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Role of Electromyography in Dental Research:
A Review. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2023. [DOI: 10.52547/jrdms.8.1.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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MR-guided navigation for botulinum toxin injection in the lateral pterygoid muscle. First results in the treatment of temporomandibular joint disorders. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:188-195. [DOI: 10.1016/j.jormas.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/22/2018] [Accepted: 11/11/2018] [Indexed: 12/20/2022]
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Kamyszek G, Ketcham R, Garcia R, Radke J. Electromyographic Evidence of Reduced Muscle Activity When ULF-TENS Is Applied to the Vthand VIIthCranial Nerves. Cranio 2016. [DOI: 10.1080/08869634.2001.11746165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nishi SE, Basri R, Alam MK. Uses of electromyography in dentistry: An overview with meta-analysis. Eur J Dent 2016; 10:419-425. [PMID: 27403065 PMCID: PMC4926600 DOI: 10.4103/1305-7456.184156] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of this study was to review the uses of electromyography (EMG) in dentistry in the last few years in related research. EMG is an advanced technique to record and evaluate muscle activity. In the previous days, EMG was only used for medical sciences, but now EMG playing a tremendous role in medical as well as dental sector. MATERIALS AND METHODS Several electronic databases such as Google Scholar, PubMed, Science Direct, and Web of Science were systematically searched for studies published until July 2015. RESULTS EMG can be used in both diagnosis and treatment purpose to record neuromuscular activity. In dentistry, we can utilize EMG to evaluate muscular activity in function such as chewing and biting or parafunctional activities such as clenching and bruxism. In case of TMJ and myofascial pain disorders, EMG widely is used in the last few years. CONCLUSIONS EMG is one of biometric tests that occur in the modern evidence-based dentistry practice.
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Affiliation(s)
- Shamima Easmin Nishi
- Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Rehana Basri
- Department of Craniofacial Sciences and Oral Biology, School of Dental Science, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Mohammad Khursheed Alam
- Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
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Cooper BC, Adib F. An assessment of the usefulness of Kinesiograph as an aid in the diagnosis of TMD: a review of Manfredini et al.'s studies. Cranio 2014; 33:46-66. [PMID: 25115950 DOI: 10.1179/2151090314y.0000000010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM Performing a literature review of publications by Dr. Manfredini et al. related to their temporomandibular joint (TMJ) injection therapy outcome with conclusions on the clinical utility of computerized measurement devices used in the management of temporomandibular disorders (TMDs). In addition, reviewing their published opinion on an occlusion: TMD versus a biopsychosocial paradigm for TMD. Manfredini et al. authored an article published in the Journal of the American Dental Association (JADA) 2013, "An Assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders," the most recent of 12 articles. In all studies, subjects received TMJ injections with an objective measurement outcome criterion; increased maximum mouth opening (MMO) and subjective symptom improvement of pain and chewing function. In the 2013 JADA article, the Mandibular Kinesiograph, referred to as KG, measured MMO before and after therapy. In 11 prior articles, all subject groups with limited mouth opening exhibited very significant increased MMO post-treatment, documenting treatment success using the same 2013 protocol. The 2013 study showed a 1·1 mm improved MMO, described as insignificant. The authors did not critique or explain the aberrant, skewed 2013 outcome data contrasted with their prior studies, which showed overwhelmingly significant increased MMO. Instead, they concluded that the MMO recording device was clinically useless. This motivated a literature review of the authors' TMD publications. CONCLUSION The publications by Manfredini et al. recognized proponents of the psychosocial model of TMD, including the 2013 article, appear to be part of a campaign denying an occlusion: TMD relationship and disparaging the specific computerized measurement devices and the dentists using them in the management of their TMD patients using neuromuscular occlusion dental treatment.
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Cooper BC. Parameters of an Optimal Physiological State of the Masticatory System: The Results of a Survey of Practitioners Using Computerized Measurement Devices. Cranio 2014; 22:220-33. [PMID: 15293778 DOI: 10.1179/crn.2004.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
While bioelectronic instruments have been available for nearly 30 years to assist dentists in day-to-day evaluations of patients' masticatory systems, little guidance has been published to support physiological norms or ideals. An electronic questionnaire was developed and administered to an international group of dentists familiar with the use of bioelectronic instrumentation. Respondents were asked to provide feedback on the norms or ideal parameters of jaw movement, masticatory muscle function with electromyography, and joint sounds through electrosonography that they use in guiding evaluation and treatment of patients with temporomandibular disorders, neuromuscular occlusion, and orthodontics. Surveys were collated to determine areas of consensus. Out of 150 surveys, 55 responses were received from dentists representing nine different countries. Sixty percent of the respondents reported treating more than 150 cases in the past five years using bioelectronic testing. While experience ranged from 2-30 years with different types of devices, average experience was longer with mandibular/jaw tracking (mean 15.3 years) and electromyography (mean 14.1 years) than with electrosonography (mean 7.0 years). Parameters proposed as norms or ideals for electromyographic rest and clench values, and mandibular tracking (velocity, freeway space, and trajectory to closure) were very consistent. Although a smaller number of respondents reported utilization of electrosonography, their criteria for data significance and tissue-type genesis of joint sounds were consistent. While the intra-patient variability may limit the diagnostic use of bioelectronic instruments, the current study demonstrates that through decades of experience, dentists have independently arrived at very consistent definitions of an ideal physiology that can be used to guide treatment.
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Affiliation(s)
- Barry C Cooper
- Department of Oral Biology and Pathology of the State University of New York (SUNY) Stony Brook School of Dental Medicine, USA.
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Woda A, L'heveder G, Ouchchane L, Bodéré C. Effect of experimental stress in 2 different pain conditions affecting the facial muscles. THE JOURNAL OF PAIN 2013; 14:455-66. [PMID: 23453565 DOI: 10.1016/j.jpain.2012.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 11/29/2012] [Accepted: 12/11/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Chronic facial muscle pain is a common feature in both fibromyalgia (FM) and myofascial (MF) pain conditions. In this controlled study, a possible difference in the mode of deregulation of the physiological response to a stressing stimulus was explored by applying an acute mental stress to FM and MF patients and to controls. The effects of the stress test were observed on pain, sympathetic variables, and both tonic and reflex electromyographic activities of masseteric and temporal muscles. The statistical analyses were performed through a generalized linear model including mixed effects. Painful reaction to the stressor was stronger (P < .001) and longer (P = .011) in FM than in MF independently of a higher pain level at baseline. The stress-induced autonomic changes only seen in FM patients did not reach significance. The electromyographic responses to the stress test were strongest for controls and weakest for FM. The stress test had no effect on reflex activity (area under the curve [AUC]) or latency, although AUC was high in FM and latencies were low in both pain groups. It is suggested that FM is characterized by a lower ability to adapt to acute stress than MF. PERSPECTIVE This study showed that an acute psychosocial stress triggered several changes in 2 pain conditions including an increase in pain of larger amplitude in FM than in MF pain. Similar stress-induced changes should be explored as possible mechanisms for differentiation between dysfunctional pain conditions.
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Affiliation(s)
- Alain Woda
- Faculté Dentaire, Centre Recherche Odontologie Clinique, France. alain.woda@-clermont1.fr
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Cooper BC. Temporomandibular disorders: A position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio 2012; 29:237-44. [PMID: 22586834 DOI: 10.1179/crn.2011.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
PURPOSE Two principal schools of thought regarding the etiology and optimal treatment of temporomandibular disorders exist; one physical/functional, the other biopsychosocial. This position paper establishes the scientific basis for the physical/functional. THE ICCMO POSITION: Temporomandibular disorders (TMD) comprise a group of musculoskeletal disorders, affecting alterations in the structure and/or function of the temporomandibular joints (TMJ), masticatory muscles, dentition and supporting structures. The initial TMD diagnosis is based on history, clinical examination and imaging, if indicated. Diagnosis is greatly enhanced with physiologic measurement devices, providing objective measurements of the functional status of the masticatory system: TMJs, muscles and dental occlusion. The American Alliance of TMD organizations represent thousands of clinicians involved in the treatment of TMD. The ten basic principles of the Alliance include the following statement: Dental occlusion may have a significant role in TMD; as a cause, precipitant and/or perpetuating factor. Therefore, it can be stated that the overwhelming majority of dentists treating TMD believe dental occlusion plays a major role in predisposition, precipitation and perpetuation. While our membership believes that occlusal treatments most frequently resolve TMD, it is recognized that TMD can be multi faceted and may exist with co-morbid physical or emotional factors that may require therapy by appropriate providers. The International College of Cranio-Mandibular Orthopedics (ICCMO), composed of academic and clinical dentists, believes that TMD has a primary physical/functional basis. Initial conservative and reversible TMD treatment employing a therapeutic neuromuscular orthosis that incorporates relaxed, healthy masticatory muscle function and a stable occlusion is most often successful. This is accomplished using objective measurement technologies and ultra low frequency transcutaneous electrical neural stimulation (TENS). CONCLUSION Extensive literature substantiates the scientific validity of the physical/functional basis of TMD, efficacy of measurement devices and TENS and their use as aids in diagnosis and in establishing a therapeutic neuromuscular dental occlusion. CLINICAL IMPLICATIONS A scientifically valid basis for TMD diagnosis and treatment is presented aiding in therapy.
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Affiliation(s)
- Barry C Cooper
- Division of Translational Oral Biology, State University of New York (SUNY) Stony Brook School of Dental Medicine, USA.
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Barão VAR, Gallo AKG, Zuim PRJ, Garcia AR, Assunção WG. Effect of occlusal splint treatment on the temperature of different muscles in patients with TMD. J Prosthodont Res 2011; 55:19-23. [DOI: 10.1016/j.jpor.2010.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 05/29/2010] [Accepted: 06/08/2010] [Indexed: 11/24/2022]
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Hiraba H, Yamaoka M, Fukano M, Fujiwara T, Ueda K. Increased secretion of salivary glands produced by facial vibrotactile stimulation. Somatosens Mot Res 2008; 25:222-9. [PMID: 19034809 PMCID: PMC2607134 DOI: 10.1080/08990220802611649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Patients with low-back pain can be evaluated immediately by means of an electrical tool that produces bony vibration to the lumbar spinal processes (Yrjama M, Vanharanta H. Bony vibrotactile stimulation: A new, non-invasive method for examining intradiscal pain. European Spine Journal 1994;3:233–235). In the rehabilitation of masticatory disturbance and dysphagia, an electric toothbrush is commonly used as an oral motor exercise tool for the facilitation of blood flow and metabolism in the orofacial region in Japanese hospitals. However, subjects receiving vibration in the facial regions reported increased salivary secretion. We attempted to develop an oral motor exercise apparatus modified by a headphone headset that was fixed and could be used for extended periods. The vibration apparatus of the heating conductor is protected by the polyethyle methacrylate (dental mucosa protective material), and electric motors for vibration control of the PWM circuit. We examined the amount of salivation during vibration stimuli on the bilateral masseter muscle belly, using a cotton roll positioned at the opening of the secretory duct for 3 min. Although the quantity of salivation in each subject showed various and large fluctuations in the right and left sides of the parotid and submandibular and sublingual glands, one or more of the salivary glands were effectively stimulated by 89 Hz vibration. The reported apparatus will be useful as an additional method in orofacial rehabilitation.
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Affiliation(s)
- Hisao Hiraba
- Department of Dysphasia Rehabilitation, Division of Functional Morphology, Dental Research Center, Tokyo, Japan.
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Castroflorio T, Bracco P, Farina D. Surface electromyography in the assessment of jaw elevator muscles. J Oral Rehabil 2008; 35:638-45. [PMID: 18466277 DOI: 10.1111/j.1365-2842.2008.01864.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Surface electromyography (EMG) allows the non-invasive investigation of the bioelectrical phenomena of muscular contraction. The clinical application of surface EMG recordings has been long debated. This paper reviews the main limitations and the current applications of the surface EMG in the investigation of jaw elevator muscles. Methodological factors associated with the recording of the surface EMG may reduce the reliability and sensitivity of this technique and may have been the cause of controversial results reported in different studies. Despite these problems, several clinical applications of surface EMG in jaw muscles are promising. Moreover, technological advances in signal detection and processing have improved the quality of the information extracted from the surface EMG and furthered our understanding of the anatomy and physiology of the stomatognathic apparatus.
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Affiliation(s)
- T Castroflorio
- Department of Biomedical Sciences and Human Oncology, Specialization School of Orthodontics, University of Turin, Turin, Italy.
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Cooper BC, Kleinberg I. Establishment of a temporomandibular physiological state with neuromuscular orthosis treatment affects reduction of TMD symptoms in 313 patients. Cranio 2008; 26:104-17. [PMID: 18468270 DOI: 10.1179/crn.2008.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The objective of this investigation was to test the hypothesis that alteration of the occlusions of patients suffering from temporomandibular disorders (TMD) to one that is neuromuscularly, rather than anatomically based, would result in reduction or resolution of symptoms that characterize the TMD condition. This hypothesis was proven correct in the present study, where 313 patients with TMD symptoms were examined for neuromuscular dysfunction, using several electronic instruments before and after treatment intervention. Such instrumentation enabled electromyographic (EMG) measurement of the activities of the masticatory muscles during rest and in function, tracking and assessment of various movements of the mandible, and listening for noises made by the TMJ during movement of the mandible. Ultra low frequency and low amplitude, transcutaneous electrical neural stimulation (TENS) of the mandibular division of the trigeminal nerve (V) was used to relax the masticatory muscles and to facilitate location of a physiological rest position for the mandible. TENS also made it possible to select positions of the mandible that were most relaxed above and anterior to the rest position when the mandible was moved in an arc that began at rest position. Once identified, the neuromuscular occlusal position was recorded in the form of a bite registration, which was subsequently used to fabricate a removable mandibular orthotic appliance that could be worn continuously by the patient. Such a device facilitated retention and stabilization of the mandible in its new-found physiological position, which was confirmed by follow up testing. Three months of full-time appliance usage showed that the new therapeutic positions achieved remained intact and were associated with improved resting and functioning activities of the masticatory muscles. Patients reported overwhelming symptom relief, including reduction of headaches and other pain symptoms. Experts consider relief of symptoms as the gold standard for assessment of effectiveness of TMD treatment. It is evident that this outcome has been achieved in this study and that taking patients from a less to a more physiological state is an effective means for reducing or eliminating TMD symptoms, especially those related to pain, most notably, headaches.
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Affiliation(s)
- Barry C Cooper
- Department of Oral Biology and Pathology, State University of New York (SUNY) Stony Brook School of Dental Medicine, USA.
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Bodéré C, Téa SH, Giroux-Metges MA, Woda A. Activity of masticatory muscles in subjects with different orofacial pain conditions. Pain 2005; 116:33-41. [PMID: 15927390 DOI: 10.1016/j.pain.2005.03.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2004] [Revised: 01/27/2005] [Accepted: 03/14/2005] [Indexed: 11/20/2022]
Abstract
The existence of a pathophysiological link between tonic muscle activity and chronic muscle pain is still being debated. The purpose of this retrospective, controlled study was to evaluate the electromyographic (EMG) activity of masticatory muscles in subjects with different orofacial pain conditions. The temporal and masseter EMG activity at rest and the masseteric reflex were recorded in two groups of patients with either myofascial pain (n=33) or neuropathic pain (n=20), one group of non-pain patients with disc derangement disorders (n=27) and one control group of healthy, asymptomatic subjects (n=32). The EMG activities of both muscles at rest were significantly higher in the pain patient groups compared to the asymptomatic control group. There was no significant difference between the disc derangement disorder group and the control group. The masseteric reflex amplitude was reduced in all patient groups when compared with the control group. In pain patient groups, the increased EMG activity at rest and the reduction of the masseteric reflex amplitude were equally distributed in the pain and non-pain sides. In addition, subjects presenting with bilateral pain showed higher EMG activity at rest than those with unilateral pain. These results suggested that the modulation of muscle activity was not the direct consequence of a peripheral nociceptive mechanism and seemed to indicate that a central mechanism was at work. The contrast between the increased EMG activity at rest and the reduction of the masseteric reflex amplitude may reflect modulations of motoneurones that differed in tonic versus phasic conditions in chronic pain patients.
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Affiliation(s)
- Céline Bodéré
- Faculté d'Odontologie, Rue Camille Desmoulins, 29200 Brest, France.
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Korn HJ. Biofeedback und zahnmedizinische Behandlungsansätze bei temporomandibulären Störungen und Bruxismus. VERHALTENSTHERAPIE 2005. [DOI: 10.1159/000085906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gatchel RJ, Robinson RC, Pulliam C, Maddrey AM. Biofeedback with pain patients: evidence for its effectiveness. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s1537-5897(03)00009-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Svensson P, Graven-Nielsen T, Matre D, Arendt-Nielsen L. Experimental muscle pain does not cause long-lasting increases in resting electromyographic activity. Muscle Nerve 1998; 21:1382-9. [PMID: 9771660 DOI: 10.1002/(sici)1097-4598(199811)21:11<1382::aid-mus4>3.0.co;2-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The mutual links between muscle pain and resting electromyographic (EMG) activity are still controversial. This study described effects of experimental muscle pain on resting EMG activity in a jaw-closing muscle and a leg muscle. Pain was induced by injections of hypertonic saline into the muscles in 10 subjects. Injections of isotonic saline served as a control. The pain intensity was scored on visual analog scales (VAS) and surface and intramuscular wire EMGs were obtained from the resting muscles before, during, and after saline injections. EMG activity was analyzed in 30-s intervals and demonstrated, in both muscles, significant increases 30-60 s after injection of hypertonic saline, but not after injection of isotonic saline. In contrast to the transient increase in EMG activity, the pain sensation lasted up to 600 s after injection of hypertonic saline. It was concluded that acute muscle pain is unable to maintain longer-lasting resting muscle hyperactivity.
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Affiliation(s)
- P Svensson
- Center for Sensory-Motor Interaction, Orofacial Pain Laboratory, Aalborg University Fredrik Bajersvej, Denmark
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Hjorth T, Melsen B, Møller E. Masticatory muscle function after unilateral condylar fractures: a prospective and quantitative electromyographic study. Eur J Oral Sci 1997; 105:298-304. [PMID: 9298360 DOI: 10.1111/j.1600-0722.1997.tb00244.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Electromyographic (EMG) recording of masticatory muscle activity was performed in 9 adult men with unilateral condylar fracture immediately after conservative treatment of the condylar fracture (T0) and 4 (T1) and 8 (T2) months after the trauma. From T0 to T2, maximal voluntary contraction of the anterior and posterior temporal muscles and of the masseter muscle opposite the fracture side (contralateral) increased significantly. Activity in the anterior temporal muscles also rose significantly during natural chewing, whereas the masseter muscles remained at the same level, but activity consistently tended to be strongest contralaterally to the condylar fracture. In addition, there was a tendency from T1 to T2 for natural chewing to take place predominantly on the contralateral side. The most obvious overall changes during the follow-up were shorter and stronger contractions in all muscles during chewing, on the side of the impaired joint. The increase of activity in the anterior temporal muscles during maximal bite and natural chewing, and the occurrence of stronger and shorter contractions during ipsilateral chewing, were interpreted as signs of improved function due to healing and relief of pain from the impaired joint. On the other hand, there was a specific rise of maximal activity only in the contralateral masseter, and during natural chewing, activity was constantly stronger in the same muscle in combination with the tendency of increasing predominance of contralateral strokes. These traits specifically related to the masseter muscles were considered an indication of a permanent functional distortion due to reflex suppression on the fracture side as an after-effect of the injury.
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Affiliation(s)
- T Hjorth
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, University of Aarhus, Denmark.
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Takata Y, Nakajima T, Yamada Y. Quantitative evaluation of the tonic vibration reflex (TVR) in the masseter muscle. J Oral Maxillofac Surg 1996; 54:1307-13. [PMID: 8941181 DOI: 10.1016/s0278-2391(96)90488-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE This study evaluated the efficacy of the tonic vibration reflex (TVR) elicited by high-frequency vibration in evaluating masticatory muscle excitability. SUBJECTS AND METHODS The experiment was performed on 16 male adult volunteers, 20 to 45 years of age, without spontaneous pain or tenderness in the masticatory muscles. The subjects were seated in a chair in a fixed head position with the mouth kept open with a bite block. TVR was elicited by vibratory stimulation applied to the mandible (approximately 15 m/s2, 160 Hz). An electromyogram (EMG) was recorded bilaterally from the masseter muscles and analyzed quantitatively using an arbitrary index (TVR index) calculated from the response. Bite force was measured during clenching using a pressure-sensitive foil. RESULTS Wide variations in the TVR index (maximum, 22.7%; minimum, 0.9%, average, 7.7%) were observed among individuals. The mean index for five subjects with a clenching habit was significantly higher than that for 11 subjects without a history of clenching. Tolperisone HCl (100 mg taken orally), a gamma-drive depressant, was found to reduce the response for 2 hours. There was a negative correlation (r = -.504, P < .05) between bite force and TVR index when the values on both sides were compared. CONCLUSIONS The TVR may be of use in evaluating masseter muscle excitability.
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Affiliation(s)
- Y Takata
- Niigata University School of Dentistry, Japan
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Zaki HS, Greco CM, Rudy TE, Kubinski JA. Elongated styloid process in a temporomandibular disorder sample: prevalence and treatment outcome. J Prosthet Dent 1996; 75:399-405. [PMID: 8642526 DOI: 10.1016/s0022-3913(96)90032-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
An elongated styloid process is an anatomic anomaly present in 2% to 30% of adults; it is occasionally associated with pain. Its prevalence among patients with classic temporomandibular disorder pain symptoms is unknown. The effect of conservative treatment on patients who have symptoms of temporomandibular disorders and an elongated styloid process is also unknown. The objectives of this study were to determine the prevalence of the elongated styloid process in a sample of patients with temporomandibular disorders and to compare patients with and without the elongated styloid process on initial presenting signs and symptoms and treatment outcome. A total of 100 panoramic radiographs of patients with symptomatic temporomandibular disorders were examined to ascertain the presence or absence of an elongated styloid process. All patients participated in a conservative treatment program of biofeedback and stress management and a flat-plane intraoral appliance. Initial symptoms and treatment outcome of patients with and without an elongated styloid process were compared by use of multivariate analysis of variance on several oral-paraoral and psychosocial-behavioral methods. The prevalence of an elongated styloid process in this clinic sample of temporomandibular disorders was 27%. The patients with or without an elongated styloid process were not significantly different in pretreatment symptoms, and both groups exhibited substantial treatment gains. However, patients with an elongated styloid process showed significantly less improvement on unassisted mandibular opening without pain than did patients who did not have an elongated styloid process. This suggests that an elongated styloid process may place structural limitations on pain-free maximum mandibular opening. The results support conservative management of patients with symptoms of temporomandibular disorders when an elongated styloid process is present.
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Affiliation(s)
- H S Zaki
- University of Pittsburgh, Pa., USA
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Gale EN. BIOFEEDBACK AND RELAXATION THERAPY FOR THE TREATMENT OF MYOFASCIAL PAIN AND DYSFUNCTION. Oral Maxillofac Surg Clin North Am 1995. [DOI: 10.1016/s1042-3699(20)30806-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dworkin SF, Turner JA, Wilson L, Massoth D, Whitney C, Huggins KH, Burgess J, Sommers E, Truelove E. Brief group cognitive-behavioral intervention for temporomandibular disorders. Pain 1994; 59:175-187. [PMID: 7892015 DOI: 10.1016/0304-3959(94)90070-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Temporomandibular disorders (TMD) are currently viewed as an interrelated set of clinical conditions presenting with signs and symptoms in masticatory and related muscles of the head and neck, and the soft tissue and bony components of the temporomandibular joint. Epidemiologic and clinical studies of TMD confirm its status as a chronic pain problem. In this report we present results from a randomized clinical trial which compared, at 3- and 12-month follow-ups, the effects of usual TMD treatment on TMD pain and related physical and psychological variables with the effects of a cognitive-behavioral (CB) intervention delivered to small groups of patients before usual TMD treatment began. The purpose of this study was to determine whether a minimal CB intervention followed by dental TMD treatment enhanced the effects of usual clinical dental treatment. A second purpose of the study was to determine whether patients classified as high in somatization and psychosocial dysfunction would respond less favorably to this minimal intervention than would those low in somatization and dysfunction. Patients who participated in the CB intervention followed by usual treatment showed greater long-term decreases in reported pain level and pain interference in daily activities than did patients who received only usual treatment. The benefits of CB intervention were not seen when the CB and UT groups were compared at 3-month follow-up. During the 3-12-month follow-up interval, however, the UT group maintained essentially the same level of improvement in characteristic pain while the CB group continued to improve, as hypothesized. During this same follow-up interval, the CB group also showed a strong trend toward continued improvement in pain interference. Such effects were not observed for depression, somatization, or clinical measures of jaw range of motion. Additionally, as hypothesized, dysfunctional chronic pain patients did not appear to benefit from the brief CB intervention. Intent to treat analyses were also performed to assess generalizability of the results.
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Affiliation(s)
- Samuel F Dworkin
- Departments of Oral Medicine (SC-63), School of Medicine, University of Washington, Seattle, WA 98195 USA Departments of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA 98195 USA Departments of Dental Public Health Sciences, School of Medicine, University of Washington, Seattle, WA 98195 USA Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195 USA
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Abstract
Temporomandibular disorders (TMD) are examined from a biopsychosocial or illness perspective. Data are reviewed in accordance with the concept that TMD is a chronic pain condition that shares many features with other common chronic pain conditions. TMD is placed within the same biopsychosocial model currently used to study and manage all common chronic pain conditions. The concept of chronic pain dysfunction, which has emerged as a critical consideration for chronic pain research and management, is also reviewed. Most chronic pain patients seem to bear their condition adequately and thus maintain adaptive levels of psychosocial function. By contrast, a psychosocially dysfunctional segment of the chronic pain population appears unable to cope as well and demonstrate higher rates of depression, somatization, and health care use, even though persons in this segment are not different from their functional peers on the basis of observable organic pathology. Finally, data are reviewed from longitudinal, epidemiologic, and experimental intervention studies that substantiate these two perspectives.
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Turk DC, Zaki HS, Rudy TE. Effects of intraoral appliance and biofeedback/stress management alone and in combination in treating pain and depression in patients with temporomandibular disorders. J Prosthet Dent 1993; 70:158-64. [PMID: 8371179 DOI: 10.1016/0022-3913(93)90012-d] [Citation(s) in RCA: 140] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
To assess the differential efficacy of two commonly used treatments for temporomandibular disorders (TMD), intraoral appliances (IAs) and biofeedback (BF), separately and in combination, two studies were conducted. The first study directly compared IA treatment, a combination of biofeedback and stress management (BF/SM), and a waiting list control group in a sample of 80 TMD patients. Both treatments were determined to be equally credible to patients, ruling out this potential threat to the validity of the results obtained. The results demonstrated that the IA treatment was more effective than the BF/SM treatment in reducing pain after treatment, but at a 6-month follow-up the IA group significantly relapsed, especially in depression, whereas the BF/SM maintained improvements on both pain and depression and continued to improve. The second study examined the combination of IA and BF/SM in a sample of 30 TMD patients. The results of this study demonstrated that the combined treatment approach was more effective than either of the single treatments alone, particularly in pain reduction, at the 6-month follow-up. These results support the importance of using both dental and psychologic treatments to successfully treat TMD patients if treatment gains are to be maintained.
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Affiliation(s)
- D C Turk
- Department of Psychiatry, University of Pittsburgh Medical Center, PA
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Tsolka P, Preiskel HW. Kinesiographic and electromyographic assessment of the effects of occlusal adjustment therapy on craniomandibular disorders by a double-blind method. J Prosthet Dent 1993; 69:85-92. [PMID: 8455175 DOI: 10.1016/0022-3913(93)90246-k] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Fifty-one patients with craniomandibular disorders were divided into two groups. One group underwent mock occlusal adjustment, the other was treated with adjustments to remove significant slides and nonworking-side interferences. Both groups received identical counseling. Kinesiographic and electromyographic assessment showed no significant difference between the two groups.
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Affiliation(s)
- P Tsolka
- Department of Prosthetic Dentistry, United Medical School, London, England
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Devices for the diagnosis and treatment of temporomandibular disorders. Part II: Electromyography and sonography. J Prosthet Dent 1990; 63:332-6. [PMID: 2407831 DOI: 10.1016/0022-3913(90)90207-s] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This second article in the three-part series on temporomandibular disorder (TMD) devices compares the claimed diagnostic usefulness of electromyography and sonography with the present scientific evidence. This review concludes that there is no evidence to support the use of either surface electromyography or silent period duration for the evaluation or diagnosis of TMD. Furthermore, in view of the available evidence, sonography and Doppler ultrasound have no particular advantage over a conventional stethoscope or direct auscultation.
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Burdette BH, Gale EN. Reliability of surface electromyography of the masseteric and anterior temporal areas. Arch Oral Biol 1990; 35:747-51. [PMID: 2091594 DOI: 10.1016/0003-9969(90)90098-u] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This was studied in 37 patients suffering from myofascial pain-dysfunction. Bipolar surface electrodes were used to record tonic, resting EMG activity for 2 consecutive trials. This protocol was repeated at a second recording session 2 weeks later. A custom-made, plastic template was constructed for each subject during the first visit in order to relocate the electrodes accurately at the second recording session. Correlation coefficients were calculated for each muscle area. Within-session (same day) r values ranged from 0.7620 to 0.8884 for the masseteric area and from 0.8686 to 0.9109 for the anterior temporal area. Across-session (different day) r values ranged from 0.5645 to 0.6503 for the masseteric area and 0.3309 to 0.4844 for the anterior temporal area. The lower correlation between different day recordings could reflect a methodological shortcoming in relocating the electrodes, particularly on the anterior temporal area. The greater variability recorded from the anterior temporal area could also reflect the dynamic role of the temporalis muscle in maintaining the postural rest position of the mandible.
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Affiliation(s)
- B H Burdette
- Department of Oral Diagnosis, Medical College of Georgia, School of Dentistry, Augusta 30912-1241
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