rosario - UGR, Rosario, Argentina
| | - D Bordachar
- Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina
| | - A Barbero
- Italian University Institute of Rosario - IUNIR, Rosario, Argentina
| | - M Trucco
- Italian University Institute of Rosario - IUNIR, Rosario, Argentina
| | - L Intelangelo
- Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina
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9
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Thymi M, Lobbezoo F, Aarab G, Ahlberg J, Baba K, Carra MC, Gallo LM, De Laat A, Manfredini D, Lavigne G, Svensson P. Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism: A scoping review. J Oral Rehabil 2021; 48:846-871. [PMID: 33772835 PMCID: PMC9292505 DOI: 10.1111/joor.13170] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/07/2021] [Accepted: 03/17/2021] [Indexed: 12/14/2022]
Abstract
Background Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. Objectives (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited‐channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. Method A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. Results Seventy‐eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). Conclusion Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA.
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Affiliation(s)
- Magdalini Thymi
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry, Ohta-ku, Japan
| | - Maria Clotilde Carra
- UFR of Odontology Garanciere, Université de Paris and Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Antoon De Laat
- Department of Oral Health Sciences, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentistry, University Hospital, Leuven, Belgium
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Gilles Lavigne
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.,CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus Universitet Tandlageskolen, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmø, Sweden
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Owczarek JE, Lion KM, Radwan-Oczko M. Manifestation of stress and anxiety in the stomatognathic system of undergraduate dentistry students. J Int Med Res 2020; 48:300060519889487. [PMID: 32046557 PMCID: PMC7105728 DOI: 10.1177/0300060519889487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective To assess the relationship between psychoemotional state and signs of oral cavity occlusal and nonocclusal parafunctions, together with masseter muscle tone, in undergraduate dentistry students. Methods The study population comprised first and fifth grade dentistry students who were investigated using psychological and health questionnaires, and stomatological examination with electromyography of the masseter muscles. Differences in variables between first and fifth grade students were analysed using Student’s t-test or χ2-test and Pearson’s correlation coefficient was used to analyse associations between variables. Results A total of 113 students (52 first-grade, mean age 20 years; and 61 fifth-grade, mean age 23.6 years) were included. Older age was associated with lower level of perceived stress and anxiety. Moreover, a significant positive relationship was observed between level of perceived stress and anxiety and tone of both masseter muscles. Conclusions Increased psychoemotional burden and increased rates of experienced anxiety were associated with growth of masseter muscle tone in this study population.
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Affiliation(s)
| | - Katarzyna Małgorzata Lion
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
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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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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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Mehrali M, Bagherifard S, Akbari M, Thakur A, Mirani B, Mehrali M, Hasany M, Orive G, Das P, Emneus J, Andresen TL, Dolatshahi‐Pirouz A. Blending Electronics with the Human Body: A Pathway toward a Cybernetic Future. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2018; 5:1700931. [PMID: 30356969 PMCID: PMC6193179 DOI: 10.1002/advs.201700931] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 05/24/2018] [Indexed: 05/22/2023]
Abstract
At the crossroads of chemistry, electronics, mechanical engineering, polymer science, biology, tissue engineering, computer science, and materials science, electrical devices are currently being engineered that blend directly within organs and tissues. These sophisticated devices are mediators, recorders, and stimulators of electricity with the capacity to monitor important electrophysiological events, replace disabled body parts, or even stimulate tissues to overcome their current limitations. They are therefore capable of leading humanity forward into the age of cyborgs, a time in which human biology can be hacked at will to yield beings with abilities beyond their natural capabilities. The resulting advances have been made possible by the emergence of conformal and soft electronic materials that can readily integrate with the curvilinear, dynamic, delicate, and flexible human body. This article discusses the recent rapid pace of development in the field of cybernetics with special emphasis on the important role that flexible and electrically active materials have played therein.
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Affiliation(s)
- Mehdi Mehrali
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | - Sara Bagherifard
- Department of Mechanical EngineeringPolitecnico di Milano20156MilanItaly
| | - Mohsen Akbari
- Laboratory for Innovations in MicroEngineering (LiME)Department of Mechanical EngineeringUniversity of VictoriaVictoriaBCV8P 5C2Canada
- Center for Biomedical ResearchUniversity of VictoriaVictoriaV8P 5C2Canada
- Center for Advanced Materials and Related Technologies (CAMTEC)University of VictoriaVictoriaV8P 5C2Canada
| | - Ashish Thakur
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | - Bahram Mirani
- Laboratory for Innovations in MicroEngineering (LiME)Department of Mechanical EngineeringUniversity of VictoriaVictoriaBCV8P 5C2Canada
- Center for Biomedical ResearchUniversity of VictoriaVictoriaV8P 5C2Canada
- Center for Advanced Materials and Related Technologies (CAMTEC)University of VictoriaVictoriaV8P 5C2Canada
| | - Mohammad Mehrali
- Process and Energy DepartmentDelft University of TechnologyLeeghwaterstraat 392628CBDelftThe Netherlands
| | - Masoud Hasany
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | - Gorka Orive
- NanoBioCel GroupLaboratory of PharmaceuticsSchool of PharmacyUniversity of the Basque Country UPV/EHUPaseo de la Universidad 701006Vitoria‐GasteizSpain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine (CIBER‐BBN)Vitoria‐Gasteiz28029Spain
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU‐Fundación Eduardo Anitua)Vitoria01007Spain
| | - Paramita Das
- School of Chemical and Biomedical EngineeringNanyang Technological University62 Nanyang DriveSingapore637459Singapore
| | - Jenny Emneus
- Technical University of DenmarkDTU Nanotech2800KgsDenmark
| | - Thomas L. Andresen
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
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Relation between Headache and Mastication Muscle Tone in Adolescents. Pain Res Manag 2018; 2018:7381973. [PMID: 30344802 PMCID: PMC6174730 DOI: 10.1155/2018/7381973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/29/2018] [Indexed: 11/18/2022]
Abstract
Headache is a common problem in the population, which decreases the quality of life and makes everyday functioning difficult. It often coexists with typical symptoms of temporomandibular disorders. The objective of the study was to clarify whether there is a relationship between the presence of headache in young volunteers and the mastication muscle tone. Material and Method. Volunteers aged 18 years who underwent general dental examination, clinical evaluation, and examination using the dual-axis diagnostic system Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) form in the Polish language version participated in the study. On the basis of the examination results, these individuals were divided into three groups according to RDC results. A group of healthy individuals (axis I value 0), a group of sick individuals (axis I diagnosis Ia, IIa, or IIIa), and a group of individuals suffering from depression (axis II values 1–3) were singled out. Then, volunteers were divided into two groups: group I reporting headache and group II without any pain. In each of these individuals, the contractile activity of the masseter muscles and anterior temporal muscles was recorded bilaterally as the surface electromyographic activity (sEMG) at rest, during swallowing, and maximum clenching. The activity index ranging between +100 (activity of the masseter muscles only) and −100 (activity of the anterior temporal muscles only) was used to indicate the predominance of activity of the study muscles. Results. The statistical analysis of data showed that there was a significant relationship between the presence of headache and a change in the mastication muscle tone, expressed as the predominant activity of the temporal muscles, only in the group of sick individuals during maximum clenching. Summary. The diversity of sEMG results implies that a change in the mastication muscle tone is not a direct consequence of headache, but it has to be modified by other factors.
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15
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Fougeront N, Fleiter B. Temporomandibular disorder and comorbid neck pain: facts and hypotheses regarding pain-induced and rehabilitation-induced motor activity changes. Can J Physiol Pharmacol 2018; 96:1051-1059. [PMID: 30067068 DOI: 10.1139/cjpp-2018-0100] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
According to the "pain adaptation model", temporomandibular disorder (TMD)-related pain induces a paradoxical activity of masticatory muscles: an agonistic hypoactivity during jaw closing and an antagonistic activity during jaw opening (agonist/antagonist co-activation). However, this model suffers several weaknesses; notably, it does not explain all types of neck muscle activities in neck pain (NP), which is a very prevalent TMD comorbid condition. In NP, neck muscle antagonistic activity is increased, and agonistic activity is decreased as postulated by the pain adaptation model. However, synergistic and compensatory activity may occur and agonistic activity may be unchanged or even increased as postulated within the "vicious cycle theory". Thus, both theories would apply partly as outlined currently in musculoskeletal disorders (MSD). Besides pain, psychological stress may also induce motor dysfunction in TMD and NP. In NP, rehabilitation may increase agonistic activity and decrease compensatory activity and antagonistic activity, thus inducing a switch from agonist/antagonist co-activation towards reciprocal inhibition. Thus, rehabilitation-induced motor activity changes constitute a new research field that should improve MSD therapeutics. Additionally, immature tongue function (so-called infantile swallow) might be connected to TMD where low agonistic activity of masticatory muscles would be compensated by facial muscle hyperactivity during oropharyngeal phase of deglutition.
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Affiliation(s)
- Nicolas Fougeront
- a Consultation de troubles fonctionnels oro-faciaux, service de médecine bucco-dentaire/odontologie, groupe hospitalier Pitié-Salpétrière Charles-Foix, 94200 Ivry-sur-Seine, France
| | - Bernard Fleiter
- a Consultation de troubles fonctionnels oro-faciaux, service de médecine bucco-dentaire/odontologie, groupe hospitalier Pitié-Salpétrière Charles-Foix, 94200 Ivry-sur-Seine, France.,b Faculté de chirurgie dentaire, Université René Descartes, Paris, France
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16
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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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Muzalev K, Lobbezoo F, Janal MN, Raphael KG. Interepisode Sleep Bruxism Intervals and Myofascial Face Pain. Sleep 2017; 40:3800074. [PMID: 28482089 DOI: 10.1093/sleep/zsx078] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Study Objectives Sleep bruxism (SB) is considered as a possible etiological factor for temporomandibular disorder (TMD) pain. However, polysomnographic (PSG) studies, which are current "gold standard" diagnostic approach to SB, failed to prove an association between SB and TMD. A possible explanation could be that PSG studies have considered only limited characteristics of SB activity: the number of SB events per hour and, sometimes, the total duration of SB per night. According to the sports sciences literature, lack of adequate rest time between muscle activities leads to muscle overloading and pain. Therefore, the aim of this study was to determine whether the intervals between bruxism events differ between patients with and without TMD pain. Methods Two groups of female volunteers were recruited: myofascial TMD pain group (n=124) and non-TMD control group (n=46). From these groups, we selected 86 (69%) case participants and 37 (80%) controls who had at least two SB episodes per night based on PSG recordings. A linear mixed model was used to compare case and control groups over the repeated observations of interepisode intervals. Results The duration of interepisode intervals was statistically similar in the case (mean [standard deviation {SD}] 1137.7 [1975.8] seconds)] and control (mean [SD] 1192.0 [1972.0] seconds) groups. There were also a similar number of SB episodes per hour and a total duration of SB episodes in both groups. Conclusions The current data fail to support the idea that TMD pain can be explained by increasing number of SB episodes per hour of sleep or decreasing the time between SB events.
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Affiliation(s)
- Konstantin Muzalev
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY
| | - Malvin N Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY
| | - Karen G Raphael
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY
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18
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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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19
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Sójka A, Huber J, Hędzelek W, Wiertel-Krawczuk A, Szymankiewicz-Szukała A, Seraszek-Jaros A, Kulczyk A, Wincek A, Sobieska M. Relations between the results of complex clinical and neurophysiological examinations in patients with temporomandibular disorders symptoms. Cranio 2017; 36:44-52. [DOI: 10.1080/08869634.2017.1290907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Anna Sójka
- Department and Clinic of Prosthodontics, University of Medical Sciences, Poznań, Poland
| | - Juliusz Huber
- Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland
| | - Wiesław Hędzelek
- Department and Clinic of Prosthodontics, University of Medical Sciences, Poznań, Poland
| | | | | | - Agnieszka Seraszek-Jaros
- Department of Bioinformatics and Computational Biology, University of Medical Sciences, Poznań, Poland
| | - Aleksandra Kulczyk
- Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland
| | - Agnieszka Wincek
- Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland
| | - Magdalena Sobieska
- Department of Rheumatology and Rehabilitation, University of Medical Sciences, Poznań, Poland
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20
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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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Ries LGK, Graciosa MD, Soares LP, Sperandio FF, Santos GM, Degan VV, Gadotti IC. Efeito do tempo de contração e repouso na atividade dos músculos masseter e temporal anterior em indivíduos com DTM. Codas 2016; 28:155-62. [DOI: 10.1590/2317-1782/201620150112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/27/2015] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo O principal objetivo deste estudo foi investigar o efeito do tempo de contração e repouso na atividade dos músculos masseter e temporal. Métodos 49 sujeitos do sexo feminino com idade entre 18 e 30 anos foram divididos em grupos DTM (n: 26) e controle (n: 23). A eletromiografia de superfície foi utilizada para avaliar os músculos temporal anterior e masseter durante protocolos de contração e repouso muscular. Foram analisados os parâmetros eletromiográfico raiz quadrada da média, frequência mediana e o coeficiente da inclinação da reta de regressão linear. Resultados Foi encontrado efeito significativo do tempo no protocolo de contração e de repouso muscular. No protocolo de contração, sujeitos com DTM apresentaram significativa diminuição da frequência mediana no masseter direito e do coeficiente de inclinação do músculo temporal direito comparados ao grupo controle. Conclusão Apesar de os sujeitos com DTM apresentarem maior suscetibilidade à fadiga, comparados aos controles, ambos os grupos devem respeitar o tempo máximo de 5 s de contração voluntária máxima e no mínimo 30 s de repouso entre sucessivas contrações da musculatura mastigatória durante protocolos de avaliação clínica ou de pesquisa.
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22
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Ries LGK, Graciosa MD, Medeiros DLD, Pacheco SCDS, Fassicolo CE, Graefling BCF, Degan VV. Influence of craniomandibular and cervical pain on the activity of masticatory muscles in individuals with Temporomandibular Disorder. Codas 2015; 26:389-94. [PMID: 25388072 DOI: 10.1590/2317-1782/20142014040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 07/15/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study aimed to establish the prevalence of pain in the craniomandibular and cervical spine region in individuals with Temporomandibular Disorders (TMD) and to analyze the effects of these disorders on the bilateral activation of anterior temporalis (AT) and masseter (MA) muscles during the masticatory cycle. METHODS The participants were 55 female volunteers aged 18-30 years. The presence of TMD and craniomandibular and cervical spine pain was evaluated by applying the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and using a combination of tests for the cervical region. The muscle activity of AT and MA during the masticatory cycle was assessed using the symmetry and antero-posterior coefficient indices. RESULTS The AT activity during the masticatory cycle is more asymmetric in individuals with TMD. The craniomandibular pain, more prevalent in these individuals, influenced these results. CONCLUSION Individuals with TMD showed changes in the pattern activity of AT. The craniomandibular nociceptive inputs can influence the increase in asymmetry of the activation of this muscle.
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Affiliation(s)
- Lilian Gerdi Kittel Ries
- Center for Health Sciences, Universidade do Estado de Santa Catarina - UDESC, Florianópolis, SC, Brazil
| | - Maylli Daiani Graciosa
- Center for Health Sciences, Universidade do Estado de Santa Catarina - UDESC, Florianópolis, SC, Brazil
| | | | | | - Carlos Eduardo Fassicolo
- Center for Health Sciences, Universidade do Estado de Santa Catarina - UDESC, Florianópolis, SC, Brazil
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Tosato JDP, Caria PHF, Gomes CAFDP, Berzin F, Politti F, Gonzalez TDO, Biasotto-Gonzalez DA. Correlation of stress and muscle activity of patients with different degrees of temporomandibular disorder. J Phys Ther Sci 2015; 27:1227-31. [PMID: 25995595 PMCID: PMC4434016 DOI: 10.1589/jpts.27.1227] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/25/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Temporomandibular disorder is one of the many different adverse health
conditions that can be triggered by stress. Therefore, a biopsychosocial model has been
proposed to characterize the multifactorial nature of temporomandibular disorder. The aim
of the present study was investigate the correlation of salivary cortisol levels with the
activities of the masseter and anterior temporal muscles of patients with different
degrees of temporomandibular disorder. [Subjects and Methods] Forty-nine women between 18
and 40 years of age with a diagnosis of myogenous temporomandibular disorder based on the
Research Diagnostic Criteria for temporomandibular disorders were evaluated using the
Fonseca Index to determine the degree of the disorder. Salivary cortisol levels were
determined and surface electromyography was used to evaluate electrical activity in the
masticatory muscles. [Results] Positive correlations were found among the degree of
temporomandibular disorder, electromyographic activity and salivary cortisol: as women
with more severe temporomandibular disorder had greater electrical activity in the muscles
analyzed, especially the anterior temporal muscle, and higher levels of cortisol.
[Conclusion] Muscle activity was greater among individuals with severe temporomandibular
disorder and positive correlations were found among electromyographic activity, salivary
cortisol and the degree of temporomandibular disorder severity.
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Affiliation(s)
| | | | | | - Fausto Berzin
- Department of Morphology, Piracicaba Dental School, State University of Campinas, Brazil
| | - Fabiano Politti
- Department of Rehabilitation Sciences, University Nove de Julho, Brazil
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Bhaskaracharya M, Memon SM, Whittle T, Murray GM. Jaw movements in patients with a history of pain: an exploratory study. J Oral Rehabil 2014; 42:18-26. [DOI: 10.1111/joor.12220] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M. Bhaskaracharya
- Jaw Function and Orofacial Pain Research Unit; Faculty of Dentistry; University of Sydney; Westmead NSW Australia
| | - S. M. Memon
- Jaw Function and Orofacial Pain Research Unit; Faculty of Dentistry; University of Sydney; Westmead NSW Australia
| | - T. Whittle
- Jaw Function and Orofacial Pain Research Unit; Faculty of Dentistry; University of Sydney; Westmead NSW Australia
| | - G. M. Murray
- Jaw Function and Orofacial Pain Research Unit; Faculty of Dentistry; University of Sydney; Westmead NSW Australia
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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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Jeong J, Kim MK, Cheng H, Yeo W, Huang X, Liu Y, Zhang Y, Huang Y, Rogers JA. Capacitive epidermal electronics for electrically safe, long-term electrophysiological measurements. Adv Healthc Mater 2014; 3:642-8. [PMID: 24132942 DOI: 10.1002/adhm.201300334] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/08/2013] [Indexed: 11/07/2022]
Abstract
Integration of capacitive sensing capabilities to epidermal electronic systems (EES) can enhance the robustness in operation for electrophysiological signal measurement. Capacitive EES designs are reusable, electrically safe, and minimally sensitive to motion artifacts. Experiments on human subjects illustrate levels of fidelity in ECG, EMG, and EOG recordings comparable to those of standard gel electrodes and of direct contact EES electrodes.
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Affiliation(s)
- Jae‐Woong Jeong
- Department of Materials Science and Engineering, Beckman Institute for Advanced Science and Technology, and Frederick Seitz Materials Research Laboratory University of Illinois at Urbana‐Champaign Urbana IL 61801 USA
| | - Min Ku Kim
- Department of Electrical and Computer Engineering University of Illinois at Urbana‐Champaign Urbana IL 61801 USA
| | - Huanyu Cheng
- Department of Civil and Environmental Engineering Department of Mechanical Engineering Northwestern University Evanston IL 60208 USA
| | - Woon‐Hong Yeo
- Department of Materials Science and Engineering, Beckman Institute for Advanced Science and Technology, and Frederick Seitz Materials Research Laboratory University of Illinois at Urbana‐Champaign Urbana IL 61801 USA
| | - Xian Huang
- Department of Materials Science and Engineering, Beckman Institute for Advanced Science and Technology, and Frederick Seitz Materials Research Laboratory University of Illinois at Urbana‐Champaign Urbana IL 61801 USA
| | - Yuhao Liu
- Department of Materials Science and Engineering, Beckman Institute for Advanced Science and Technology, and Frederick Seitz Materials Research Laboratory University of Illinois at Urbana‐Champaign Urbana IL 61801 USA
| | - Yihui Zhang
- Center for Engineering and Health Skin Disease Research Center Northwestern University Evanston IL 60208 USA
- Center for Mechanics and Materials Tsinghua University Beijing 100084 China
| | - Yonggang Huang
- Department of Civil and Environmental Engineering Department of Mechanical Engineering Northwestern University Evanston IL 60208 USA
| | - John A. Rogers
- Department of Materials Science and Engineering Beckman Institute for Advanced Science and Technology and Frederick Seitz Materials Research Laboratory University of Illinois at Urbana‐Champaign Urbana IL 61801 USA
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Electromyographic evaluation of masticatory muscles at rest and maximal intercuspal positions of the mandible in children with sleep bruxism. Eur Arch Paediatr Dent 2014; 15:269-74. [DOI: 10.1007/s40368-014-0111-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 01/17/2014] [Indexed: 12/11/2022]
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Venezian GC, Antônio Moreira Rodrigues da Silva M, Mazzetto RG, Oliveira Mazzetto M. Low Level Laser Effects On Pain to Palpation and Electromyographic Activity in TMD Patients: A Double-Blind, Randomized, Placebo-Controlled Study. Cranio 2014; 28:84-91. [DOI: 10.1179/crn.2010.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cooper BC, Kleinberg I. Relationship of Temporomandibular Disorders to Muscle Tension-Type Headaches and a Neuromuscular Orthosis Approach to Treatment. Cranio 2014; 27:101-8. [DOI: 10.1179/crn.2009.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Leal Turcio KH, Garcia AR, Junqueira Zuim PR, Mazza Sundefeld MLM, Goiato MC, dos Santos DM. Electrical Activities and Pressure Pain Threshold in Oral Contraceptives Users and Nonusers. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/pst.2014.22016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jeong JW, Yeo WH, Akhtar A, Norton JJS, Kwack YJ, Li S, Jung SY, Su Y, Lee W, Xia J, Cheng H, Huang Y, Choi WS, Bretl T, Rogers JA. Materials and optimized designs for human-machine interfaces via epidermal electronics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2013; 25:6839-46. [PMID: 24327417 DOI: 10.1002/adma.201301921] [Citation(s) in RCA: 332] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Indexed: 05/23/2023]
Abstract
Thin, soft, and elastic electronics with physical properties well matched to the epidermis can be conformally and robustly integrated with the skin. Materials and optimized designs for such devices are presented for surface electromyography (sEMG). The findings enable sEMG from wide ranging areas of the body. The measurements have quality sufficient for advanced forms of human-machine interface.
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Affiliation(s)
- Jae-Woong Jeong
- Department of Materials Science and Engineering, Beckman Institute for Advanced Science and Technology and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign Urbana, Illinois, 61801, USA
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Manfredini D, Cocilovo F, Stellini E, Favero L, Guarda-Nardini L. Surface Electromyography Findings in Unilateral Myofascial Pain Patients: Comparison of Painful vs Non Painful Sides. PAIN MEDICINE 2013; 14:1848-53. [DOI: 10.1111/pme.12159] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Woda A, L'heveder G, Ouchchane L, Bodéré C. Effect of experimental stress in 2 different pain conditions affecting the facial muscles. THE JOURNAL OF PAIN 2013; 14:455-66. [PMID: 23453565 DOI: 10.1016/j.jpain.2012.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 11/29/2012] [Accepted: 12/11/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Chronic facial muscle pain is a common feature in both fibromyalgia (FM) and myofascial (MF) pain conditions. In this controlled study, a possible difference in the mode of deregulation of the physiological response to a stressing stimulus was explored by applying an acute mental stress to FM and MF patients and to controls. The effects of the stress test were observed on pain, sympathetic variables, and both tonic and reflex electromyographic activities of masseteric and temporal muscles. The statistical analyses were performed through a generalized linear model including mixed effects. Painful reaction to the stressor was stronger (P < .001) and longer (P = .011) in FM than in MF independently of a higher pain level at baseline. The stress-induced autonomic changes only seen in FM patients did not reach significance. The electromyographic responses to the stress test were strongest for controls and weakest for FM. The stress test had no effect on reflex activity (area under the curve [AUC]) or latency, although AUC was high in FM and latencies were low in both pain groups. It is suggested that FM is characterized by a lower ability to adapt to acute stress than MF. PERSPECTIVE This study showed that an acute psychosocial stress triggered several changes in 2 pain conditions including an increase in pain of larger amplitude in FM than in MF pain. Similar stress-induced changes should be explored as possible mechanisms for differentiation between dysfunctional pain conditions.
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Affiliation(s)
- Alain Woda
- Faculté Dentaire, Centre Recherche Odontologie Clinique, France. alain.woda@-clermont1.fr
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Cooper BC. Temporomandibular disorders: A position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio 2012; 29:237-44. [PMID: 22586834 DOI: 10.1179/crn.2011.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
PURPOSE Two principal schools of thought regarding the etiology and optimal treatment of temporomandibular disorders exist; one physical/functional, the other biopsychosocial. This position paper establishes the scientific basis for the physical/functional. THE ICCMO POSITION: Temporomandibular disorders (TMD) comprise a group of musculoskeletal disorders, affecting alterations in the structure and/or function of the temporomandibular joints (TMJ), masticatory muscles, dentition and supporting structures. The initial TMD diagnosis is based on history, clinical examination and imaging, if indicated. Diagnosis is greatly enhanced with physiologic measurement devices, providing objective measurements of the functional status of the masticatory system: TMJs, muscles and dental occlusion. The American Alliance of TMD organizations represent thousands of clinicians involved in the treatment of TMD. The ten basic principles of the Alliance include the following statement: Dental occlusion may have a significant role in TMD; as a cause, precipitant and/or perpetuating factor. Therefore, it can be stated that the overwhelming majority of dentists treating TMD believe dental occlusion plays a major role in predisposition, precipitation and perpetuation. While our membership believes that occlusal treatments most frequently resolve TMD, it is recognized that TMD can be multi faceted and may exist with co-morbid physical or emotional factors that may require therapy by appropriate providers. The International College of Cranio-Mandibular Orthopedics (ICCMO), composed of academic and clinical dentists, believes that TMD has a primary physical/functional basis. Initial conservative and reversible TMD treatment employing a therapeutic neuromuscular orthosis that incorporates relaxed, healthy masticatory muscle function and a stable occlusion is most often successful. This is accomplished using objective measurement technologies and ultra low frequency transcutaneous electrical neural stimulation (TENS). CONCLUSION Extensive literature substantiates the scientific validity of the physical/functional basis of TMD, efficacy of measurement devices and TENS and their use as aids in diagnosis and in establishing a therapeutic neuromuscular dental occlusion. CLINICAL IMPLICATIONS A scientifically valid basis for TMD diagnosis and treatment is presented aiding in therapy.
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Affiliation(s)
- Barry C Cooper
- Division of Translational Oral Biology, State University of New York (SUNY) Stony Brook School of Dental Medicine, USA.
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Okamoto K, Tashiro A, Chang Z, Thompson R, Bereiter DA. Temporomandibular joint-evoked responses by spinomedullary neurons and masseter muscle are enhanced after repeated psychophysical stress. Eur J Neurosci 2012; 36:2025-34. [PMID: 22519876 DOI: 10.1111/j.1460-9568.2012.08100.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Psychological stress is a risk factor for the development of musculoskeletal pain of the head and neck; however, the basis for this relationship remains uncertain. This study tested the hypothesis that psychophysical stress alone was sufficient to alter the encoding properties of spinomedullary dorsal horn neurons and masseter muscle activity in male rats. Repeated forced swim conditioning increased markedly both the background firing rate and temporomandibular joint (TMJ)-evoked activity of neurons in deep dorsal horn, while neurons in superficial laminae were less affected. Stress also increased the responses to stimulation of facial skin overlying the TMJ of neurons in deep and superficial dorsal horn. TMJ-evoked masseter muscle activity was enhanced significantly in stressed rats, an effect that was reduced by prior blockade of the spinomedullary junction region. These data indicated that repeated psychophysical stress induced widespread effects on the properties of medullary dorsal horn neurons and masseter muscle activity. The effects of stress were seen preferentially on neurons in deep dorsal horn and included enhanced responses to chemosensory input from the TMJ and mechanical input from overlying facial skin. The stress-induced elevation in TMJ-evoked masseter muscle activity matched well with the changes seen in dorsal horn neurons. It is concluded that the spinomedullary junction region plays a critical role in the integration of psychophysical stress and sensory information relevant for nociception involving deep craniofacial tissues.
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Affiliation(s)
- Keiichiro Okamoto
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, 18-186 Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455, USA.
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Ishii H, Izumi H. GABAB receptors in the NTS mediate the inhibitory effect of trigeminal nociceptive inputs on parasympathetic reflex vasodilation in the rat masseter muscle. Am J Physiol Regul Integr Comp Physiol 2012; 302:R776-84. [DOI: 10.1152/ajpregu.00569.2011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present study was designed to examine whether trigeminal nociceptive inputs are involved in the modulation of parasympathetic reflex vasodilation in the jaw muscles. This was accomplished by investigating the effects of noxious stimulation to the orofacial area with capsaicin, and by microinjecting GABAA and GABAB receptor agonists or antagonists into the nucleus of the solitary tract (NTS), on masseter hemodynamics in urethane-anesthetized rats. Electrical stimulation of the central cut end of the cervical vagus nerve (cVN) in sympathectomized animals bilaterally increased blood flow in the masseter muscle (MBF). Increases in MBF evoked by cVN stimulation were markedly reduced following injection of capsaicin into the anterior tongue in the distribution of the lingual nerve or lower lip, but not when injected into the skin of the dorsum of the foot. Intravenous administration of either phentolamine or propranolol had no effect on the inhibitory effects of capsaicin injection on the increases of MBF evoked by cVN stimulation, which were largely abolished by microinjecting the GABAB receptor agonist baclofen into the NTS. Microinjection of the GABAB receptor antagonist CGP-35348 into the NTS markedly attenuated the capsaicin-induced inhibition of MBF increase evoked by cVN stimulation, while microinjection of the GABAA receptor antagonist bicuculline did not. Our results indicate that trigeminal nociceptive inputs inhibit vagal-parasympathetic reflex vasodilation in the masseter muscle and suggest that the activation of GABAB rather than GABAA receptors underlies the observed inhibition in the NTS.
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Affiliation(s)
- Hisayoshi Ishii
- Division of Physiology, Department of Oral Biology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - Hiroshi Izumi
- Division of Physiology, Department of Oral Biology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
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Conti PCR, Silva RDS, Araujo CDRPD, Rosseti LMN, Yassuda S, da Silva ROF, Pegoraro LF. Effect of experimental chewing on masticatory muscle pain onset. J Appl Oral Sci 2011; 19:34-40. [PMID: 21437467 PMCID: PMC4245861 DOI: 10.1590/s1678-77572011000100008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 10/22/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To evaluate the effect of a chewing exercise on pain intensity and pressure-pain threshold in patients with myofascial pain. METHODS Twenty-nine consecutive women diagnosed with myofascial pain (MFP) according to the Research Diagnostic Criteria comprised the experimental group and 15 healthy age-matched female were used as controls. Subjects were asked to chew a gum stick for 9 min and to stay at rest for another 9 min afterwards. Pain intensity was rated on a visual analog scale (VAS) every 3 min. At 0, 9 and 18 min, the pressure-pain threshold (PPT) was measured bilaterally on the masseter and the anterior, medium, and posterior temporalis muscles. RESULTS Patients with myofascial pain reported increase (76%) and no change (24%) on the pain intensity measured with the VAS. A reduction of the PPT at all muscular sites after the exercise and a non-significant recovery after rest were also observed. CONCLUSION The following conclusions can be drawn: 1. there are at least two subtypes of patients with myofascial pain that respond differently to experimental chewing; 2. the chewing protocol had an adequate discriminative ability in distinguishing patients with myofascial pain from healthy controls.
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MANFREDINI D, COCILOVO F, FAVERO L, FERRONATO G, TONELLO S, GUARDA-NARDINI L. Surface electromyography of jaw muscles and kinesiographic recordings: diagnostic accuracy for myofascial pain. J Oral Rehabil 2011; 38:791-9. [DOI: 10.1111/j.1365-2842.2011.02218.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Moving differently in pain: A new theory to explain the adaptation to pain. Pain 2011; 152:S90-S98. [PMID: 21087823 DOI: 10.1016/j.pain.2010.10.020] [Citation(s) in RCA: 602] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 10/15/2010] [Accepted: 10/18/2010] [Indexed: 11/20/2022]
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Localised muscle pain and dysfunction: a review of theoretical and suppositional biological effects of jaw exercises. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2010. [DOI: 10.1007/s12548-010-0064-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Tosato JDP, Caria PHF. Electromyographic activity assessment of individuals with and without temporomandibular disorder symptoms. J Appl Oral Sci 2010; 15:152-5. [PMID: 19089121 PMCID: PMC4327249 DOI: 10.1590/s1678-77572007000200016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Accepted: 04/17/2007] [Indexed: 11/22/2022] Open
Abstract
Introduction: Temporomandibular disorders (TMD) present several signs and symptoms that hinder their correct diagnosis, which is imperative on the elaboration of a treatment plan. Over the past years, several studies have been conducted to characterize and classify TMD to better understand these disorders. Therefore, the purpose of this study was to assess the electromyographic behavior of the masseter and temporal muscles in individuals with and without myogenic, arthrogenic and mixed TMD. Method: Forty volunteers of both genders responded to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) Questionnaire, were submitted to clinical exam and underwent bilateral electromyographic exam of the masseter and temporal muscles. Results: No statistically significant difference (p>0.05) was observed during the assessment of isotonic contraction. Regarding isometric contraction, pairing between the mixed TMD group and the asymptomatic subjects did not present significant difference (p>0.05). Comparison between the myogenic and arthrogenic TMD groups and the asymptomatic group showed statistically significant difference (p<0.05). The findings of the present study demonstrated alteration on the muscle contraction pattern of TMD individuals compared to that of asymptomatic patients.
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Affiliation(s)
- Juliana de Paiva Tosato
- Department of Morphology, Dental School of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil.
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Suzuki E, Ishigaki S, Yatani H, Morishige E, Uchida M. Mean power frequency during speech in myalgia patients. J Oral Rehabil 2010; 37:692-7. [PMID: 20492433 DOI: 10.1111/j.1365-2842.2010.02101.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to clarify a difference of mean power frequency (MPF) during speech between control and myalgia patients groups. The control group consisted of 20 asymptomatic volunteers and the myalgia patients group consisted of 19 patients. A bilateral electromyogram (EMG) of masseter muscles during speech movement was recorded using surface electrodes, and the EMG data were stored and analysed with a computer-based EMG analyzer. The MPF during the entire duration of EMG burst during speech was compared between the control and myalgia group. The average (SD) MPFs during speech in the myalgia and control groups were 214.06 (17.23) and 183.39 (22.35) Hz, respectively, significantly higher in the former (P < 0.001). In myalgia patients, firing rates or recruitment of motor units innervated by high threshold motoneurons might decrease and lead to a higher MPF. The result suggests the possibility that muscle pain, that is a subjective experience, could be evaluated by objective data that is calculated from electromyographic activities which is recorded during speech.
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Affiliation(s)
- E Suzuki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Cairns BE. Pathophysiology of TMD pain--basic mechanisms and their implications for pharmacotherapy. J Oral Rehabil 2010; 37:391-410. [PMID: 20337865 DOI: 10.1111/j.1365-2842.2010.02074.x] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article discusses the pathophysiology of temporomandibular disorders (TMD)-related pain and its treatment with analgesic drugs. Temporomandibular disorders are comprised of a group of conditions that result in temporomandibular joint pain (arthralgia, arthritis) and/or masticatory muscle pain (myofascial TMD). In at least some patients with TMD, a peripheral mechanism contributes to this pain. However, there is often a poor correlation between the severity of TMD-related pain complaints and evidence of definitive tissue pathology. This has led to the concept that pain in some patients with TMD may result from altered central nervous system pain processing and further that this altered pain processing may be attributable to specific genes that are heritable. Psychosocial stressors are also thought to contribute to the development of TMD-related pain, particularly masticatory muscle pain. Finally, substantially more women suffer from TMD than men. Although there are arguably multiple reasons for sex-related differences in the prevalence of TMD, one candidate for the increased occurrence of this disorder in women has been suggested to be the female sex hormone oestrogen. Analgesic drugs are an integral part of the primary treatment for TMD-related pain and dysfunction with more that 90% of treatment recommendations involving use of medications. The most commonly used agents include non-steroidal anti-inflammatory drugs, corticosteroids, muscle relaxants, anxiolytics, opiates and tricyclic antidepressants, however, evidence in support of the effectiveness of these drugs is lacking. Continued research into the pathophysiology of TMD-related pain and the effectiveness of analgesic treatments for this pain is required.
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Affiliation(s)
- B E Cairns
- Canada Research Chair in Neuropharmacology, Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver, Canada.
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Douglas CR, Avoglio JLV, de Oliveira H. Stomatognathic adaptive motor syndrome is the correct diagnosis for temporomandibular disorders. Med Hypotheses 2009; 74:710-8. [PMID: 19910127 DOI: 10.1016/j.mehy.2009.10.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Accepted: 10/14/2009] [Indexed: 11/18/2022]
Abstract
Temporomandibular disorder is a generic and inadequate conception to be used as a diagnosis. It fails to express the etiology or the pathophysiology and it is mainly associated with the anatomical site. Moreover, the clinical condition presents a mandibular motor problem and not a joint problem. The hypothesis presents the new diagnosis stomatognathic motor adaptive syndrome, which comprehend a motor response and the adaptive processes it induces. Inadequate occlusal contacts cause the mandible to shift in order to reach an ideal intercuspal position. The condylar displacements are proportional to such movements. Temporomandibular joint (TMJ) receptors respond to the capsular mechanical stress and the information reaches the trigeminal sensory nuclei. The mandibular modified position seems to be relevant information and may interfere with catecholaminergic neurotransmission in basal ganglia. The main motor responses comprise increased jaw muscle tone, decreased velocity of movements and incoordination. The overload of muscle function will produce adaptive responses on many stomatognathic structures. The muscle adaptive responses are hypertonia, pain, fatigue and weakness. Temporomandibular joint presents tissue modification, disc alteration and cracking noise. Periodontium show increased periodontal membrane, bone height loss and gingival recession. Teeth manifest increased wear facets, abfraction and non-accidental fractures. The periodontal and teeth adaptive processes are usually identified as occlusal trauma. The altered stomatognathic functions will show loss of velocity during mastication and speech. Fatigue, weakness in jaw muscle and difficulties to chew hard food are related to hypertonia. Incoordination between stomatognathic muscles groups is found, causing involuntary tongue/cheek biting and lateral jaw movements on speech. Otologic complaints, as aural fullness and tinnitus, are related to the tensor tympani muscle, innervated by the trigeminal nerve.
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Peddireddy A, Wang K, Svensson P, Arendt-Nielsen L. Blink reflexes in chronic tension-type headache patients and healthy controls. Clin Neurophysiol 2009; 120:1711-6. [PMID: 19632150 DOI: 10.1016/j.clinph.2009.06.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Revised: 06/22/2009] [Accepted: 06/28/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To use the R2 component of nociceptive-specific blink reflex (nBR) to probe the trigeminal nociceptive system and compare chronic tension-type headache (CTTH) patients and healthy controls. METHODS Thirty patients with CTTH and 30 age- and sex-matched healthy control subjects were included. nBR were evoked by painful electrical pulses (0.5ms duration), delivered by a concentric electrode placed on the left lower forehead close to the supraorbital foramen. The EMG activity in the orbicularis oculi muscles was recorded bilaterally. The electrical stimulus intensities to evoke individual sensory threshold (Is) and pin-prick pain sensation (Ip) were assessed. A fixed stimulation intensity of 1.5x Ip was used to evoke the nBR. The perceived pain intensity of the electrical stimulus (I(BR)) was assessed by the subjects on a 0-10cm visual analogue scale (VAS). RESULTS Is did not differ between CTTH patients and controls (P=0.687) but were lower in females than in males (P=0.020). CTTH patients had higher scores on I(BR) than controls (P=0.026). ANOVA showed significantly higher pre-stimulus EMG values in CTTH patients on the left (stimulated) side (P<0.001), whereas there were no differences between males and females (P>0.168). There were no significant differences in the absolute values of the nBR, however CTTH patients had significantly lower values of the normalized root mean square (RMS) (P=0.035) and area under the curve (AUC) (P=0.042) of the nBR on the left side compared with control subjects with no sex-related differences (P>0.070). The onset latencies and duration were not significantly different between CTTH and control subjects or between female and male subjects (P>0.270). There was no significant correlation between any of the BR parameters (RMS, AUC) and clinical characteristics of CTTH (headache intensity and duration) (P>0.163). CONCLUSIONS The results of the present study did not detect a significantly different blink reflex response in CTTH patients, but suggested that painful electrical stimulation was associated with consistent increases in eye muscle activity on the same side. SIGNIFICANCE These findings add further information to central nociceptive pathways in CTTH patients.
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Affiliation(s)
- Anitha Peddireddy
- Orofacial Pain Laboratory, Center for Sensory-Motor Interaction, Aalborg University, Denmark
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Influence of changing occlusal support on jaw-closing muscle electromyographic activity in healthy men and women. Acta Odontol Scand 2009; 67:187-92. [PMID: 19291503 DOI: 10.1080/00016350902794800] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To test whether changes in occlusal support differentially modulate masseter and anterior temporalis muscle electromyographic (EMG) activity during controlled maximal voluntary clenching. MATERIAL AND METHODS Forty-seven healthy subjects (32 M and 15 F, 22.9+/-1.3 years) were recruited. Cotton-rolls were used to modify the occlusal contact relations and were positioned on the right, left, or both sides, and either in the molar or premolar regions, i.e. six different occlusal combinations. Surface EMG activity was recorded bilaterally from the masseter and anterior temporalis area and normalized with respect to maximal voluntary clenching in the intercuspal position. Analysis of variance and the paired t-test were used to test the data. RESULTS Normalized EMG activity was influenced by changes in cotton-roll modified occlusal support, and there were differences between muscles (p<0.001). In general, EMG activity decreased in both muscles when occlusal support was moved from the molar to the premolar region. When occlusal support was moved from bilateral to unilateral contacts, EMG activity in the balancing-side anterior temporalis muscle and in bilateral masseter muscles decreased. Unilateral clenching on the molars, but not on the premolars, was associated with lower EMG activity in the balancing-side masseter and always associated with lower EMG activity in the balancing-side anterior temporalis compared to the working side (p<0.05). CONCLUSIONS Masseter and anterior temporalis muscles respond differently to changes in occlusal support, which may have implications for stability of the mandible during intense clenching.
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Peddireddy A, Wang K, Svensson P, Arendt-Nielsen L. Stretch Reflex and Pressure Pain Thresholds in Chronic Tension-Type Headache Patients and Healthy Controls. Cephalalgia 2009; 29:556-65. [DOI: 10.1111/j.1468-2982.2008.01772.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To compare the jaw-stretch reflex and pressure pain thresholds (PPT) in chronic tension-type headache (CTTH) patients and healthy controls, 30 patients (15 male and 15 female) and 30 age- and sex-matched healthy subjects were investigated. Stretch reflexes were recorded in the temporalis and masseter muscles and PPT was determined in the anterior temporalis, splenius capitis and masseter muscles. The results showed that the amplitude of the stretch reflex in CTTH patients was higher compared with control subjects ( P < 0.045), and higher in women compared with men in the right and left anterior temporalis muscles ( P < 0.009). There were no differences in the PPT value between CTTH and control subjects ( P > 0.509), whereas women showed significantly lower PPT measurements ( P < 0.046). The results demonstrated a facilitation of the stretch reflex pathways in CTTH patients that is unrelated to measures of pericranial sensitivity.
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Affiliation(s)
- A Peddireddy
- Orofacial Pain Laboratory, Centre for Sensory-Motor Interaction, Aalborg University, Aalborg
| | - K Wang
- Orofacial Pain Laboratory, Centre for Sensory-Motor Interaction, Aalborg University, Aalborg
- Department o Oral and Maxillofacial Surgery, Aalborg Hospital, Aalborg
| | - P Svensson
- Department of Clinical Oral Physiology, School of Dentistry, University of Aarhus, Aarhus, Denmark
| | - L Arendt-Nielsen
- Orofacial Pain Laboratory, Centre for Sensory-Motor Interaction, Aalborg University, Aalborg
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Li J, Jiang T, Feng H, Wang K, Zhang Z, Ishikawa T. The electromyographic activity of masseter and anterior temporalis during orofacial symptoms induced by experimental occlusal highspot. J Oral Rehabil 2008; 35:79-87. [PMID: 18197840 DOI: 10.1111/j.1365-2842.2007.01750.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to investigate the short-term impact of an occlusal highspot on the occurrence of orofacial symptoms by collecting self-evaluation and using electromyography (EMG) evaluation. A rigid unilateral intercuspal occlusal highspot (A cast onlay of 0.5 mm) was placed on the right lower first molar of six adult volunteers (three males, three females), and remained for 6 days. Continuously all the induced orofacial symptoms were collected and the subjects scored the orofacial pain on a 10-cm visual analogue scale (VAS) during the placement of onlay. The surface EMG was recorded before the placement of onlay, during (on the 3rd and 6th day) and after the onlay was removed. Then the contractile symmetry of bilateral masseter (MAL, MAR) and anterior temporalis (TAL, TAR) was measured by using an asymmetry index. On the 3rd day of the placement of the occlusal highspot, all subjects complained of headache in right temporal region (mean VAS +/- s.d.=3.7+/-0.5); the activity of TAR at rest position of mandible increased significantly (P=0.027). In addition, on the 3rd and 6th day with the highspot the EMG activity of the tested muscles during maximal voluntary contraction (MVC) was significantly reduced; the asymmetry index of bilateral anterior temporalis during MVC was increased significantly (P(3rd)=0.028; P(6th)=0.046). A unilateral occlusal highspot may make the ipsilateral anterior temporalis become tenser at rest position. Furthermore, the activity of bilateral anterior temporalis becomes more unsymmetrical during MVC although there are inter-individual differences between subjects. The changes in muscular activity may have some relationship with the occurrence of tension-type headache in temporal region.
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Affiliation(s)
- J Li
- Department of Prosthodontics, Peking University School of Stomatology, Beijing, China
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Castroflorio T, Bracco P, Farina D. Surface electromyography in the assessment of jaw elevator muscles. J Oral Rehabil 2008; 35:638-45. [PMID: 18466277 DOI: 10.1111/j.1365-2842.2008.01864.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Surface electromyography (EMG) allows the non-invasive investigation of the bioelectrical phenomena of muscular contraction. The clinical application of surface EMG recordings has been long debated. This paper reviews the main limitations and the current applications of the surface EMG in the investigation of jaw elevator muscles. Methodological factors associated with the recording of the surface EMG may reduce the reliability and sensitivity of this technique and may have been the cause of controversial results reported in different studies. Despite these problems, several clinical applications of surface EMG in jaw muscles are promising. Moreover, technological advances in signal detection and processing have improved the quality of the information extracted from the surface EMG and furthered our understanding of the anatomy and physiology of the stomatognathic apparatus.
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Affiliation(s)
- T Castroflorio
- Department of Biomedical Sciences and Human Oncology, Specialization School of Orthodontics, University of Turin, Turin, Italy.
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