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Accurate Diagnosis and Treatment of Painful Temporomandibular Disorders: A Literature Review Supplemented by Own Clinical Experience. Pain Res Manag 2023; 2023:1002235. [PMID: 36760766 PMCID: PMC9904928 DOI: 10.1155/2023/1002235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/04/2022] [Accepted: 01/21/2023] [Indexed: 02/04/2023]
Abstract
Introduction Temporomandibular disorders (TMD) is a multifactorial group of musculoskeletal disorders often with combined etiologies that demand different treatment plans. While pain is the most common reason why patients decide to seek help, TMD is not always painful. Pain is often described by patients as a headache, prompting patients to seek the help of neurologists, surgeons, and ultimately dentists. Due to the unique characteristics of this anatomical area, appropriate diagnostic tools are needed, as well as therapeutic regimens to alleviate and/or eliminate the pain experienced by patients. Aim of the Study. The aim of this study is to collect and organize information on the diagnosis and treatment of pain in TMD, through a review of the literature supplemented by our own clinical experience. Material and Methods. The study was conducted by searching scientific databases PubMed, Scopus, and Google Scholar for documents published from 2002-2022. The following keywords were used to build the full list of references: TMD, pain, temporomandibular joint (TMJ), TMJ disorders, occlusal splint, relaxing splints, physiotherapy TMD, pharmacology TMD, natural therapy TMD, diagnostic criteria for TMD, and DC/TMD. The literature review included 168 selected manuscripts, the content of which was important for pain diagnosis and clinical treatment of TMD. Results An accurate diagnosis of TMD is the foundation of appropriate treatment. The most commonly described treatments include physiotherapy, occlusal splints therapy, and pharmacological treatment tailored to the type of TMD. Conclusions Based on the literature review and their own experience, the authors concluded that there is no single ideal form of pain therapy for TMD. Treatment of TMD should be based on a thorough diagnostic process, including the DC/TMD examination protocol, psychological evaluation, and cone beam computer tomography (CBCT) imaging. Following the diagnostic process, once a diagnosis is established, a treatment plan can be constructed to address the patient's complaints.
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Jung JK, Im YG. Can the subject reliably reproduce maximum voluntary contraction of temporalis and masseter muscles in surface EMG? Cranio 2022:1-10. [PMID: 36334278 DOI: 10.1080/08869634.2022.2142234] [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: 11/07/2022]
Abstract
OBJECTIVE To evaluate the repeatability of the surface EMG variables of myoelectric signals from the masseter and temporalis muscles according to three methods to induce maximum voluntary contraction (MVC) in healthy adults. METHODS Thirty healthy young subjects performed the following three MVC tasks three times each in three sessions on the same day without replacing surface electrodes: clenching the teeth (MVCIC) and biting down on two cotton rolls bilaterally with the posterior teeth (MVCBP) or first molars (MVCB6). RESULTS The intra-class correlation coefficient (ICC) of the amplitudes during the three MVC tasks ranged from 65 to 79%. The ICCs of the spectral variables ranged from 78 to 86%. The ICCs of the asymmetry index of the masseter ranged from 77 to 86%, and those of the activity index ranged from 68 to 90%. CONCLUSION The surface EMG measurements according to the three MVC methods exhibited good to excellent reproducibility.
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Affiliation(s)
- Jae-Kwang Jung
- Department of Oral Medicine, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Yeong-Gwan Im
- Department of Oral Medicine, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
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Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Machoy M, Wilczyński S, Maglitto M, Cernera M, Spagnuolo G, Woźniak K. Electromyographic Study of Masticatory Muscle Function in Children with Down Syndrome. J Clin Med 2022; 11:jcm11030506. [PMID: 35159958 PMCID: PMC8837010 DOI: 10.3390/jcm11030506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
This study assessed the electrical activity of the masticatory muscles in both children with down syndrome (DS) and healthy children. After applying the inclusion and exclusion criteria, 30 patients aged between 7.9 and 11.8 years participated in the study. They were divided into two groups of 15: DS and non-DS. A DAB-Bluetooth device (Zebris Medical GmbH, Germany) was used to record the electromyographical (EMG) activity of the right and left temporal and of the right and left masseter muscles at rest and during maximum voluntary clenching (MVC). The asymmetry index between right and left masticatory muscle EMG activity was calculated for each position. The Mann–Whitney U test was applied to analyze the study results. There were no differences in the electrical activity of the temporal and masseter muscles at rest between the groups. During MVC, the asymmetry index for the masseter muscles was significantly higher in subjects with DS. The electrical potentials of the temporal and masseter muscles in children with DS were significantly lower compared to the corresponding parameters for healthy children when clenching.
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Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
| | - Magdalena Sycińska-Dziarnowska
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
| | - Monika Machoy
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Medical University of Silesia in Katowice, 3 Kasztanowa Street, 41200 Sosnowiec, Poland;
| | - Marzia Maglitto
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (M.M.); (M.C.)
| | - Mariangela Cernera
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (M.M.); (M.C.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (M.M.); (M.C.)
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia
- Correspondence:
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
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Nguyen MS, Saag M, Jagomägi T, Nguyen QH, Voog-Oras Ü. The impact of occlusal support on temporomandibular disorders: a literature review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211023779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Temporomandibular disorders are a multifactorial disease. Occlusal support and the number of teeth in dentition have significant effects on the masticatory system. The current study aims to review the role of occlusal support in association with findings of temporomandibular disorders. Data sources were PubMed, Web of Science and Google Scholar, with 1411 citations published over the period 1992–2019. The selection criteria stipulated that articles must have reported the association between the number of teeth, occlusal unit, occlusal support and temporomandibular disorders. A total of 15 full-text articles was finally accessed for eligibility in the current review. The studies on temporomandibular disorders were collected from various sources, including articles reporting temporomandibular disorder symptoms ( n=1), temporomandibular disorder signs ( n=5), temporomandibular joint osseous changes ( n=1), temporomandibular joint dysfunction using the Helkimo index ( n=2), and temporomandibular disorder classification ( n=6). Of these articles, significant associations were found between: the number of missing teeth and temporomandibular disorders ( n=5); the number of occlusal units and occlusal supports and temporomandibular disorders ( n=3); the position of the lost occlusal units and temporomandibular disorders ( n=1). Loss of the occlusal unit has more impact on temporomandibular disorders than the loss of posterior teeth. The total loss of unilateral occlusal support seems to be an aetiological factor for temporomandibular disorders, and maintenance of balanced posterior occlusal support has a role in the prevention and management of temporomandibular disorders.
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Affiliation(s)
- Minh Son Nguyen
- Faculty of Dentistry, Danang University of Medical Technology and Pharmacy, Vietnam
| | - Mare Saag
- Institute of Dentistry, University of Tartu, Estonia
| | | | - Quang Hai Nguyen
- Department of Surgery – Anesthesia and Resuscitation, Danang Hospital of Odonto-Stomatology, Vietnam
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García-Espinosa LA, Minor-Martínez A, Pérez-Escamirosa F, Morales-González J, Rodríguez-Castañeda I, Flores-Ramírez B, Pacheco-Guerrero N, Ángeles-Medina F. Multi-fractal DFA analysis of masseter muscles SEMG signal in patients with TMD, pilot study. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Electromyography as a Means of Assessing Masticatory Muscle Activity in Patients with Pain-Related Temporomandibular Disorders. Pain Res Manag 2020; 2020:9750915. [PMID: 32855751 PMCID: PMC7443041 DOI: 10.1155/2020/9750915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/28/2020] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to evaluate masticatory muscle electrical activity in patients with pain-related and pain-free temporomandibular disorders (TMDs) as well as in subjects with no TMD. Methods Ninety children with mixed dentition were recruited to the study. Of this total, 30 subjects were diagnosed with pain-related TMD (TMD-P), 30 with pain-free TMD (TMD-PF), and 30 without TMD. We used Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD) to assess the presence of TMD in the examined children. The electromyographical (EMG) potentials of the temporalis and masseter muscles were measured with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) at rest and during maximum voluntary clenching (MVC). Results An analysis of the EMG recordings showed statistically significant intergroup differences in masticatory muscle electrical activity at rest and during MVC. Significantly higher rest temporalis muscle activity was noted in pain-related TMD subjects compared with that children from the pain-free TMD and non-TMD groups, as well as in TMD-PF children in relation to those without TMD. The EMG potentials of the temporalis muscle during MVC were much lower in patients with TMD-P than in pain-free TMD and non-TMD subjects. Masseter muscle activity at rest in the TMD-pain group was significantly greater, and masseter muscle EMG potentials during clenching were markedly lower than in patients with no TMD diagnosis. Conclusion The use of electromyography to assess masticatory muscle function revealed alterations in the pattern of temporalis and masseter muscle activity in patients with pain-related TMD compared with the pain-free subjects.
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Pires PF, Rodrigues-Bigaton D. Evaluation of integral electromyographic values and median power frequency values in women with myogenous temporomandibular disorder and asymptomatic controls. J Bodyw Mov Ther 2018; 22:720-726. [DOI: 10.1016/j.jbmt.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 08/28/2017] [Accepted: 09/01/2017] [Indexed: 11/26/2022]
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Giannakopoulos NN, Schindler HJ, Hellmann D. Co-contraction behaviour of masticatory and neck muscles during tooth grinding. J Oral Rehabil 2018; 45:504-511. [PMID: 29761534 DOI: 10.1111/joor.12646] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2018] [Indexed: 12/19/2022]
Abstract
The objective of this study was to analyse the co-contraction behaviour of jaw and neck muscles during force-controlled experimental grinding in the supine position. Twelve symptom-free subjects were enrolled in the experimental study. Electromyographic (EMG) activity of semispinalis capitis, splenius capitis and levator scapulae muscles was recorded bilaterally with intramuscular fine-wire electrodes, whereas that of sternocleidomastoideus, infrahyoidal, suprahyoidal, masseter and anterior temporalis muscles were registered with surface electrodes. EMG and force measurements were performed during tasks simulating tooth grinding on custom-made intraoral metal splints. The mean EMG activity normalised by maximum voluntary contraction (% MVC) of each of the neck muscles studied during grinding was analysed and compared with previous data from jaw clenching at identical force (100 N) and (supine) position. The occurrence of low-level, long-lasting tonic activation (LLTA) of motor units was also documented. The mean three-dimensional force vector of the grinding forces was 106 ± 74 N. In the frontal plane, the incline to the midsagittal plane ranged between 10° and 15°. In the midsagittal plane, the incline to the frontal plane was negligibly small. Posterior neck muscle activity during grinding ranged between 4.5% and 12% MVC and during clenching with 100 N between 1.8% and 9.9% MVC. Masticatory muscle activity during grinding ranged between 17% and 21% MVC for contralateral masseter and ipsilateral temporalis and between 4% and 6.5% for ipsilateral masseter and contralateral temporalis. LLTA had an average duration of 195 ± 10 seconds. The findings from this study do not support pathophysiological muscle chain theories postulating simple biomechanical coupling of neck and jaw muscles. Co-contractions of neck and masticatory muscles may instead occur as a result of complex neurophysiological interactions.
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Affiliation(s)
| | - H J Schindler
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - D Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
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Electromyographic Analysis of Masticatory Muscles in Cleft Lip and Palate Children with Pain-Related Temporomandibular Disorders. Pain Res Manag 2018; 2018:4182843. [PMID: 29861801 PMCID: PMC5971269 DOI: 10.1155/2018/4182843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/16/2018] [Accepted: 04/12/2018] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to assess the electrical activity of temporalis and masseter muscles in children with cleft lip and palate (CLP) and pain-related temporomandibular disorders (TMD-P). Methods The sample consisted of 31 CLP patients with a TMD-P (mean age 9.5 ± 1.8 years) and 32 CLP subjects with no TMD (mean age 9.2 ± 1.7 years). The children were assessed for the presence of temporomandibular disorders (TMD) using Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the mandibular rest position and during maximum voluntary contraction (MVC). Results The rest activity of the temporalis and masseter muscles was significantly higher in TMD-P group compared with non-TMD children. A significant decrease in temporalis muscle activity during MVC was observed in TMD-P patients. There was a significant increase in the Asymmetry Index for temporalis and masseter muscle rest activity in the TMD-P group. Conclusion Cleft children diagnosed with TMD-P have altered masticatory muscle activity, and this can affect their muscle function.
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Eberhard L, Terebesi S, Giannakopoulos NN, Hellmann D, Schindler HJ, Schmitter M, Pfau D. Quantitative sensory response of the SCM muscle on sustained low level activation simulating co-contractions during bruxing. Arch Oral Biol 2017; 86:87-93. [PMID: 29202311 DOI: 10.1016/j.archoralbio.2017.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/20/2017] [Accepted: 09/24/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Bruxism is discussed as an etiological factor in the pathogenesis of orofacial and cervical pain. As the sternocleidomastoid muscle (SCM) is co-activated during clenching, our aim was to investigate, whether the muscle loading leads to peripheral or central sensitizations. DESIGN In twenty-one healthy female volunteers, somatosensory profiles of the SCM were recorded according to the test battery of the German Research Network on Neuropathic Pain (DFNS) prior to and after an isometric muscle exercise. QST comprised thermal and mechanical stimuli. A submaximal activation of the SCM (15% MVC) was kept for 10min in sitting position. In separate test sessions one month apart, one sham and one verum experiment were conducted in randomized order. During the muscle loading, the parameters cold detection threshold (CDT), mechanical pain sensitivity (MPS) and pressure pain treshold (PPT) were tested and experimental pain recorded by visual analogoue scales (VAS). All test sessions were performed during the follicular phase of the menstrual cycle (day 5), to avoid effects on pain perception. Data were analyzed with Repeated Measures ANOVA (SPSS 22.0) RESULTS: No significant changes were found during or after (sham) loading except for stimulus-response-function (SR, P=0.01) and PPT (P=0.02) in the sham test. No effect was observed in the verum experiment (P=0.12 up to 1.0). CONCLUSION Prolonged low level contraction of the SCM does not evoke painful sensitization. In contrast, submaximal muscle activation seems to have a protective effect corresponding to a training effect preventing sensitization.
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Affiliation(s)
- Lydia Eberhard
- Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
| | - Sophia Terebesi
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | | | - Daniel Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | | | - Marc Schmitter
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - Doreen Pfau
- Department of Neurophysiology, Center of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Seifi M, Nodehi D, Ghahramanloo A, Ahmadi Z, Farhangnia A, Saedi M, Mozaffari HR, Sharifi R. Comparing the Electromyographic Features of the Masseter and Temporal Muscles in Patients with full Mouth Implant-supported FDPs and Natural Dentition. Acta Inform Med 2017; 25:49-53. [PMID: 28484298 PMCID: PMC5410628 DOI: 10.5455/aim.2017.25.49-53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Due to increasing demands for a full mouth implant reconstructions and the fact that the most failures are associated with biomechanical complications, determining the effect of different occlusal patterns on these complications seems inevitable. The aim of this study is to compare affection of different occlusal designs in full mouth implant reconstructed patients on electromyographic activity of temporal and masseter muscles compared to natural dentition. METHODS Thirty-two patients were included in this study, considering that 16 patients had natural dentition and the other 16 were full mouth implant reconstruction patients. In both groups, the participants were divided into two subgroups: 8 patients had canine guidance occlusal pattern and the other eight had a group function occlusal pattern. Muscle contractions were studied during both maximum intercuspation and lateral excursions to the point of intercanine contact using an electromyography device. RESULTS The average percentages of masseter muscle contraction in lateral excursions relative to maximum intercuspation were as follows: 72.20% in full mouth implant reconstruction patients with group function occlusion 69.49% in natural dentition with group function occlusion 58.85% in full mouth implant reconstruction patients with canine guidance occlusion 30.91% in natural dentition with canine guidance occlusion. The average percentages of temporal muscle contraction in lateral excursions relative to maximum intercuspation were as follows: 70.87% in full mouth implant reconstruction patients with group function occlusion 78.57% in natural dentition with group function occlusion 51.99% in full mouth implant reconstruction patients with canine guidance occlusion 31.55% in natural dentition with canine guidance occlusion. CONCLUSION A canine guidance occlusal pattern in both, natural dentition and full mouth implant-supported FDP, patients resulted in decreased muscle contraction. This decreasing is more significant in natural dentition and it is better to establish a canine guided occlusion in a full mouth reconstruction patient.
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Affiliation(s)
- Mahdieh Seifi
- Department of Prosthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Davood Nodehi
- Department of Prosthodontics Dental School, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Ahmad Ghahramanloo
- Department of Prosthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Ahmadi
- Department of Prosthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azade Farhangnia
- Department of Prosthodontics Dental School, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Morteza Saedi
- Neorology Department of Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roohollah Sharifi
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Im YG, Han SH, Park JI, Lim HS, Kim BG, Kim JH. Repeatability of measurements of surface electromyographic variables during maximum voluntary contraction of temporalis and masseter muscles in normal adults. J Oral Sci 2017. [DOI: 10.2334/josnusd.16-0434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Yeong-Gwan Im
- Department of Oral Medicine, Chonnam National University Dental Hospital
| | | | - Ji-Il Park
- Department of Dental Hygiene, Gwangju Health College
| | - Hae-Soon Lim
- Department of Dental Education, School of Dentistry, Chonnam National University
| | - Byung-Gook Kim
- Department of Oral Medicine, School of Dentistry, Chonnam National University
| | - Jae-Hyung Kim
- Department of Oral Medicine, School of Dentistry, Chonnam National University
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Mapelli A, Tartaglia GM, Connelly ST, Ferrario VF, De Felicio CM, Sforza C. Normalizing surface electromyographic measures of the masticatory muscles: Comparison of two different methods for clinical purpose. J Electromyogr Kinesiol 2016; 30:238-42. [DOI: 10.1016/j.jelekin.2016.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/05/2016] [Indexed: 11/28/2022] Open
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Silva PFDC, Motta LJ, Silva SM, Ferrari RAM, Fernandes KPS, Bussadori SK. Computerized analysis of the distribution of occlusal contacts in individuals with Parkinson's disease and temporomandibular disorder. Cranio 2015; 34:358-362. [PMID: 26714395 DOI: 10.1080/08869634.2015.1097315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aims of the present study were to determine the prevalence of temporomandibular disorder (TMD) in a sample of patients with Parkinson's disease (PD) and to analyze the distribution of occlusal contacts. METHOD The sample was composed of patients with PD aged 50-75 years. Temporomandibular disorder was evaluated using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The distribution of occlusal contacts was determined using the portable T-Scan III® occlusal analysis system during maximum voluntary clenching. Fisher's exact test was used to test the association between TMD and occlusal contact symmetry. RESULTS Forty-two individuals with PD were analyzed. The prevalence of TMD was 23.8%. No statistically significant association was found between TMD and occlusal contact symmetry. Moreover, no significant difference in the distribution of occlusal contacts was found between the groups with and without TMD. DISCUSSION The present data suggest no association between TMD and occlusal contact asymmetry in individuals with PD. CONCLUSION The results of this study identified a prevalence of 23.8% of TMD signs in subjects with PD and a high frequency of occlusal asymmetry in this sample.
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Waheed El-Anwar M, Elsheikh E, Sweed AH, Ezzeldin N. Electromyography assessment in zygomaticomaxillary complex fractures. Oral Maxillofac Surg 2015; 19:375-379. [PMID: 25934247 DOI: 10.1007/s10006-015-0505-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/24/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this study was to assess the activity of the masseter and temporalis muscles using surface electromyography (EMG) in patients with zygomaticomaxillary complex (ZMC) fractures. PATIENTS AND METHODS This prospective study was carried out on 25 patients who had ZMC fractures. Fifteen patients were managed by open reduction and rigid fixation (ORIF) using titanium miniplates. This study, using surface electromyography, analyzed the activity of the masseter and temporalis muscles of 25 patients with ZMC fractures; 15 of them were surgically treated under general anesthesia (GA). Evaluations were made before surgery and 6 weeks after surgery by recording the mean of muscle contraction of 20 motor unit action potential (MUAP) against resistance, and statistical analyses were performed. RESULTS A significant EMG difference between the normal and ZMC fracture sides was found (P < 0.0001) for both masseter and temporalis muscles and was significantly improved after ORIF. However, postoperative EMV values of the repaired side was significantly less than measured postoperatively in the normal side (P < 0.0001) for both muscles. CONCLUSION ZMC fractures significantly diminish muscular activity of the masseter and temporalis and even though significant recovery of muscle activity was revealed after 6 weeks, it is still less than normal activity, highlighting the importance of postoperative rehabilitation.
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Affiliation(s)
- Mohammad Waheed El-Anwar
- Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Ezzeddin Elsheikh
- Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Hassan Sweed
- Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nillie Ezzeldin
- Rheumatology and Rehabilitation department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Lodetti G, Marano G, Fontana P, Tartaglia GM, Maria de Felício C, Biganzoli E, Sforza C. Surface electromyography and magnetic resonance imaging of the masticatory muscles in patients with arthrogenous temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:248-56. [DOI: 10.1016/j.oooo.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
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Wirianski A, Deall S, Whittle T, Wong M, Murray GM, Peck CC. Isotonic resistance jaw exercise alters jaw muscle coordination during jaw movements. J Oral Rehabil 2014; 41:353-66. [PMID: 24612288 DOI: 10.1111/joor.12153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2014] [Indexed: 11/28/2022]
Abstract
The aim was to investigate the effects of isotonic resistance exercise on the electro-myographic (EMG) activity of the jaw muscles during standardised jaw movements. In 12 asymptomatic adults surface EMG activity was recorded from the anterior temporalis and masseter muscles bilaterally and the right anterior digastric muscle during right lateral jaw movements that tracked a target. Participants were randomly assigned to a Control group or an Exercise group. Jaw movement and EMG activity were collected (i) at baseline, before the exercise task (pre-exercise); (ii) immediately after the exercise task (isotonic resistance at 60% MVC against right lateral jaw movements); (iii) after 4 weeks of a home-based exercise programme; and, (iv) at 8-weeks follow-up. There were no significant within-subject or between-group differences in the velocity and amplitude of the right lateral jaw movements either within or between data collection sessions (P > 0.05). However, over the 8 weeks of the study, three of the tested EMG variables (EMG Duration, Time to Peak EMG from EMG Onset, and Time to Peak EMG activity relative to Movement Onset) showed significant (P < 0.05) differences in the five tested muscles. Many of the significant changes occurred in the Control group, while the Exercise group tended to maintain the majority of the tested variables at pre-exercise baseline values. The data suggest a level of variability between recording sessions in the recruitment patterns of some of the muscles of mastication for the production of the same right lateral jaw movement and that isotonic resistance exercise may reduce this variability.
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Affiliation(s)
- A Wirianski
- Jaw Function and Orofacial Pain Research Unit, Westmead Hospital Centre for Oral Health, Faculty of Dentistry, University of Sydney, Professorial Unit, Level 2, Westmead, NSW, Australia
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Aldana K, Miralles R, Fuentes A, Valenzuela S, Fresno MJ, Santander H, Gutiérrez MF. Anterior Temporalis and Suprahyoid EMG Activity During Jaw Clenching and Tooth Grinding. Cranio 2014; 29:261-9. [DOI: 10.1179/crn.2011.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Manfredini D, Cocilovo F, Stellini E, Favero L, Guarda-Nardini L. Surface Electromyography Findings in Unilateral Myofascial Pain Patients: Comparison of Painful vs Non Painful Sides. PAIN MEDICINE 2013; 14:1848-53. [DOI: 10.1111/pme.12159] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giannakopoulos NN, Schindler HJ, Rammelsberg P, Eberhard L, Schmitter M, Hellmann D. Co-activation of jaw and neck muscles during submaximum clenching in the supine position. Arch Oral Biol 2013; 58:1751-60. [PMID: 24200301 DOI: 10.1016/j.archoralbio.2013.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 08/26/2013] [Accepted: 09/11/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to test the hypothesis that jaw clenching induces co-contraction and low-level long-lasting tonic activation (LLTA) of neck muscles in the supine position. DESIGN Ten healthy subjects developed various feedback-controlled submaximum bite forces in different bite-force directions in supine position. The electromyographic (EMG) activity of the semispinalis capitis, semispinalis cervicis, multifidi, splenius capitis, levator scapulae, trapezius, sternocleidomastoideus, masseter and infra/supra-hyoidal muscles was recorded. For normalization of EMG data, maximum-effort tasks of the neck muscles were performed. RESULTS Co-contractions of the posterior neck muscles varied between 2% and 11% of their maximum voluntary contraction. Different bite forces and bite-force directions resulted in significant (p<.05) activity differences between the co-contraction levels of the neck muscles. In addition, LLTA of specific neck muscles, provoked by the jaw clenching tasks, was observed. CONCLUSIONS This study demonstrated for the first time moderate co-contractions of jaw and neck muscles in the supine position under controlled submaximum jaw clenching forces. LLTA of most neck muscles was observed, outlasting clenching episodes and indicating an additional neuromuscular interaction between the two muscle groups.
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Mandibular kinematics and masticatory muscles EMG in patients with short lasting TMD of mild-moderate severity. J Electromyogr Kinesiol 2013; 23:627-33. [DOI: 10.1016/j.jelekin.2013.01.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 01/27/2013] [Accepted: 01/28/2013] [Indexed: 11/21/2022] Open
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Assessment of thickness and function of masticatory and cervical muscles in adults with and without temporomandibular disorders. Arch Oral Biol 2013; 58:1100-8. [PMID: 23684155 DOI: 10.1016/j.archoralbio.2013.04.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 04/17/2013] [Accepted: 04/18/2013] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the maximal bite force (MBF), electromyographic (EMG) activity and thickness of the masseter, anterior part of the temporalis and sternocleidomastoid (SCM) muscles in a group of young adults with and without temporomandibular disorders (TMDs). DESIGN Nineteen individuals comprised the TMD group (6 males/13 females, aged 25.4±3.8 years), classified based on the Research Diagnostic Criteria for TMD (RDC/TMD), and 19 comprised the control group (6 males/13 females, aged 24.1±3.6 years). The MBF was determined with a transducer placed between the dental arches at the first molars level (N). The muscles were evaluated bilaterally at rest and during maximal voluntary clenching (MVC) by assessing EMG activity and performing ultrasonography (USG). The mean values of these measures for both sides of the mouth were used. The normality of the distributions was assessed by the Shapiro-Wilks test. Variables between groups and genders were compared using two-way factorial ANOVA test and correlated using the Spearman coefficient (α=0.05). Unpaired t test was used to compare variables between TMD subgroups. Logistic regression analysis was used to identify the variables associated with the presence of TMD. RESULTS MBF, EMG and USG data were similar among clinical groups and among TMD subgroups. The thickness of masseter and SCM muscles in the relaxed and clenching states were significantly higher in males than females. On the other hand, the EMG of the temporalis muscle in the rest state was significantly higher in females than males. Additionally, the MBF was positively correlated with the USG characteristics of masseter and SCM muscles, as well as with the EMG activity of masseter and temporalis muscles in the TMD group. In this group, there was also a positive correlation between the thickness of the masseter muscle and its activity. On the other hand, the thickness of the SCM muscle was negatively correlated with its activity. A lower MBF was independently associated with the presence of TMD. CONCLUSIONS Subjects with TMD exhibited similar values of MBF, thickness and electrical activity of masticatory and cervical muscles when compared with controls; positive correlations observed between these variables may suggest a muscular alteration in TMD patients and a co-activation of masticatory and cervical muscles during mandibular movement. This fact may also be confirmed by the negative association between bite forces and presence of TMD.
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Relationship between occlusal force distribution and the activity of masseter and anterior temporalis muscles in asymptomatic young adults. BIOMED RESEARCH INTERNATIONAL 2012; 2013:354017. [PMID: 23509713 PMCID: PMC3591202 DOI: 10.1155/2013/354017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 10/10/2012] [Accepted: 10/18/2012] [Indexed: 02/01/2023]
Abstract
Healthy subjects have a prevalent side on which they display higher-muscle activity during clenching. The relationship between symmetry of masseter muscle (MM) and anterior temporalis (TA) muscle activities and occlusion has been evaluated on the basis of physiological parameters. The aim of the present study was to investigate whether the symmetry of surface EMG (sEMG) activity in asymptomatic young adults is related to symmetry of occlusal contacts. Material. The study population consisted of seventy-two 18-year-old subjects with no temporomandibular disorder (TMD) symptoms. Method. All the participants underwent an sEMG recording with an 8-channel electromyograph (BioEMG III). A T-Scan III evolution 7.01 device was used to analyze the occlusal contact points. Results. The correlation between the activity of right (R) and left (L) TA and the percentage of occlusal contacts was assessed, but no significant differences were found between the RMM and LMM muscles. The differences in the medium values of sEMG between males and females were not statistically significant. Equilibrated muscular activity between RTA and LTA occurred when occlusal contacts reached the percentage of 65% on the left side. Conclusion. The symmetry of sEMG activity in asymptomatic young adults is not related to symmetry of occlusal contacts.
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Hellmann D, Giannakopoulos NN, Schmitter M, Lenz J, Schindler HJ. Anterior and posterior neck muscle activation during a variety of biting tasks. Eur J Oral Sci 2012; 120:326-34. [DOI: 10.1111/j.1600-0722.2012.00969.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel Hellmann
- Department of Prosthodontics; University of Heidelberg; Heidelberg; Germany
| | | | - Marc Schmitter
- Department of Prosthodontics; University of Heidelberg; Heidelberg; Germany
| | - Jürgen Lenz
- Research Group Biomechanics; Institute for Mechanics; Karlsruhe Institute of Technology (KIT); Karlsruhe; Germany
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The influence of different registration techniques on condyle displacement and electromyographic activity in stomatognathically healthy subjects: a prospective study. J Prosthet Dent 2012; 107:47-54. [PMID: 22230915 DOI: 10.1016/s0022-3913(12)60017-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM It is unclear whether different intermaxillary registration techniques are related to a physiological condylar position that permits neuromuscular equilibrium. PURPOSE This study analyzes and quantifies the effects of different registration techniques on the condyle position and how the registration technique modulates bilateral masseter and anterior temporalis muscle electromyographic activity. MATERIAL AND METHODS Three-dimensional electronic condylar position analysis (EPA) with an ultrasound-based jaw-tracking system and surface electromyographic activity (sEMG) was recorded during the registration of a manually guided centric relation (CR), maximal intercuspation (MI), and Gothic arch tracing guided centric relation (DIR method). Participants were 26 stomatognathically healthy volunteers (mean age, 30.6 ±9.5 years). Data were analyzed by 1-way ANOVA and post hoc Bonferroni correction (α=.05). RESULTS EPA showed significant differences (P<.001) for CR, MI, and DIR in the vertical, sagittal, and horizontal axes. The condyle position during DIR was found to be significantly more anteriorly and inferiorly located than with CR (P<.001) and MI (P<.04). There were no significant differences in the mean muscle activity among CR, MI, and DIR. Muscular symmetry ranged from 63.87 to 81.47%. Significantly higher symmetry for the anterior temporalis (P=.03) and the masseter (P=.03) was found during the DIR than with CR. Torque coefficients (potential laterodeviating effect) were between 88.02% (CR) and 89.94% (MI). CONCLUSIONS Registration technique significantly influenced the condyle position, while mean muscular activity was minimally affected. With respect to muscular balance and activation, the DIR position proved to be capable of inducing the greatest motor unit activity when compared with manually guided CR and MI.
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Neuromuscular adaptations with flexible fixed functional appliance – a 2-year follow-up study. J Orofac Orthop 2011; 72:434-45. [DOI: 10.1007/s00056-011-0048-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Revised: 08/17/2011] [Indexed: 11/26/2022]
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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.
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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
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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
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SFORZA C, ROSATI R, De MENEZES M, MUSTO F, TOMA M. EMG analysis of trapezius and masticatory muscles: experimental protocol and data reproducibility. J Oral Rehabil 2011; 38:648-54. [DOI: 10.1111/j.1365-2842.2011.02208.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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FORRESTER SE, PRESSWOOD RG, TOY AC, PAIN MTG. Occlusal measurement method can affect SEMG activity during occlusion. J Oral Rehabil 2011; 38:655-60. [DOI: 10.1111/j.1365-2842.2011.02205.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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