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Lu C, Zhu Y, Zhang W, Xu B. A New Method in Dealing With Children's Condylar Fracture by Botulinum Toxin A Injection in Lateral Pterygoid Muscle. J Craniofac Surg 2024:00001665-990000000-01745. [PMID: 38953580 DOI: 10.1097/scs.0000000000010450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/31/2024] [Indexed: 07/04/2024] Open
Abstract
Condylar is one of the most vulnerable sites to be traumatized in pediatric mandible fracture, while temporomandibular joint ankylosis might be the most severe complication of condylar fracture in children. There exists a long-time controversy on the treatment of condylar fractures in children. Considering the risk of facial nerve injury and a certain probability of absorption or even ankylosis after open reduction and internal fixation (ORIF) of condylar fractures, a series of nonsurgical approaches are preferred in cases without severe malocclusion or shortening of the ramus. Our treatment plan was carried out through combining procedures of Botulinum toxin A injection in lateral pterygoid muscle with ORIF of para symphyseal fracture; subsequently, a conservative way of the occlusal splint with elastic traction was performed. Three patients of bilateral or unilateral condylar fractures, aged between 2 y and 6 y, were involved in this treatment. After more than 1 year's follow-up, the occlusion was satisfactory in all patients. Condylar remodeling was approximately complete in 3 months, and no unwanted complications were observed. We may expect this method to offer a new idea when dealing with children's condylar fracture.
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Affiliation(s)
- Chenpei Lu
- Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yanfei Zhu
- Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wenbin Zhang
- Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Bing Xu
- Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Mandal G, Montalbano M, Natsis K, Piagkou M, Tubbs RS, Loukas M. Musculus pterygoideus proprius: A meta-analysis. Clin Anat 2023. [PMID: 37964709 DOI: 10.1002/ca.24121] [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: 08/29/2023] [Accepted: 09/14/2023] [Indexed: 11/16/2023]
Abstract
The pterygoideus proprius muscle can be found incidentally in the infratemporal fossa, where it is spatially associated with the muscles of mastication, the maxillary artery, and the trigeminal nerve and its branches. Anatomists have described the muscle in various ways over the past 160 years, chiefly as a musculotendinous structure that originates from the infratemporal crest of the sphenoid bone and inserts into the lateral pterygoid plate and the lateral pterygoid muscle. It is present in non-human primates, albeit rarely, with similar anatomical findings. Embryologically, the pterygoideus proprius is thought to have developed from the first pharyngeal arch mesenchyme along with other muscles of mastication. Its close association with the maxillary artery and trigeminal nerve suggests possible clinical significance in trigeminal neuralgia and temporomandibular joint disorders. The literature was reviewed systematically to detail the historical background of research on the pterygoideus proprius muscle and explain its morphology, prevalence, embryology, and potential clinical significance. Despite its rarity, we propose that it is important to recognize its presence when the infratemporal fossa is approached.
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Affiliation(s)
- Gaurav Mandal
- Department of the Internal Medicine, Trinity Health System, Steubenville, Ohio, USA
| | - Michael Montalbano
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
| | - Konstantinos Natsis
- Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
- Department of Anatomy, University of Warmia and Mazury, Olsztyn, Poland
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Liu S, Wan C, Li H, Chen W, Pan C. Diffusion Tensor Imaging of the Lateral Pterygoid Muscle in Patients with Temporomandibular Joint Disorders and Healthy Volunteers. Korean J Radiol 2021; 23:218-225. [PMID: 34668354 PMCID: PMC8814700 DOI: 10.3348/kjr.2021.0132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 07/22/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022] Open
Abstract
Objective This study aimed to explore the feasibility of functional evaluation of the lateral pterygoid muscle (LPM) using diffusion tensor imaging (DTI) in patients with temporomandibular joint disorders (TMDs). Materials and Methods A total of 119 patients with TMD (23 male and 96 female; mean age ± standard deviation, 41 ± 15 years; 58 bilateral and 61 unilateral involvements for a total of 177 joints) and 20 healthy volunteers (9 male and 11 female; 40 ± 13 years; 40 joints) were included in this prospective study. Based on DTI of the jaw in the resting state, the diffusion parameters, apparent diffusion coefficient (ADC), fractional anisotropy (FA), λ1, λ2, and λ3 of the superior and inferior heads of the LPM (SHLPM and IHLPM) were measured. Patients with TMD with normal disc position (ND), anterior disc displacement with reduction (ADWR), and anterior disc displacement without reduction (ADWOR) were compared. Results Patients with TMD overall, and ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 in both the SHLPM and IHLPM than those in volunteers (p < 0.05 for all), whereas the ND subgroup only had significantly higher ADC and λ1 (p < 0.001). Meanwhile, significant differences in FA in the SHLPM and IHLPM were found between volunteers and ADWOR (p = 0.014 and p = 0.037, respectively). Among the three TMD subgroups, except for λ3 and FA in the ADWR subgroup, ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 and lower FA than those in the ND group (p < 0.050). There was no significant difference in diffusion variables between ADWR and ADWOR. In ADWOR, the osteoarthritis group had significantly higher λ3 and lower FA values in the IHLPM than those in the non-osteoarthritis group. Conclusion DTI successfully detected functional changes in the LPM in patients with TMD. The unsynchronized diffusivity changes in the LPM in different subgroups of TMD signified the possibility of using diffusion parameters as indicators to identify the severity of LPM hyperfunction at various stages of TMD.
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Affiliation(s)
- Simin Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changhua Wan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haosen Li
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiwei Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. ; and
| | - Chu Pan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Sritara S, Tsutsumi M, Fukino K, Matsumoto Y, Ono T, Akita K. Evaluating the morphological features of the lateral pterygoid insertion into the medial surface of the condylar process. Clin Exp Dent Res 2021; 7:219-225. [PMID: 33205570 PMCID: PMC8019758 DOI: 10.1002/cre2.353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The lateral pterygoid is vital in coordinating multidimensional jaw movements. Since a vector in three-dimensional (3D) space is defined by two 3D points, the role of the lateral pterygoid in 3D jaw movements is defined by its origin and insertion. Reportedly, the lateral pterygoid is inserted into not only the pterygoid fovea but also into the medial surface of the condylar process. The objective was to investigate the morphological features of the region of the lateral pterygoid that inserted into the medial surface of the condylar process. MATERIAL AND METHODS Ten head halves of seven cadaveric donors were analyzed. In all specimens, the insertion area on the medial surface of the condylar process was measured based on microcomputed tomography images. Muscle fibers were separated into ≥50 small bundles, and positional relationships between the origins and insertions were investigated. RESULTS Overall, 28.8 ± 5.0% of the insertion area of the lateral pterygoid was situated on the medial surface of the condylar process. Moreover, muscle fiber arrangement revealed that origins of the muscle bundles inserting into the medial surface in seven specimens posteriorly occupied the lateral plate of the pterygoid process longitudinally, whereas those in three specimens mainly occupied the posteroinferior portion. CONCLUSIONS Muscle bundle inserting on the medial surface of the condylar process had a broad insertion area and a distinct origin on the posterior region of the lateral plate of the pterygoid process. This muscle bundle could act as one of the significant subunits within the lateral pterygoid. Therefore, anatomical coordination mechanisms underlying jaw movement cannot be elucidated without considering this subunit.
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Affiliation(s)
- Sasin Sritara
- Department of Orthodontic Science, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Masahiro Tsutsumi
- Department of Clinical Anatomy, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Keiko Fukino
- Department of Orthodontic Science, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Yoshiro Matsumoto
- Department of Orthodontic Science, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Keiichi Akita
- Department of Clinical Anatomy, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
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Fiorelli G, Merlo P, Dalstra M, Melsen B. [Mandibular repositioning in adult patients. An alternative to surgery in some patients? A two-year follow-up]. Orthod Fr 2018; 89:123-135. [PMID: 30040612 DOI: 10.1051/orthodfr/2018013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 12/12/2017] [Indexed: 11/14/2022]
Abstract
INTRODUCTION A number of adult patients with skeletal discrepancies refuse surgical intervention. AIMS The aim was to assess the reaction to mandibular repositioning in simulating a skeletal correction in such patients. MATERIALS AND METHODS 32 consecutive patients without any signs of temporo-mandibular dysfunction (TMD) were offered mandibular repositioning, as a non-invasive alternative and it was explained to them that the approach was based on the results described in case reports. Before initiating any treatment initial records, headfilms, study casts and photos were taken (T0) and the mandible was repositioned to camouflage the skeletal discrepancy by means of an occlusal built-up in Triad® Gel. RESULTS Three months later (T1) 23 patients had adapted to the new occlusion reflected in absence of functional problems and lack of fracture of the built-up. In these patients the mandibular position was maintained by orthodontics adjusting the occlusion to the built-up position (T1). The skeletal changes occurring during repositioning were assessed on sagittal and frontal head films while intra-articular changes occurring during a 2-year follow-up period (T2) were evaluated on images constructed from CBCT images. No significant changes, neither in the direction of a relapse nor in the direction of further normalization of the condylar positioning, were observed during the 2-year observation period. CONCLUSIONS Repositioning is a non-invasive intervention and may be considered a valid alternative to surgery in some patients. Morphological variables from the radiographs taken at T0 and the results of the initial clinical evaluation of dysfunction yielded only vague and insignificant indications regarding the predictability of adaptation to the repositioning.
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Affiliation(s)
| | | | - Michel Dalstra
- Section of Orthodontics, Institute of Odontology, Aarhus University, Denmark - Department of Orthodontics and Pediatrics, University Center of Dental Health Basel, Basel University, Switzerland
| | - Birte Melsen
- Department of Orthodontics at Hannover University Germany, and University of West Australia Perth - Holtevej 11, 8000C Aarhus, Denmark
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Chen H, Whittle T, Gal JA, Murray GM, Klineberg IJ. The medial pterygoid muscle: a stabiliser of horizontal jaw movement. J Oral Rehabil 2017; 44:779-790. [PMID: 28664577 DOI: 10.1111/joor.12542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2017] [Indexed: 11/30/2022]
Abstract
There is limited information of the normal function of the human medial pterygoid muscle (MPt). The aims were to determine whether (i) the MPt is active throughout horizontal jaw movements with the teeth apart and (ii) whether single motor units (SMUs) are active during horizontal and opening-closing jaw movements. Intramuscular electrodes were placed in the right MPt of 18 participants who performed five teeth-apart tasks: (i) postural position, (ii) ipsilateral (i.e. right) jaw movement, (iii) contralateral movement, (iv) protrusive movement and (v) opening-closing movement. Movement tasks were guided by a target and were divided into BEFORE, OUT, HOLDING, RETURN and AFTER phases according to the movement trajectories recorded by a jaw tracking system. Increased EMG activity was consistently found in the OUT, HOLDING and RETURN phases of the contralateral and protrusive movement tasks. An increased RETURN phase activity in the ipsilateral task indicates an important role for the MPt in the contralateral force vector. Of the 14 SMUs active in the opening-closing task, 64% were also active in at least one horizontal task. There were tonically active SMUs at the postural jaw position in 44% of participants. These new data point to an important role for the MPt in the fine control of low forces as required for stabilisation of vertical mandibular position not only to maintain postural position, but also throughout horizontal jaw movements with the teeth apart. These findings provide baseline information for future investigations of the possible role of this muscle in oro-facial pain conditions.
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Affiliation(s)
- H Chen
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - T Whittle
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - J A Gal
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - G M Murray
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
| | - I J Klineberg
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital Centre for Oral Health, University of Sydney, Westmead, NSW, Australia
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Liu S, Wang M, Ai T, Wang Q, Wang R, Chen W, Pan C, Zhu W. In vivo morphological and functional evaluation of the lateral pterygoid muscle: a diffusion tensor imaging study. Br J Radiol 2016; 89:20160041. [PMID: 27222273 DOI: 10.1259/bjr.20160041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To explore the feasibility of morphological and functional evaluation of the lateral pterygoid muscle (LPM) by diffusion tensor imaging (DTI) in vivo. METHODS: 30 healthy volunteers underwent DTI with the jaw in the rest position, opening and clenching. Diffusion parameters of the superior head of the LPM (SHLP) and the inferior head of the LPM (IHLP) at different jaw positions were calculated. RESULTS: When the jaw was in the rest position, λ3 of the SHLP was significantly lower than that of the IHLP; fractional anisotropy (FA) value of the SHLP was significant higher than that of the IHLP. There was no significant difference in λ1, λ2 and apparent diffusion coefficient (ADC) value. During jaw opening, there was significant increase of all three eigenvalues and ADC value, and significant decrease of FA value both at the SHLP and IHLP. Clenching caused a significant increase in the ADC and all three eigenvalues, and caused a significant decrease of FA at the SHLP. However, at the IHLP, the variations of all diffusion parameters by clenching in the intercuspal position showed no significance when compared with those at rest. CONCLUSION: The morphological and functional changes of LPM fibres caused by jaw movements could be sensitively detected by DTI which may serve as a new and non-invasive method for simultaneously investigating the functional and morphological features of the LPM during jaw movement. ADVANCES IN KNOWLEDGE: A new application of DTI is proposed for the morphological and functional evaluation of the LPMs. The results show that the significant change of three eigenvalues indicates the activity of the LPM in a specific jaw movement, a finding that shows the potential value of DTI serving as a new and non-invasive method for investigation of the LPM.
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Affiliation(s)
- Simin Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuxia Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Renfa Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiwei Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chu Pan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Iwasaki LR, Liu H, Gonzalez YM, Marx DB, Nickel JC. Modeling of muscle forces in humans with and without temporomandibular joint disorders. Orthod Craniofac Res 2015; 18 Suppl 1:170-9. [PMID: 25865546 DOI: 10.1111/ocr.12075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Subjects with/without temporomandibular joint disorders (TMJD) were tested for differences in muscle forces. SETTING AND SAMPLE POPULATION School of Dental Medicine, University at Buffalo. Ninety-one subjects were classified in four groups based on the presence/absence (±) of chronic myofascial and/or TMJ pain (P) and bilateral disc displacement (DD). MATERIAL AND METHODS Validated numerical models employed an organizational objective and subjects' anatomy to calculate masticatory muscle forces during static biting. anova and Holm's step-down procedure post hoc tests assessed group differences. Theoretical geometries, representing the range of subjects' muscle orientations, were surveyed via numerical models to identify key combinations resulting in high muscle forces. Effect size (Cohen's d) and anova/post hoc tests assessed group differences in key muscle orientations. RESULTS +P-DD subjects had significantly higher muscle forces, especially for lateral pterygoid muscles, compared to the other groups (p<0.01) for bite forces that were directed posteromedially or posterolaterally on mandibular molars and posteriorly and slightly medially on mandibular incisors. Key muscle orientations for peak lateral pterygoid muscle forces were identified, and group comparisons showed mean orientation in +P-DD compared to other diagnostic groups was ≥5° more upright for masseter and ≥3° more posteriorly directed for temporalis muscles (all Cohen's d≥0.8). CONCLUSION Predicted lateral pterygoid muscle forces were significantly higher in +P-DD compared to other groups for specific biting conditions and were attributable, in part, to differences in masseter and temporalis muscle orientations.
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Affiliation(s)
- L R Iwasaki
- Departments of Orthodontics & Dentofacial Orthopedics and Oral & Craniofacial Sciences, University of Missouri-Kansas City, Kansas City, MO, USA
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van Bruggen HW, Van Den Engel-Hoek L, Steenks MH, Bronkhorst EM, Creugers NHJ, de Groot IJM, Kalaykova SI. Reduced mandibular range of motion in Duchenne Muscular Dystrophy: predictive factors. J Oral Rehabil 2015; 42:430-8. [PMID: 25600935 DOI: 10.1111/joor.12274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2014] [Indexed: 11/26/2022]
Abstract
Patients with Duchenne muscular dystrophy (DMD) experience negative effects upon feeding and oral health. We aimed to determine whether the mandibular range of motion in DMD is impaired and to explore predictive factors for the active maximum mouth opening (aMMO). 23 patients with DMD (mean age 16.7 ± 7.7 years) and 23 controls were assessed using a questionnaire about mandibular function and impairments. All participants underwent a clinical examination of the masticatory system, including measurement of mandibular range of motion and variables related to mandibular movements. In all patients, quantitative ultrasound of the digastric muscle and the geniohyoid muscle and the motor function measure (MFM) scale were performed. The patients were divided into early and late ambulatory stage (AS), early non-ambulatory stage (ENAS) and late non-ambulatory stage (LNAS). All mandibular movements were reduced in the patient group (P < 0.001) compared to the controls. Reduction in the aMMO (<40 mm) was found in 26% of the total patient group. LNAS patients had significantly smaller mandibular movements compared to AS and ENAS (P < 0.05). Multiple linear regression analysis for aMMO revealed a positive correlation with the body height and disease progression, with MFM total score as the strongest independent risk factor (R(2) = 0.71). Mandibular movements in DMD are significantly reduced and become more hampered with loss of motor function, including the sitting position, arm function, and neck and head control. We suggest that measurement of the aMMO becomes a part of routine care of patients with DMD.
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Affiliation(s)
- H W van Bruggen
- Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands
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Commisso MS, Martínez-Reina J, Ojeda J, Mayo J. Finite element analysis of the human mastication cycle. J Mech Behav Biomed Mater 2014; 41:23-35. [PMID: 25460400 DOI: 10.1016/j.jmbbm.2014.09.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/18/2014] [Accepted: 09/23/2014] [Indexed: 12/27/2022]
Abstract
The aim of this paper is to propose a biomechanical model that could serve as a tool to overcome some difficulties encountered in experimental studies of the mandible. One of these difficulties is the inaccessibility of the temporomandibular joint (TMJ) and the lateral pterygoid muscle. The focus of this model is to study the stresses in the joint and the influence of the lateral pterygoid muscle on the mandible movement. A finite element model of the mandible, including the TMJ, was built to simulate the process of unilateral mastication. Different activation patterns of the left and right pterygoid muscles were tried. The maximum stresses in the articular disc and in the whole mandible during a complete mastication cycle were reached during the instant of centric occlusion. The simulations show a great influence of the coordination of the right and left lateral pterygoid muscles on the movement of the jaw during mastication. An asynchronous activation of the lateral pterygoid muscles is needed to achieve a normal movement of the jaw during mastication.
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Affiliation(s)
- Maria S Commisso
- Department of Mechanical Engineering, University of Seville, Camino de los Descubrimientos s/n, E-41092 Seville, Spain.
| | - Javier Martínez-Reina
- Department of Mechanical Engineering, University of Seville, Camino de los Descubrimientos s/n, E-41092 Seville, Spain
| | - Joaquín Ojeda
- Department of Mechanical Engineering, University of Seville, Camino de los Descubrimientos s/n, E-41092 Seville, Spain
| | - Juana Mayo
- Department of Mechanical Engineering, University of Seville, Camino de los Descubrimientos s/n, E-41092 Seville, Spain
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Donovan TE, Anderson M, Becker W, Cagna DR, Carr GB, Albouy JP, Metz J, Eichmiller F, McKee JR. Annual Review of selected dental literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2013; 110:161-210. [DOI: 10.1016/s0022-3913(13)60358-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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