Changes in bite force and dentoskeletal morphology in prognathic patients after orthognathic surgery

Masticatory function and three-dimensional facial morphology of soft tissues: One year after orthognathic surgery

OBJECTIVE

Dentofacial deformities (DFD) require orthodontic treatment, orthognathic surgery, and speech therapy for aesthetic and functional problems. This longitudinal study analyzed changes in masticatory function and three-dimensional (3D) facial soft tissue in patients with Class II and Class III DFD after orthognathic surgery. In addition, the study investigated the relationship between facial measurements, maximum bite force (MBF), and orofacial myofunctional status (OMS).

DESIGN

The sample consisted of 46 participants, including 10 patients with Class II DFD, and 11 patients with Class III DFD. These groups were assessed before (T0) and 6 months (T1) after surgery. Twelve patients who completed the treatment protocol were evaluated 12 months post-surgery (T2). The patient groups were compared with each other and with a control group (CG) of 25 healthy subjects. The participants underwent MBF and clinical evaluation of OMS, including masticatory behavior, using a validated protocol. The 3D facial soft tissue was assessed using laser scanning.

RESULTS

Compared to the CG, DFD patients showed reduced MBF, masticatory behavior, and OMS scores at T0. At T2, there was an improvement in MBF, masticatory, and OMS scores, but differences were observed compared to the CG. Changes in facial soft tissue followed the underlying hard tissue movement resulting from surgery, and reduction of vertical measurements contributed to improvements in masticatory function.

CONCLUSION

These findings indicated that combined surgery, orthodontic treatment, and speech therapy can lead to a significant improvement in masticatory function and facial soft tissue in DFD patients, although not completely 12 months post-surgery.

Evaluation of occlusal force changes in orthognathic surgery using force-sensing sensors in 3 years of follow-up

Purpose

The aim of this study was to test a prototype device called occlusal force diagnostic system in relation to occlusal force adaptation following orthognathic surgery.

Methods

Retrospective study of 10 patients scheduled for a bimaxillary osteotomy involving a combination of maxillary Le Fort I impaction procedure coupled with a sagittal split advancement of the mandible; in a 3 years follow-up period.

Results

The selection of examiner is not a variable that affects the occlusal force (N) measured by FSS sensors in any of the experimental conditions tested. The sensor position and the surgery recovery time affect the occlusal force irrespective of the examiner selection and/or the surgery recovery time.

Conclusion

The piezoelectric sensors used in the present study have shown high reliability and validity of measurement. The surgery recovery time impacts the occlusal force (N), with a 50% increase in occlusal force (N) measured after 6 months post-surgery, with the value keeping stable at 36 months. This suggests that the patient is only fully recovered from the functional point-of-view at 6 months, having from that point on an improved and stable masticatory function.

Effect of condylar rotation on the stress environment of the temporomandibular joint in patients with mandibular protrusion

PURPOSE

The study aims to analyse the effects of condylar rotation on the biomechanical environment of the TMJ after bilateral sagittal split ramus osteotomy (BSSRO) through the finite element method (FEM).

METHODS

Thirteen patients with mandibular prognathism and twenty-three normal subjects were recruited. The three-dimensional (3D) models were reconstructed. 13 representative morphological parameters were measured for comparison. A patient was selected to perform virtual BSSRO surgery by rotating the condyles in MIMICS. The preoperative and postoperative 3D models of the patient were subsequently imported into ABAQUS for finite element analysis. The preoperative and postoperative stresses and joint spaces in the TMJs were investigated.

RESULTS

The maxillofacial morphologies of the patients with mandibular protrusion was significantly different from those of the asymptomatic subjects (P<.05). Stresses in the postoperative group were lower than those in the preoperative group. The rotation of the condyle could cause the variations in stress levels and joint spaces within the TMJs. Inward and upward rotation of the condyle was associated with higher stress in the TMJ, whereas the lowest stress was observed when the condyle remained stationary following surgical intervention.

SIGNIFICANCE

Lateral, medial and superior joint spaces were more related to the stresses in the TMJs. The condyle should be kept in place as much as possible to avoid disrupting the balance of the TMJ in patients with mandibular protrusion.

Changes in occlusion after orthognathic surgery: a systematic review and meta-analysis

PURPOSE

This study aims to systematically review and identify the changes of occlusion in patients after orthognathic surgery.

METHODS

The protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and was registered to the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42021253129. Studies included were Original articles only, Additionally, studies were included if the outcome of occlusal force was measured pre- and postoperatively and if occlusal forces resulted from a long follow-up of a minimum of 1 year following orthognathic surgery using adequate measurement tools. Non-English articles, case reports, case series, and non-original articles, including systematic reviews and literature reviews, were excluded.

RESULTS

The search strategy yielded a total of 978 articles. Of the 978 articles, 285 were duplicates. After reading the titles and abstracts, 649 articles were excluded, and full-text articles of the remaining 47 studies were reviewed independently by two authors for eligibility wherein 33 articles were excluded, because they did not meet the inclusion criteria. Finally, a total of 14 studies were processed for critical review.

CONCLUSION

The occlusal force increased after orthognathic surgery, although not to the level of the control group; however, the maximal bite force remained unchanged. Immediately after orthognathic surgery, chewing and swallowing forces increased. Significant reductions in the postoperative occlusal contact pressure areas was also observed.

Use of Transcutaneous Electrical Nerve Stimulation (TENS) for the Recovery of Oral Function after Orthognathic Surgery

The oral functions of patients are markedly diminished immediately after orthognathic surgery, and novel approaches are needed to accelerate their recovery. The aim of this study was to examine the usefulness of weekly applications of transcutaneous electrical nerve stimulation (TENS) for this purpose, based on the evidence of its effectiveness in other types of patients with muscle alterations. Maximum jaw opening, bite force, pain, and facial inflammation were compared between patients receiving TENS and those receiving sham-TENS for 30 min at baseline and weekly over a four-week period after orthognathic surgery and were also compared between the before and after of each procedure. TENS was applied at 220 Hz, applying the maximum intensity tolerated by each individual patient. The TENS procedure was identical for all patients, but the device was not turned on in the sham-TENS group. Patients were blinded to their group membership. Results were analyzed separately in skeletal class II and III patients. Improvements in jaw opening and inflammation were significantly greater in the TENS than in the sham-TENS group, attributable to the muscle relaxation achieved with the procedure. Research is warranted on the benefits of a more frequent application of TENS.

Hard- and soft-tissue profiles of the midface region in patients with skeletal Class III malocclusion using cone-beam computed tomography multiplanar-reconstructed image analysis

Objective

This study examined cone-beam computed tomography (CBCT)-derived multiplanar-reconstructed (MPR) cross-sections to clarify the salient characteristics of patients with skeletal class III malocclusion with midface deficiency (MD).

Methods

The horizontal and sagittal plane intersection points were identified for middle-third facial analysis in 40 patients in the MD or normal (N) groups. MPR images acquired parallel to each horizontal plane were used for length and angular measurements.

Results

A comparison of the MD and N groups revealed significant differences in the zygoma prominence among female patients. The convex zygomatic area in the N group was larger than that in the MD group, and the inferior part of the midface in the N group was smaller than that in the MD group for both male and female patients. A significant difference was observed in the concave middle maxillary area among male patients.

Conclusions

This study was conducted to demonstrate the difference between MD and normal face through MPR images derived from CBCT. Male patients in the MD group had a more flattened face than did those in the N group. Female patients in the MD group showed a concave-shaped lower section of the zygoma, which tended to have more severe MD. These findings indicate that orthognathic surgery to improve skeletal discrepancy requires different approaches in male and female patients.

Stability of biodegradable metal (Mg-Ca-Zn alloy) screws compared with absorbable polymer and titanium screws for sagittal split ramus osteotomy of the mandible using the finite element analysis model

Mg-Ca-Zn alloy has been suggested for the application of fixation materials during maxillofacial surgery. We investigated the stability of Mg-Ca-Zn alloy for clinical application during orthognathic surgery. The finite element model for the fixation of sagittal split ramus osteotomy was constructed. In the bicortical screw fixation of the mandible setback condition, the stress distributions of Mg-Ca-Za alloy, polylactic acid polymer, and titanium were evaluated using the virtual model with occlusal loading of 132 N. The deformations of the three different materials of fixation screw were observed according to masticatory force ranging from 132 to 1,000 N. When comparing the stress distribution placed on cortical bone between the polymer and magnesium alloy groups, the magnesium alloy screws could bear more stress, thereby decreasing the stress, which might be distributed to other biologic components, such as the condyle and cortical ramus of the mandible. Deformations of the screws according to functional load were minimal, and the deformation remained <0.21 mm at the initial functional load of the mandible after surgery, regardless of materials used. The biodegradable magnesium alloy screw can bear more stress and decrease the detrimental effect on the stability of sagittal split ramus osteotomy setback surgery.

Changes in bite force after orthognathic surgical correction of mandibular prognathism: a systematic review

Patients requesting treatment for mandibular prognathism seek functional and aesthetic improvements. Improvements in bite force and efficiency are generally used as measures of better function. It is unclear what effect the surgical correction of mandibular prognathism will have on the patient's occlusal forces. The literature was searched using medical subject heading (MeSH) and key word terms 'bite force', 'osteotomy', 'orthognathic surgery', and 'prognathism'. A total of 17 articles were included in this review. These included a total of 697 patients, who ranged in age from 15 to 44 years. Male patients outnumbered female patients in only one study. Five hundred and thirty-two patients underwent bilateral sagittal split osteotomy, 108 patients underwent intraoral vertical ramus osteotomy, and 24 patients underwent extraoral vertical ramus osteotomy (approach unspecified). In general, masticatory efficiency at 3 months after surgery was greater than that found pre-surgically; the increase was significant at 6 months after surgery. The occlusal contact area and points tended to increase from 3 months after surgery, and there was a significant increase at 12 months after surgery. Occlusal forces, although improved, will be lower in corrected prognathic patients than in normognathic patients even at 2 years after surgery.

The effect of orthognathic surgery on the temporomandibular joint and oral function: a systematic review

The objective of this systematic review was to examine the effect of orthognathic surgery (OS) on the temporomandibular joint and oral function. Electronic databases were systematically searched for studies published until October 2015. Articles were assessed against predefined inclusion criteria. The included papers were divided into four groups based on the type of OS performed. The following items were recorded: quality of evidence using the Oxford Centre for Evidence-Based medicine (CEBM) criteria, number of patients, presence/absence of controls, mean age at treatment, follow-up time, clinical examination findings, bite force, use of the Helkimo Index and Research Diagnostic Criteria for Temporomandibular Disorders, imaging findings, and patient questionnaire results. A total of 4669 articles were identified; 76 relevant articles were included in the review. These studies assessed a total 3399 patients and 380 controls, with a mean age of 25.4 years. The great variety of OS techniques, examination techniques, diagnostic criteria, and imaging techniques used in the articles studied, as well as the quality of the study designs, made it difficult to compare studies and to draw conclusions. However, looking at the different aspects studied in general, it can be stated that OS seems to have little or no harmful effect on the TMJ and oral function (level of evidence: levels II, III, and IV).

The amount of mandibular setback influence on occlusal force following sagittal split ramus osteotomy

PURPOSE

The purpose of this study was to examine the influence between the magnitude of setback in sagittal split ramus osteotomy (SSRO) and occlusal contact area and bite force without relapse after surgery.

PATIENTS AND METHODS

Sixty female patients with a diagnosis of mandibular prognathism were divided into 3 groups according to the magnitude of setback: group 1 (≤5 mm), group 2 (>5 mm but <10 mm), and group 3 (≥10 mm). All patients underwent skeletal analysis by lateral and frontal cephalogrammetry and measured the occlusal contact area and bite force by the pressure-sensitive system (Dental Prescale, Dental Occlusion Pressuregraph FDP-705; Fuji Photo Film Co., Tokyo, Japan) preoperatively and postoperatively at 1 month, 3 months, 6 months, and 1 year.

RESULTS

There were no significant differences in occlusal contact area and bite force between the 3 groups. Only group 3 showed a significant difference in occlusal contact area and bite force between the preoperative and 1-year measurements.

CONCLUSION

The results indicate that the magnitude of setback did not influence the bite force or occlusal contact area in SSRO.

Changes in occlusal function after orthognathic surgery in mandibular prognathism with and without asymmetry

This study aimed to evaluate the postoperative changes in masticatory function in patients with jaw deformities with or without asymmetry treated by orthognathic surgery. Thirty female patients who underwent a Le Fort I osteotomy with sagittal split ramus osteotomy (SSRO) were enrolled. The patients were divided into symmetry and asymmetry groups. The bite force, occlusal contact area, and bite force balance were measured before and at 1, 3, and 6 months and 1 year after surgery; these measurements were compared statistically within and between the two groups. In the symmetry group, there was a significant difference in the preoperative bite force and the 1 month postoperative bite force (P=0.0033). In the asymmetry group, the bite force before surgery was significantly different from that at 1 month (P=0.0375) and at 1 year (P=0.0353) after surgery. Significant differences in the bite force were also observed between the following time points: 1 month and 1 year (P=0.0003), 3 months and 1 year (P=0.0034), and 1 month and 6 months (P=0.0486). The occlusal contact area, bite force, and occlusal balance tended to change after Le Fort I osteotomy with SSRO, with a significantly improved bite force in patients with asymmetry before surgery.

Lip competence in Class III patients undergoing orthognathic surgery: an electromyographic study

PURPOSE

The aim of this study was to compare the presurgical and postsurgical electromyographic (EMG) activities of the lips in patients with skeletal Class III treated with combined orthognathic surgery and contrast these data with those obtained from a control group with skeletal Class I.

PATIENTS AND METHODS

Ten patients with skeletal Class III underwent the registration of EMG activity before an orthognathic surgical procedure and 4 months after surgery. The results were compared with a control group of 11 healthy patients with skeletal Class I and clinical and EMG lip competence. EMG activity was recorded from the upper orbicularis oris and mentalis muscles during swallowing, lips in contact (LC), and lips apart (LA) using bipolar surface electrodes. The competence condition was assessed by determining the difference in the EMG activity of the mentalis muscle (LC-LA ≤0 for lip competence).

RESULTS

Patients with skeletal Class III showed greater EMG activity than the control group before and after surgery. Patients with skeletal Class III showed a significantly greater difference in LC-LA than the control group before surgery for the 2 muscles (P < .05). No significant difference was found between the skeletal Class III group after surgery and the control group for the mentalis muscle (P > .05).

CONCLUSIONS

Four months after treatment with orthognathic surgery, patients with skeletal Class III and an initial muscle activity pattern of lip incompetence different from the control group (P < .05) showed EMG values compatible with lip competence. These values were similar to the control group.

The effect of mastication on occlusal parameters in healthy volunteers

PURPOSE

To assess possible associations between occlusal parameters and comminution of solid food during chewing in a group of completely dentate subjects.

MATERIALS AND METHODS

Twenty-five completely dentate volunteers (28 teeth, 14 functional dental units) aged 24-50 yrs, without any complaints of the stomatognathic system participated in this study. An Optosil test was used to estimate masticatory efficiency for 20 and 80 cycles of chewing. An occlusal analysis, using the T-Scan II System, was performed to assess the following occlusal parameters: the distribution of occlusal contacts, the time of occlusion, the chewing platform area before chewing and after 20 and 80 cycles of chewing.

RESULTS

The parameters, that were taken into account: i. X50 for 20 and 80 cycles of chewing, ii. the occlusion time, iii. the occlusal contact area. The occlusion time decreased after 20 and 80 chewing cycles (mean TO0=0.28+/-0.07 vs TO20=0.21+/-0.05 s vs TO80=0.18+/-0.05 s, respectively). The mean value of the chewing platform area was 125.12+/-46.5 mm2.

CONCLUSION

Prolongation of chewing produces, shortening of the occlusion time while the chewing platform area remains at the same level independent of the number of chewing cycles.

Functional assessment of the stomatognathic system

Clinically objective assessment of the occlusal function remains largely, even today, in the research laboratory instead of in the clinical setting, as part of the routine assessment along with the morphologic documentation. Functional outcomes of the stomatognathic system can be measured in terms of occlusal contact area, maximal voluntary bite force, maximal voluntary excursions, masticatory force, masticatory cycle pattern and masticatory performance. It should be emphasized, however, that many of these measures remain to be standardized and validated as tools relevant for assessment of patients who have dentofacial skeletal deformities. This remains a promising area of active research.

Three-dimensional facial morphometry in skeletal Class III patients

Nine patients aged between 18 and 35 years who had severe skeletal Class III malocclusion and moderate-to-severe mandibular asymmetry, were assessed by a non-invasive, landmark-based, three-dimensional system before and after mandibular reduction by sagittal split osteotomy and LeFort I maxillary advancement. The three-dimensional coordinates of 50 facial soft tissue landmarks were collected, and a series of anthropometric measurements was calculated and compared with reference values from 240 healthy subjects of similar sex, age, and ethnic group. Patients were more asymmetrical than normal subjects before the operations, particularly in the gonion. Postoperatively, total and lateral asymmetry was considerably reduced. The three-dimensional approach was a valuable complementary diagnostic aid that enabled quantitative evaluation of the final soft-tissue results without invasive procedures.

Soft tissue facial volumes and shape in skeletal Class III patients before and after orthognathic surgery treatment

BACKGROUND

To obtain the best surgical results in orthognathic surgery, treatment planning and the evaluation of results should be performed on measurable three-dimensional reproductions of the face of the patients, and compared to reference subjects.

METHODS

Seven women aged 18-35 years, all with a skeletal Class III and mandibular asymmetry, were assessed both before (on average, 2 months) and after (on average, 10.7 months) surgical intervention (mandibular reduction by sagittal split osteotomy and LeFort I maxillary advancement). The three-dimensional coordinates of 50 soft tissue facial landmarks (face, eyes, nose, mouth and lips, ears) were collected with a noninvasive, electromagnetic digitizer; facial volumes were estimated, and compared to reference values collected in 87 healthy women of the same age and ethnic group. Inter-individual modifications in facial shape were also assessed.

RESULTS

Before surgery the patients had smaller faces than the reference women, with larger lower lips and noses. A large within-group variability was found. Surgical treatment significantly reduced total facial volume and mandibular volume, increased total and upper lip volumes (Student's t test, p<0.05), and made all values more homogenous within the group. Shape differences were significantly larger before than after surgery. On average, right side gonion was the landmark that moved the most, closely followed by menton, while the tragi and ala nasi moved the least. The three-dimensional approach used in this study enabled quantitative evaluation of the final soft tissue results of surgery, without submitting the patients to invasive procedures.

A new evaluation method for neurosensory disturbance in the chin of patients undergoing mandibular sagittal split ramus osteotomy: an application of the heat flux technique

OBJECTIVE

To examine neurosensory changes in the chin following bilateral sagittal split ramus osteotomy (BSSRO) using the heat flux technique.

STUDY DESIGN

Twelve healthy adults (C-group) and 23 patients undergoing BSSRO (P-group) were examined. The warm sense threshold (WHF) and cold sense threshold (CHF) in the chin of these patients were measured by the heat flux technique. In the P-group, touch sensation also was measured with a visual analog scale (VAS) and the Semmes-Weinstein monofilament test (SW test).

RESULTS

Both WHF and CHF were significantly larger in the P-group than in the C-group (P = .024). Touch sensation (VAS and SW test) were damaged in some patients of the P-group. However, no correlation was revealed between thermal sensation (WHF and CHF) and touch sensation (VAS and SW test) in the P-group.

CONCLUSIONS

These results suggest that the thermal sensation in the chin was damaged after BSSRO. The heat flux technique appears to be one of the useful methods for the examination of neurosensory disturbance in the chin.

The Incidence of Postoperative Wound Healing Problems Following Sagittal Ramus Osteotomies Stabilized With Miniplates and Monocortical Screws

PURPOSE

Titanium plates and monocortical screws are commonly used to stabilize the mandible following sagittal split ramus osteotomies. Despite widespread use of this type of fixation, there is a paucity of large studies evaluating the infection rate and need for hardware removal.

MATERIALS AND METHODS

This study is a retrospective cohort evaluation of 1,066 consecutive mandibular sagittal ramus osteotomies in 533 patients, performed between January 2002 and December 2003. All osteotomies were stabilized with 4-hole miniplates and 2.0 mm x 5.0 mm monocortical screws. Study variables included disturbances of wound healing, age, gender, plate and screw position, direction of mandibular movement, adjunctive procedures performed, and the patient's medical history. Data were collected by chart and radiographic review. The above variables were analyzed using Fisher's exact test, Chi-square, Cochran-Armitage Trend Test, and multiple logistic regression.

RESULTS

Of 533 patients 26% (138) demonstrated wound healing problems. This occurred in 15% of all 1,066 osteotomy sites. 6.5% of plates required removal in 10% of patients. In no case did disturbance of wound healing or plate removal result in non-union or relapse of the osteotomy. Wound healing problems were fewer when mandibular osteotomies were done in conjunction with maxillary surgery (18.9% versus 29.1%). Disturbances of wound healing were not related to the direction of movement of the mandible and were lower when hardware was placed closer to the inferior border.

CONCLUSION

An overall low incidence (6.5%) of hardware infection requiring plate removal was found in this study. Screw proximity to the osteotomy site did not correlate with higher rates of healing problems, but there was a statistically significant trend of fewer disturbances of healing when the hardware was placed closer to the inferior border of the mandible.

An In Vitro Comparison of an Adjustable Bone Fixation System

PURPOSE

The purpose of this study was to biomechanically compare an adjustable plating system and several variations with an inverted-L pattern of 3 bicortical screws to fix a bilateral sagittal split osteotomy.

MATERIALS AND METHODS

Sixty polyurethane mandible replicas (Synbone, Laudquart, Switzerland) were used in this study. Ten uncut mandibular replicas served as control models. Fifty experimental synthetic mandibles had bilateral sagittal split osteotomies created with a 7-mm advancement. Fixation modalities included 3 bicortical screws in an inverted-L pattern, a 4-hole sagittal split plate with adjustable slider (slide 0), an adjustable plate with an additional bicortical screw (slide 1), an adjustable plate with 2 additional bicortical screws (slide 2), and an adjustable plate with 3 additional bicortical screws (slide 3). The alloplastic mandibles were secured in a custom fabricated jig and subjected to vertical loads at the incisal edge and torsional loading at the molar region by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Mechanical deformation data within a 0- to 900-N range were recorded. Yield load, yield displacement, and stiffness were determined. Means and standard deviations were derived and compared for statistical significance using a Fisher's Protected Least Significant Differences Test with a confidence level of 95% (P < .05). Second-order best-fit polynomials were created for the experimental data curves.

RESULTS

For incisal edge loading, the control was significantly greater for yield load than the experimental models. No significant difference was noted between slide 0, slide 1, and slide 2, but significant differences were seen with slide 3 and the inverted-L. There were no significant differences between slide 1, slide 2, slide 3, and inverted-L. For molar load, the control was significantly different than the experimental models. However, there was no significant difference between the experimental models.

CONCLUSIONS

Mandibular advancements of 7 mm in a synthetic mandible fixed with a 4-hole sagittal split plate with adjustable slider alone is resistant to torsional forces and comparable to that seen with 3 bicortical screws placed in an inverted-L fashion. However, when loading at the incisal edge, additional bicortical screws are necessary to achieve the similar resistance to vertical load as that seen with 3 bicortical screws.

Maximal bite forces in healthy young adults as predicted by surface electromyography

OBJECTIVES

To assess the repeatability of maximal bite force estimates as obtained by submaximal electromyographic-force relationships performed simultaneously and symmetrically in both sides of the mouth. The protocol could be used in a clinical context to obtain indicative values for the occlusal loads to be resisted by the prosthetic reconstructions.

METHODS

Ten young healthy subjects performed; (1) a maximum voluntary clench (MVC) directly on their occlusal surfaces; (2) four simultaneous recording of submaximal bite forces (98, 196, 304 and 392 N on two transducers positioned on the left and right first mandibular molars) and surface EMG potentials of the masseter and temporalis anterior muscles. The actual force peak value was recorded. For each subject, a linear regression was run between the simultaneous bite force and EMG submaximal values recorded in the four tests. Using the EMG potentials obtained during the MVC tests, the best fitting line was used to estimate a maximum bite force. Two independent recordings were made by each subject (2 week interval) and analyzed by correlation analysis, paired Student's t-test, and Dahlberg statistic.

RESULTS

Significant linear relationships were found between bite force and EMG potentials (p<0.01). The two series of indirect estimates of maximal bite force were correlated (r=0.626) without systematic differences (Student's t, p>0.01). Dahlberg statistic was 115.37 N (approximately 36% of the total variance of the group).

CONCLUSIONS

Simultaneously recorded submaximal bite forces and surface EMG potentials of mandibular elevator muscles had a linear relationship. The estimates of maximum bite force were repeatable on a short-term basis (2 weeks). The method limited the disadvantages of bite force recordings, and it could be used to obtain indicative values for the occlusal loads to be resisted by the prosthetic reconstructions.

Bite force measurement in awake rats

This report describes the implementation of bite force measurement in awake rats and software instruments (Spike 2 script programs) that quantify and analyze the bite force data. One script program employs user-defined control of threshold bite force, which allows an easy adjustment of target force prior to training the rat. Furthermore, the interactive program allows on-line control of threshold bite force at anytime during the training session. Upon detection of the bite force crossing the threshold, it automatically triggers the external water delivery system for reinforcement. Another script program detects successful biting attempts, compiles times stamps and force level for each attempted bite, and calculates the total number of bites, success rate and mean bite force per training session. Using the new methodology, we trained five adult rats to produce the bite force of 1300 g. Our results demonstrated that all rats achieved the target force with a similar time course and exhibited little variability in success rate and mean bite force. The script programs provided instant review and analyses of the captured data. These techniques simplify assessment of bite force in behaving rats.