1
|
Lassmann Ł, Calamita MA, Manfredini D. Myths surrounding vertical dimension of occlusion in restorative dentistry: A scoping review. J ESTHET RESTOR DENT 2024. [PMID: 39189329 DOI: 10.1111/jerd.13303] [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: 07/29/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE This scoping review aims to clarify the concept of vertical dimension of occlusion (VDO) in prosthetic dentistry, addressing prevalent myths, and controversies regarding its clinical management and impact on the stomatognathic system. METHODS This paper critically examines common beliefs about VDO alteration and its effects on temporomandibular disorders (TMD) through an extensive literature review and an international survey. The survey included 862 general dentists and prosthodontists and explored their approaches to altering VDO and their perceptions of the clinical implications. The literature review provided a thorough analysis of existing research on VDO modification techniques, the adaptability of the stomatognathic system, and the relationship between VDO changes and TMD. RESULTS The survey revealed insights into dentists' perspectives on VDO, showing that while many practitioners test a new VDO due to concerns about patient adaptation, a significant majority observed that patients typically adjust well to a new VDO regardless of the technique used. The survey highlighted differing beliefs about the need for a gradual process and trial phase for VDO alteration, as well as the stability of modified VDO. Literature review suggests the stability and adaptability of VDO changes due to muscle adaptability and indicates no direct causal or curative link between VDO changes and TMD. Traditional methods for determining VDO in complete dentures may not be suitable for worn dentition, underscoring the need for tailored approaches. CONCLUSION This paper suggests that the traditional belief in the need for a prolonged trial phase for VDO alterations may be reconsidered in light of evidence supporting the adaptability of the stomatognathic system. Moreover, it emphasizes the importance of distinguishing between methods suitable for complete dentures and those for managing cases of worn dentition. The purported link between VDO alterations and TMD is also found to lack scientific evidence, highlighting the need for individualized patient care based on current evidence and clinical judgment.
Collapse
Affiliation(s)
- Łukasz Lassmann
- Independent Researcher, One & Only Institute, Gdánski, Poland
| | - Marcelo A Calamita
- Department of Restorative Dental Sciences, University of Florida, Gainesville, Florida, USA
| | - Danielle Manfredini
- Department of Medical Biotechnology, School of Dentistry, University of Siena, Siena, Italy
| |
Collapse
|
2
|
Bogdanov V. Type of correlation between bite force and EMG activity of the temporalis and masseter muscles during maximal and submaximal clenching. Folia Med (Plovdiv) 2023; 65:975-985. [PMID: 38351788 DOI: 10.3897/folmed.65.e107180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/24/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Maximal bite force is an important determinant of masticatory function and is essential for the estimation of dental status. Bite force is usually measured by gnathodynamometry.
Collapse
|
3
|
Kwon JS, Han SH, Im YG. Effect of passive jaw opening on the electromyographic activity of the temporalis, masseter, digastric, and infrahyoid muscles in healthy adults. Cranio 2022:1-9. [PMID: 35261336 DOI: 10.1080/08869634.2022.2048225] [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 investigate the surface electromyography (EMG) activity of the temporalis, masseter, digastric, and infrahyoid muscles during passive jaw opening in healthy adults. METHODS The EMG activity of the masseter, temporalis, digastric anterior belly, and infrahyoid muscles on the right side was recorded during the four jaw-opening tasks: active opening to 20 mm (AO20); active opening to 40 mm (AO40); passive opening to 40 mm with a rubber mouth prop on the right posterior teeth (POR40); and passive opening to 40 mm with a mouth prop on the left posterior teeth (POL40). RESULTS The EMG amplitude of the digastric anterior belly and infrahyoid muscles in either POL40 or POR40 was significantly less than that in AO20 or AO40, respectively. CONCLUSION Passive jaw opening reduces the EMG activity of the digastric and infrahyoid muscles significantly and could help reduce the load on these muscles during prolonged mouth-opening conditions.
Collapse
Affiliation(s)
- Jeong-Seung Kwon
- Department of Orofacial Pain & Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sang-Ho Han
- GnS International, Daejeon, Republic of Korea
| | - Yeong-Gwan Im
- Department of Oral Medicine, Dental Science Research Institute, School of Dentistry, Chonnam National University
| |
Collapse
|
4
|
Shopova D, Yordanova M, Yordanova S. 3Shape Digital Design Software in Splints Creation-A Pilot Study. Eur J Dent 2021; 16:815-819. [PMID: 34952555 DOI: 10.1055/s-0041-1739546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Digital technologies have widened their horizons into the world of dental medicine and now further expanding to cover all branches. This new modern technology replaces traditional laboratory techniques allowing effective patient care. Patients who suffer from bruxism-the act of involuntary habitual grinding of teeth-have widely been benefited by splint treatments. The aim of this article is to display the variety of occlusal splints that can be created by the 3Shape Digital Design Software and their application in specific clinical situations. MATERIALS AND METHODS Six variations in the splints were created digitally-three with uncombined designs and the remaining three with a combination of two of the main options available. During this study, 36 splints were made for patients aged 24 to 55 inclusively. RESULTS The largest number of splints according to the clinical picture were made of "raise to antagonist cusp tips" (14 pieces) and the remaining were of combined type "raise to antagonist cusp tips + raise to antagonist plane" (12 pieces). There thickness was within the range of 1.5 and 5 mm. CONCLUSION 3Shape Digital Design Software-Splint Studio is a suitable system for designing and creating occlusal splints with respect to certain clinical situations. It is possible to combine the three main types in a separate section of the dental arch according to the case.
Collapse
Affiliation(s)
- Dobromira Shopova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Miroslava Yordanova
- Department of Orthodontics, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Svetlana Yordanova
- Department of Orthodontics, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| |
Collapse
|
5
|
Surface Electromyography as a Method for Diagnosing Muscle Function in Patients with Congenital Maxillofacial Abnormalities. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8846920. [PMID: 33029337 PMCID: PMC7527883 DOI: 10.1155/2020/8846920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/24/2022]
Abstract
Electromyography (EMG) is the most objective and reliable method available for imaging muscle function and efficiency, which is done by identifying their electrical potentials. In global surface electromyography (sEMG), surface electrodes are located on the surface of the skin, and it detects superimposed motor unit action potentials from many muscle fibers. sEMG is widely used in orthodontics and maxillofacial orthopaedics to diagnose and treat temporomandibular disorders (TMD) in patients, assess stomatognathic system dysfunctions in patients with malocclusions, and monitor orthodontic therapies. Information regarding muscle sEMG activity in subjects with congenital maxillofacial abnormalities is limited. For this reason, the aim of this review is to discuss the usefulness of surface electromyography as a method for diagnosing muscle function in patients with congenital malformations of the maxillofacial region. Original papers on this subject, published in English between 1995 until 2020, are located in the MEDLINE/PubMed database.
Collapse
|
6
|
Comparison of clinical and electromyographic rest vertical dimensions in dolichofacial and brachyfacial young adults: A cross-sectional study. J Prosthet Dent 2018; 120:513-519. [DOI: 10.1016/j.prosdent.2017.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 11/23/2022]
|
7
|
Dalewski B, Chruściel-Nogalska M, Frączak B. Occlusal splint versus modified nociceptive trigeminal inhibition splint in bruxism therapy: a randomized, controlled trial using surface electromyography. Aust Dent J 2015; 60:445-54. [DOI: 10.1111/adj.12259] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- B Dalewski
- Department of Prosthodontics; Pomeranian Medical University in Szczecin; Szczecin Poland
| | - M Chruściel-Nogalska
- Department of Prosthodontics; Pomeranian Medical University in Szczecin; Szczecin Poland
| | - B Frączak
- Department of Prosthodontics; Pomeranian Medical University in Szczecin; Szczecin Poland
| |
Collapse
|
8
|
Davoudi A, Haghighat A, Rybalov O, Shadmehr E, Hatami A. Investigating activity of masticatory muscles in patients with hypermobile temporomandibular joints by using EMG. J Clin Exp Dent 2015; 7:e310-5. [PMID: 26155352 PMCID: PMC4483343 DOI: 10.4317/jced.52125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/15/2014] [Indexed: 11/29/2022] Open
Abstract
Background Temporomandibular joint hypermobility (TMJH) can manifest higher range of motions in mandible. The aim of this study was to investigate and compare the activity of masticatory muscle of TMJs in healthy individuals and patients with mild, moderate and severe TMJH. Material and Methods In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of TMJH were included. The patients were divided into three groups based on their maximum mouth opening (MMO): (light) with MMO of 50-55 mm; (moderate) with MMO between 55 to 65 mm; and (severe) with MMO >65 mm. Also, 20 healthy people with profiled tomography in the last 6 months were invited as control group (healthy) with normal MMO (<50 mm). All the groups subjected to electromyogram (EMG) in 2 steps: maximal voluntary clenching (MVC) of the jaws; and during chewing of bread by using one side of the jaws voluntary.
The collected data were analyzed by Student T-test and Chi-Square tests using SPSS software version 15 at significant level of 0.05. Results Both TMJs of light, moderate and severe groups showed significant differences in frequency, time of activity and rest in comparison with healthy group during chewing and MVC (all p values < 0.01). Conclusions Masticatory muscles activity reduced in relation with the severity of TMJH and higher excessive mouth opening. Key words:Electromyography, joint hypermobility, mouth opening, tempormandibular joint.
Collapse
Affiliation(s)
- Amin Davoudi
- Dentistry Student, Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Haghighat
- Assistant Professor of Oral and Maxillofacial Surgery Dental Implants Research Center, Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Oleg Rybalov
- MD Professor of Oral and Maxillofacial Surgery, Department of Surgical Dentistry and Maxillofacial Surgery in plastic and reconstructive surgery of head and neck, Poltava, Ukraine
| | - Elham Shadmehr
- Assistant Professor, Torabinejad Research Center and Departments of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
9
|
Ceneviz C, Mehta NR, Forgione A, Sands MJ, Abdallah EF, Lobo Lobo S, Mavroudi S. The Immediate Effect of Changing Mandibular Position on the EMG Activity of the Masseter, Temporalis, Sternocleidomastoid, and Trapezius Muscles. Cranio 2014; 24:237-44. [PMID: 17086852 DOI: 10.1179/crn.2006.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study investigated the immediate effect of changing mandibular position on the electromyographic (EMG) activity of the masseter (MS), temporalis (TM), sternocleidomastoid (SCM) and trapezius (TR) muscles. Thirty-three (33) asymptomatic subjects (16 males and 17 females), ages 23 to 52 were selected. Surface EMG recordings were obtained for all muscles bilaterally with the mandible in a relaxed open position (relaxed) and during maximal voluntary clenching (fullbite) for the following: a non-repositioning appliance (NONREPOS) and repositioning appliance (REPOS). REPOS significantly reduced EMG activity of all muscles bilaterally during fullbite. During relaxation, reduction in EMG activity was only found for TR bilaterally. NONREPOS decreased the EMG activity bilaterally for TM and TR and unilaterally (left) for MS and SCM during fullbite. During relaxation, NONREPOS decreased muscle activity bilaterally for TR and SCM. A unilateral reduction was found for TM (right). These findings suggest that immediate alterations in mandibular position affect the cranio-cervical system. Both mandibular positions tested lowered the EMG activity of masticatory and cervical muscles in the relaxed and fullbite positions. The trapezius muscle was the most responsive to alterations in mandibular position.
Collapse
Affiliation(s)
- Caroline Ceneviz
- The Craniofacial Pain Center, Tufts University School of Dental Medicine, Box 1, One Kneeland St., 6th Floor, Boston, MA 02111, USA.
| | | | | | | | | | | | | |
Collapse
|
10
|
Woźniak K, Piątkowska D, Lipski M, Mehr K. Surface electromyography in orthodontics - a literature review. Med Sci Monit 2013; 19:416-23. [PMID: 23722255 PMCID: PMC3673808 DOI: 10.12659/msm.883927] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Electromyography is the most objective and reliable technique for evaluating muscle function and efficiency by detecting their electrical potentials. It makes it possible to assess the extent and duration of muscle activity. The main aim of surface electromyography is to detect signals from many muscle fibers in the area of the detecting surface electrodes. These signals consist of a weighted summation of the spatial and temporal activity of many motor units. Hence, the analysis of the recordings is restricted to an assessment of general muscle activity, the cooperation of different muscles, and the variability of their activity over time. This study presents the main assumptions in the assessment of electrical muscle activity through the use of surface electromyography, along with its limitations and possibilities for further use in many areas of orthodontics. The main clinical uses of sEMG include the diagnostics and therapy of temporomandibular joint disorders, an assessment of the extent of stomatognathic system dysfunctions in subjects with malocclusion, and the monitoring of orthodontic therapies.
Collapse
Affiliation(s)
- Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | | | | | | |
Collapse
|
11
|
Monaco A, Sgolastra F, Pietropaoli D, Giannoni M, Cattaneo R. Comparison between sensory and motor transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorder: a controlled clinical trial. BMC Musculoskelet Disord 2013; 14:168. [PMID: 23672400 PMCID: PMC3660267 DOI: 10.1186/1471-2474-14-168] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 05/03/2013] [Indexed: 01/31/2023] Open
Abstract
Background The purpose of the present controlled clinical trial was to assess the effect of a single 60 min application of transcutaneous electrical nervous stimulation (TENS) at sensory stimulation threshold (STS), compared to the application of motor stimulation threshold (MTS) as well as to untreatment, on the surface electromyographic (sEMG) and kinesiographic activity of patients with tempormanbibular disorder (TMD). Methods Sixty female subjects, selected according to the inclusion/exclusion criteria, suffering from unilateral TMD in remission were assigned to MTS, STS or untreatment. Pre- and post-treatment differences in the sEMG activity of temporalis anterior (TA), masseter (MM), digastric (DA) and sternocleidomastoid muscles (SCM), as well in the interocclusal distance (ID), within group were tested using the Wilcoxon test, while differences among groups were assessed by Kruskal-Wallis test; the level of significance was set at p ≤ 0.05. Results Significant pre- and post-treatment differences were observed in MTS and STS groups, for TA and MM of both sides; no significant difference was detected between MTS and STS groups. Kinesiographic results showed that the vertical component of ID was significantly increased after TENS in MTS and STS groups. Conclusions STS TENS could be effective, as well as MTS, in reduce the sEMG activity of masticatory muscles and to improve the ID of TMD patients in remission. Future studies are needed to confirm the results of the present study. Clinical relevance. The present study demonstrates that the application of TENS is effective in reduce the sEMG activity, as well as in increasing the ID of patients with TMD; our study did not support superior effectiveness of MTS or STS. Trial registration ClinicalTrials.gov: NCT01832207
Collapse
Affiliation(s)
- Annalisa Monaco
- University of L'Aquila Department of Health Sciences, Via Vetoio 1, Italy, L'Aquila 67100, Italy.
| | | | | | | | | |
Collapse
|
12
|
Pita MS, Ribeiro AB, Garcia AR, Pedrazzi V, Zuim PRJ. Effect of occlusal splint thickness on electrical masticatory muscle activity during rest and clenching. Braz Oral Res 2012; 25:506-11. [PMID: 22147230 DOI: 10.1590/s1806-83242011000600006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 09/28/2011] [Indexed: 11/21/2022] Open
Abstract
The extent of separation between the maxillary and mandibular teeth in the fabrication of interocclusal splints designed to achieve efficiency and muscle relaxation is controversial and undefined in the literature. Based on this premise, the aim of this study was to evaluate the effect of interocclusal splint thicknesses of 3 and 6 millimeters on the electrical activity of the anterior temporal and masseter muscles during rest and dental clenching. Twenty asymptomatic individuals (10 males and 10 females) were selected using the Research Diagnostic Criteria (RDC). Electromyography (EMG) was performed both with and without the 3- and 6-mm splints using the Bio EMG software package, which recorded values given in microvolts (µV). The results, which were assessed using analysis of variance (ANOVA) to a 5% significance level (p < 0.05), showed increased electrical activity of the masticatory muscles during dental clenching compared with at rest, with greater activity in the masseter muscle. The electrical activity did not differ according to the thickness of the splints or between males and females. We can conclude that both splint thicknesses are effective in treating muscle hyperactivity given their similar clinical behavior for asymptomatic individuals.
Collapse
Affiliation(s)
- Murillo Sucena Pita
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | | | | |
Collapse
|
13
|
Monaco A, Sgolastra F, Ciarrocchi I, Cattaneo R. Effects of transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorders: A placebo-controlled study. J Electromyogr Kinesiol 2012; 22:463-8. [DOI: 10.1016/j.jelekin.2011.12.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 10/20/2011] [Accepted: 12/12/2011] [Indexed: 11/17/2022] Open
|
14
|
Kostrzewa-Janicka J, Mierzwińska-Nastalska E, Jarzębski G, Okoński P. Vertical jaw separation for vertical thickness of occlusal stabilization splint. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2012. [DOI: 10.1007/s12548-012-0034-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
Daif ET. Correlation of splint therapy outcome with the electromyography of masticatory muscles in temporomandibular disorder with myofascial pain. Acta Odontol Scand 2012; 70:72-7. [PMID: 21728748 DOI: 10.3109/00016357.2011.597776] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effect of occlusal splint therapy on the electromyographic amplitude records (μV) of masticatory muscles in temporomandibular disorder (TMD) with myofascial pain and to detect a possible existence of a relationship between this effect and the treatment outcome. MATERIALS AND METHODS Forty patients (23 females and 17 males) having TMD with myofascial pain were included in this study. They were randomly divided into two equal groups (20 of each). The first group (A) was treated by occlusal splints for 6 months while the second group (B) acted as a control. A clinical assessment and surface electromyography (EMG) for the masticatory muscles were performed at the beginning of the study, then 6 months later. The collected data were statistically analyzed using paired t-test. The differences were considered significant at p < 0.05. RESULTS The results showed that 85% of group A either completely recovered (35%) or clinically improved (50%) while only 20% of group B had a spontaneous improvement. In group A, the means of the electromyographic amplitude records (μV) of the monitored muscles have decreased after 6 months. However, the decrease was statistically insignificant (p > 0.05) in the patients (15%) who had no clinical changes. In group B, the means of the muscles' records (μV) in the left side slightly increased while those of the right side slightly decreased. These changes were statistically insignificant (p > 0.05). CONCLUSIONS Occlusal splint could eliminate or improve the signs and symptoms of TMD patients with myofascial pain. It reduces the electromyographic amplitude records (μV) of the masticatory muscles. The splint therapy outcome has a correlation with the electromyographic amplitude changes of the masticatory muscles.
Collapse
Affiliation(s)
- Emad T Daif
- Oral & Maxillofacial Surgery, Faculty of Oral & Dental Medicine, Cairo University, Egypt.
| |
Collapse
|
16
|
Lodetti G, Mapelli A, Musto F, Rosati R, Sforza C. EMG spectral characteristics of masticatory muscles and upper trapezius during maximum voluntary teeth clenching. J Electromyogr Kinesiol 2011; 22:103-9. [PMID: 22100151 DOI: 10.1016/j.jelekin.2011.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 10/21/2011] [Accepted: 10/21/2011] [Indexed: 02/03/2023] Open
Abstract
To assess the surface electromyographic spectral characteristics of masticatory and neck muscles during the performance of maximum voluntary clench (MVC) tasks, 29 healthy young adults (15 men, 14 women, mean age 22years) were examined. Electromyography of masseter, temporalis and upper trapezius muscles was performed during 5-s MVCs either on cotton rolls or in intercuspal position. Using a fast Fourier transform, the median power frequency (MPF) was obtained for the first and last seconds of clench, and compared between sexes, muscles, sides, tests and time intervals using ANOVAs. On average, the MPFs did not differ between sexes or sides (p>0.05), but significant effects of muscle (MPF temporalis larger than masseter, larger than trapezius muscles), test (larger MPFs when clenching in intercuspal position than when clenching on cotton rolls) and time (larger MPFs in the first than in the fifth second of clench) were found. In conclusion, a set of data to characterize the sEMG spectral characteristics of jaw and neck muscles in young adult subjects performing MVC tasks currently in use within the dental field was obtained. Reference values may assist in the assessment of patients with alterations in the cranio-cervical-mandibular system.
Collapse
Affiliation(s)
- Gianluigi Lodetti
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Morfologia Umana e Scienze Biomediche Città Studi, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Italy
| | | | | | | | | |
Collapse
|
17
|
Tartaglia GM, Lodetti G, Paiva G, Felicio CMD, Sforza C. Surface electromyographic assessment of patients with long lasting temporomandibular joint disorder pain. J Electromyogr Kinesiol 2011; 21:659-64. [DOI: 10.1016/j.jelekin.2011.03.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 01/27/2011] [Accepted: 03/14/2011] [Indexed: 02/05/2023] Open
|
18
|
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.
Collapse
Affiliation(s)
- Juliana de Paiva Tosato
- Department of Morphology, Dental School of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil.
| | | |
Collapse
|
19
|
SFORZA C, MONTAGNA S, ROSATI R, DE MENEZES M. Immediate effect of an elastomeric oral appliance on the neuromuscular coordination of masticatory muscles: a pilot study in healthy subjects. J Oral Rehabil 2010; 37:840-7. [DOI: 10.1111/j.1365-2842.2010.02114.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
20
|
Suvinen TI, Malmberg J, Forster C, Kemppainen P. Postural and dynamic masseter and anterior temporalis muscle EMG repeatability in serial assessments. J Oral Rehabil 2009; 36:814-20. [PMID: 19744168 DOI: 10.1111/j.1365-2842.2009.01999.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Electromyographic (EMG) assessment has been used as a non-invasive tool to objectively assess muscle function, although with controversial research and clinical potential. The aim of this study was to assess within-, inter-subject and between-day repeatability of serial EMG recordings. The study sample included 10 asymptomatic subjects with no history of temporomandibular disorders or muscle parafunctions. Bilateral masseter and anterior temporalis muscle EMG parameters were assessed in two standardized serial recordings (day 1 to day 2) using a portable EMG equipment (ME 6000 recorder, Mega Electronics, Kuopio, Finland). The functional tasks included postural/resting activities as pre- and post-recording series of 30 s each and jaw opening/closing, intercuspal and maximal voluntary clenching activities of 5 s, repeated three times. The assessed EMG parameters included the mean amplitude, s.d. and error. In addition, the power spectrum EMG parameter assessment included the median power frequencies and the averaged EMG spectrum data values. The results of the intraclass correlation coefficient analysis indicated reliability for nearly all of the intercuspal and all clenching EMG amplitude and power spectrum parameters. This was complemented by the repeated measures anova and post hoc analyses that indicated non-significant differences between day 1 and 2 in task- and muscle-related analyses. Most variability was noted in postural and some in opening/closing tasks. In conclusion this study assessed the reliability, repeatability and limitations of postural and various dynamic masseter and temporalis EMG recordings for serial assessment.
Collapse
Affiliation(s)
- T I Suvinen
- Department of Stomatognathic Physiology, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, Turku, FIN-20520, Finland.
| | | | | | | |
Collapse
|
21
|
Hamata MM, Zuim PRJ, Garcia AR. Comparative evaluation of the efficacy of occlusal splints fabricated in centric relation or maximum intercuspation in temporomandibular disorders patients. J Appl Oral Sci 2009; 17:32-8. [PMID: 19148403 PMCID: PMC4327611 DOI: 10.1590/s1678-77572009000100007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2008] [Accepted: 08/30/2008] [Indexed: 11/21/2022] Open
Abstract
Fabrication of occlusal splints in centric relation for temporomandibular disorders (TMD) patients is arguable, since this position has been defined for asymptomatic stomatognathic system. Thus, maximum intercuspation might be employed in patients with occlusal stability, eliminating the need for interocclusal records. This study compared occlusal splints fabricated in centric relation and maximum intercuspation in muscle pain reduction of TMD patients. Twenty patients with TMD of myogenous origin and bruxism were divided into 2 groups treated with splints in maximum intercuspation (I) or centric relation (II). Clinical, electrognathographic and electromyographic examinations were performed before and 3 months after therapy. Data were analyzed by the Student's t test. Differences at 5% level of probability were considered statistically significant. There was a remarkable reduction in pain symptomatology, without statistically significant differences (p>0.05) between the groups. There was mandibular repositioning during therapy, as demonstrated by the change in occlusal contacts on the splints. Electrognathographic examination demonstrated a significant increase in maximum left lateral movement for group I and right lateral movement for group II (p<0.05). There were no significant differences (p>0.05) in the electromyographic activities at rest after utilization of both splints. In conclusion, both occlusal splints were effective for pain control and presented similar action. The results suggest that maximum intercuspation may be used for fabrication of occlusal splints in patients with occlusal stability without large discrepancies between centric relation and maximum intercuspation. Moreover, this technique is simpler and less expensive.
Collapse
Affiliation(s)
- Marcelo Matida Hamata
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, São Paulo State University, Araçatuba, SP, Brazil.
| | | | | |
Collapse
|
22
|
Tartaglia GM, Moreira Rodrigues da Silva MA, Bottini S, Sforza C, Ferrario VF. Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups. MANUAL THERAPY 2008; 13:434-40. [PMID: 17643338 DOI: 10.1016/j.math.2007.05.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Revised: 03/28/2007] [Accepted: 05/22/2007] [Indexed: 05/16/2023]
Abstract
The research diagnostic criteria for temporomandibular disorders (RDC/TMD) are used for the classification of patients with temporomandibular disorders (TMD). Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 103 TMD patients subdivided according to the RDC/TMD into 3 non-overlapping groups: (a) 25 myogenous; (b) 61 arthrogenous; and (c) 17 psycogenous patients. Thirty-two control subjects matched for sex and age were also measured. During clenching, standardized total muscle activities (electromyographic potentials over time) significantly differed: 131.7 microV/muVs % in the normal subjects, 117.6 microV/microVs % in the myogenous patients, 105.3 microV/microVs % in the arthrogenous patients, 88.7 microV/microVs % in the psycogenous patients (p<0.001, analysis of covariance). Symmetry in the temporalis muscles was larger in normal subjects (86.3%) and in myogenous patients (84.9%) than in arthrogenous (82.7%), and psycogenous patients (80.5%) (p=0.041). No differences were found for masseter muscle symmetry and torque coefficient (p>0.05). Surface electromyography of the masticatory muscles allowed an objective discrimination among different RDC/TMD subgroups. This evaluation could assist conventional clinical assessments.
Collapse
Affiliation(s)
- Gianluca M Tartaglia
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Morfologia Umana, Facoltà di Medicina e Chirurgia, Università Degli Studi, Via Mangiagalli 31, I-20133 Milano, Italy
| | | | | | | | | |
Collapse
|
23
|
Suvinen TI, Kemppainen P. Review of clinical EMG studies related to muscle and occlusal factors in healthy and TMD subjects. J Oral Rehabil 2007; 34:631-44. [PMID: 17716262 DOI: 10.1111/j.1365-2842.2007.01769.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Several electronic instruments have been developed as adjuncts to objectively record the dysfunctional features of temporomandibular disorders and to study the effectiveness of various treatment interventions. The aim of this review was to assess the value and contribution of clinical electromyographic research in the understanding of asymptomatic and dysfunctional muscle function and the therapeutic effects of interocclusal appliances. For this purpose MedLine and PubMed searches were conducted with the following main keywords alone and in various combinations: electromyography, muscles of mastication, masseter, temporalis, temporomandibular, TMD, utility, validity, repeatability, rest, postural, vertical dimension, occlusal, splint, treatment. The review includes critical evaluation, discussion and conclusions regarding electromyographic studies in asymptomatic and dysfunctional muscles, rest position, occlusal parameters and interocclusal appliances, as well as a critical summary and proposals for further research. Much of earlier critique of many electromyographic studies still applies regarding comparative sample selections, research designs, analyses and conclusions. The areas not well-understood include normal biological variation, capacity for adaptation, fluctuations regarding the clinical course and multidimensional features of temporomandibular disorders and long-term follow-up data, especially in studies that evaluate the effectiveness of therapeutic measures. Considering the required improvements in technical and research designs features and critical appraisal electromyographic research could have value as an adjunct research tool to study features of craniofacial muscle-related dysfunction. Until electromyographic measures are correlated with other multidimensional, especially subjective and pain-related methods, the clinical use of this method for diagnostic purposes of temporomandibular disorders remains in doubt, and is not at present recommended.
Collapse
Affiliation(s)
- T I Suvinen
- Department of Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland.
| | | |
Collapse
|
24
|
Ferrario VF, Tartaglia GM, Luraghi FE, Sforza C. The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders. MANUAL THERAPY 2006; 12:372-9. [PMID: 16973402 DOI: 10.1016/j.math.2006.07.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Revised: 03/06/2006] [Accepted: 07/03/2006] [Indexed: 02/02/2023]
Abstract
The aim of this study was to assess the electromyographic characteristics of the masticatory muscles (masseter and temporalis) of patients with either "temporomandibular joint disorder" or "neck pain". Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 38 patients aged 21-67 years who had either (a) temporomandibular joint disorder (24 patients); (b) "neck pain" (13 patients). Ninety-five control, healthy subjects were also examined. During clenching, standardized total muscle activities (electromyographic potentials over time) were significantly different in the three groups: 75 microV/microVs% in the temporomandibular joint disorder patients, 124 microV/microVs% in the neck pain patients, and 95 microV/microVs% in the control subjects (analysis of variance, P<0.001). The temporomandibular joint disorder patients also had significantly (P<0.001) more asymmetric muscle potentials (78%) than either neck pain patients (87%) or control subjects (92%). A linear discriminant function analysis allowed a significant separation between the two patient groups, with a single patient error of 18.2%. Surface electromyographic analysis during clenching allowed to differentiate between patients with a temporomandibular joint disorder and patients with a neck pain problem.
Collapse
Affiliation(s)
- Virgilio F Ferrario
- Dipartimento di Morfologia Umana, Via Mangiagalli 31, I-20133 Milano, Italy.
| | | | | | | |
Collapse
|
25
|
Klasser GD, Okeson JP. The clinical usefulness of surface electromyography in the diagnosis and treatment of temporomandibular disorders. J Am Dent Assoc 2006; 137:763-71. [PMID: 16803805 DOI: 10.14219/jada.archive.2006.0288] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND This article presents a comprehensive review of the recent literature regarding the scientific support for the use of surface electromyography (SEMG) in diagnosing and treating temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED The authors conducted a Medline search involving human studies using the key words "surface electromyography or electromyography" and "masticatory muscles or temporomandibular disorders or craniomandibular disorders." They also reviewed relevant articles regarding the clinical usefulness of SEMG based on reliability, validity, sensitivity and specificity, as well as additional references included in some of the articles. RESULTS The clinical use of SEMG in the diagnosis and treatment of TMD is of limited value when one considers reliability, validity, sensitivity and specificity as measurement standards. SEMG does not appear to contribute any additional information beyond what can be obtained from the patient history, clinical examination and, if needed, appropriate imaging. CONCLUSIONS Clinically, the determination of the presence or absence of TMD does not appear to be enhanced by the use of SEMG. However, the modality may be useful in a meticulously controlled research setting. CLINICAL IMPLICATIONS SEMG has limited value in the detection or management of TMD and in some instances may lead to unnecessary dental therapy as a solution for those disorders.
Collapse
Affiliation(s)
- Gary D Klasser
- University of Illinois at Chicago, College of Dentistry, Department of Oral Medicine and Diagnostic Sciences, Chicago, IL 60612, USA.
| | | |
Collapse
|
26
|
Stiesch-Scholz M, Kempert J, Wolter S, Tschernitschek H, Rossbach A. Comparative prospective study on splint therapy of anterior disc displacement without reduction. J Oral Rehabil 2005; 32:474-9. [PMID: 15975126 DOI: 10.1111/j.1365-2842.2005.01452.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A prospective randomized study was carried out to compare the therapeutic success of two different types of splint in patients with painful anterior disc displacement of the temporomandibular joint. The patients in Group I (n = 20) received stabilization splint therapy and the patients in Group II (n = 20) pivot splint therapy. Clinical investigation of the craniomandibular system was performed before and 1, 2 and 3 months after therapy and this was accompanied by subjective evaluation by the patients of their symptoms, using a validated questionnaire with visual analogue scales (VAS). There was a significant increase in maximum jaw opening and a significant reduction in subjective pain in both groups during the course of therapy (Wilcoxon test, P < 0.05). Active jaw opening increased by a mean of 8.05 mm in the group of patients treated with a stabilization splint (Group I). The comparable figure with pivot splint therapy (Group II) was 8.26 mm. The VAS scale value in Group I was reduced by 30.54 units and in Group II by 39.36 scale units. However, neither of these differences between the groups was statistically significant (Mann-WhitneyU-test, P > 0.05). It can be concluded that both types of splint provided effective therapy in patients with anterior disc displacement.
Collapse
Affiliation(s)
- M Stiesch-Scholz
- Department of Prosthetic Dentistry, Hannover University Medical School, Hannover, Germany.
| | | | | | | | | |
Collapse
|
27
|
Chandu A, Suvinen TI, Reade PC, Borromeo GL. Electromyographic activity of frontalis and sternocleidomastoid muscles in patients with temporomandibular disorders. J Oral Rehabil 2005; 32:571-6. [PMID: 16011635 DOI: 10.1111/j.1365-2842.2005.01469.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Little is known of the effects of an interocclusal appliance on the activity of craniocervical muscles in patients with temporomandibular disorder. The bilateral electromyographic activity of the frontalis muscle and sternocleidomastoid muscle were assessed in 10 patients with temporomandibular disorders and eight gender, age and dentally matched asymptomatic control subjects during rest and different clenching tasks with or without an interocclusal appliance. Clenching significantly increased both frontalis and sternocleidomastoid activity from rest. Clenching with an interocclusal appliance, as compared with clenching alone, also significantly reduced frontalis activity in both groups, but not for sternocleidomastoid. Increased electromyographic activity of these muscles may represent co-activation of the craniocervical musculature during clenching.
Collapse
Affiliation(s)
- A Chandu
- Oral and Maxillofacial Surgery, Austin Health, Heidelberg, Australia
| | | | | | | |
Collapse
|