Morphologic and biochemical changes of the masseter muscles induced by occlusal wear: studies in a rat model

A two-year clinical trial of enamel wear opposing 5Y-TZP and lithium disilicate crowns

STATEMENT OF PROBLEM

Clinical information on enamel wear opposing 5 mol% yttria-stabilized tetragonal zirconia polycrystal (5Y-TZP) or lithium disilicate crowns is lacking. Moreover, the effect of surface roughness on the wear of enamel antagonists remains unclear.

PURPOSE

The purpose of this clinical study was to quantify the vertical wear and total volume of wear while also measuring the surface roughness of antagonists at 6-month intervals over 2 years.

MATERIAL AND METHODS

A tooth-supported first molar 5Y-TZP Lava Esthetic Fluorescent Zirconia crown or an IPS e.max CAD lithium disilicate crown was randomly provided for 24 participants (n=12). The contralateral first molar and opposite teeth were the natural enamel controls. The crowns were fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology and then polished. The data were gathered every 6 months at recall appointments with an intraoral scanner and a polyvinyl siloxane impression. A 3-dimensional (3D) comparative software program was used to measure the maximum vertical and volume loss on opposing enamel, as well as on the enamel control on the opposite side of the mouth. The surface of epoxy resin replicas was analyzed using a scanning electron microscope. The surface roughness of the cusp replica was measured with a 3D laser microscope. The crown's antagonist enamel and natural enamel wear were compared using a 2-way repeated measure ANOVA (α=.05).

RESULTS

No significant difference was found in the average volume loss between the crown's antagonist enamel (ZTE 0.042 ±0.005 mm3, LTE 0.048 ±0.006 mm3) and the enamel control (ZCE 0.046 ±0.004 mm3, LCE 0.050 ±0.005 mm3) (P>.05). No significant difference was found in surface roughness between the crown's antagonist enamel (antagonist enamel of zirconia group [ZTE] 0.7 ±0.3 µm, antagonist enamel of lithium disilicate group [LTE] 0.6 ±0.3 µm) and the enamel control (enamel control of zirconia group [ZCE] 0.7 ±0.3 µm, enamel control of lithium disilicate group [LCE] 0.5 ±0.2 µm) in both zirconia and lithium disilicate groups (P>.05). Also, no correlation was found between the amount of wear and the roughness of the surface. The wear patterns observed on the opposing enamel surfaces of the monolithic zirconia and lithium disilicate materials were found to be similar to those seen on natural enamel.

CONCLUSIONS

A 2-year clinical investigation found that polished lithium disilicate and 5Y-TZP crowns did not affect enamel wear more than enamel against enamel, contrary to laboratory studies. Another finding revealed that surface roughness did not significantly affect wear.

Digital technique to analyze the wear of screw-retained implant supported metal-ceramic dental prostheses and natural tooth as antagonist: a pilot study

The aim of this study was to describe a novel digital technique to analyze the wear of screw-retained implant-supported metal-ceramic dental prostheses and natural tooth as antagonist.Materials and methods Ten patients were consecutively included to rehabilitate partial edentulism by dental implants. Both the screw-retained implant-supported metal-ceramic dental prostheses and the natural tooth as antagonist were submitted to a digital impression through an intraoral scan to generate a Standard Tessellation Language digital file preoperatively (STL1), at 3 months (STL2), and 6 months (STL3) follow-up. Afterwards, an alignment procedure of the digital files (STL1-STL3) was performed on a reverse engineering morphometric software (3D Geomagic Capture Wrap) and volume changes at the screw-retained implant-supported metal-ceramic dental prostheses and the natural tooth as antagonist were analyzed using Student's t-test. Moreover, Gage R&R statistical analysis was conducted to analyze the repeatability and reproducibility of the digital technique.Results Gage R&R showed a variability attributable to the digital technique of 3.8% (among the measures of each operator) and 4.5% (among operators) of the total variability; resulting repeatable and reproducible, since the variabilities were under 10%. In addition, statistically significant differences were shown at the wear volume (μm3) of both the natural tooth as antagonist (p < 0.0001) and the screw-retained implant-supported metal-ceramic dental prostheses between 3- and 6-months follow-up (p = 0.0002).Conclusion The novel digital measurement technique results repeatable and reproducible to analyze the wear of screw-retained implant-supported metal-ceramic dental prostheses and natural tooth as antagonist.

Research progress in effect of chewing-side preference on temporomandibular joint and its relationship with temporo-mandibular disorders

Chewing-side preference is one of the risk factors for temporomandibular disorders (TMD), and people with chewing-side preference is more prone to have short and displaced condyles, increased articular eminence inclination and glenoid fossa depth. The proportion of TMD patients with chewing-side preference is often higher than that of the normal subjects. Clinical studies have shown a strong correlation between chewing-side preference and TMD symptoms and signs; and animal studies have shown that chewing-side preference can affect the growth, development, damage and repair of the mandible. After long-term unilateral mastication, changes in the stress within the joint cause the imbalance of temporomandibular joint (TMJ) structural reconstruction, the transformation and even destruction of the fiber structure of masticatory muscle, resulting in uncoordinated movement of bilateral muscles. The joint neurogenic diseases caused by the increase of neuropeptide substance P and calcitonin-gene-related-peptide (CGRP) released locally by TMJ may be the mechanism of TMD. This article reviews the research progress of the influence of chewing-side preference on the structure of TMJ, the relationship between chewing-side preference and TMD, and the related mechanisms.

Functional magnetic resonance imaging evaluation of masticatory muscle dysfunction in unilateral exodontia rabbits

Objective:

Occlusal alteration due to tooth loss may cause overload of masticatory muscle and promote muscle dysfunction. This study explored the feasibility of using functional magnetic resonance imaging (fMRI) to evaluate muscle dysfunction in an established unilateral exodontia animal model.

Methods:

six rabbits were extracted right maxillary molars. T2 mapping, T2* mapping and Iterative Decomposition of water and fat with Echo Asymmetry and Least Square Estimation (IDEAL-IQ) were performed one day before extraction and every 2 weeks (2th~12th week) after extraction. The T2 and T2* values and fat fraction (FF) of bilateral temporal muscle (TM), masseter muscle (MM) and medial pterygoid muscle (MPM) were measured and compared between the extraction side-and the contralateral side. Parameters of three monitoring time points (0th, sixth, 12th week) were also analyzed.

Results:

T2 values of MM on extraction side-were significantly higher than those of contralateral side-from fourth week to 12th week after extraction (p < 0.05). T2 values of MM and MPM on extraction side-and TM on contralateral side-were significantly higher in 12th week than those in 0th week (p < 0.05). And FF of bilateral MM was significantly higher in 12th week than those in 0th week (p < 0.05). T2* value showed no significant difference between extraction side-and contralateral side-and also at above three time points.

Conclusion:

T2 and T2* value and FF can be used as indicators of masticatory muscle dysfunction. fMRI is expected to be a non-invasive method for in vivo and real-time evaluation of masticatory muscle functional abnormality.

Characterization of various acrylate based artificial teeth for denture fabrication

Acrylic resins-based artificial teeth are frequently used for the fabrication of dentures has and contribute a very strong share in the global market. However, the scientific literature reporting the comparative analysis data of various artificial teeth is scarce. Focusing on that, the present study investigated various types of commercially available artificial teeth, composed of polymethyl methacrylate (PMMA). Artificial teeth are characterized for chemical analysis, morphological features, thermal analysis, and mechanical properties (surface hardness, compressive strength). Different types of artificial teeth showed distinct mechanical (compression strength, Vickers hardness) and thermal properties (thermal gravimetric analysis) which may be attributed to the difference in the content of PMMA and type and quantity of different fillers in their composition. Thermogravimetric analysis (TGA) results exhibited that vinyl end groups of PMMA degraded above 200 °C, whereas 340-400 °C maximum degradation temperature was measured by differential thermal analysis (DTA) for all samples. Crisma brand showed the highest compressive strength and young modulus (88.6 MPa and 1654 MPa) while the lowest value of Vickers hardness was demonstrated by Pigeon and Vital brands. Scanning electron microscope (SEM) photographs showed that Crisma, Pigeon, and Vital exhibited characteristics of a brittle fracture; however, Artis and Well bite brands contained elongated voids on their surfaces. According to the mechanical analysis and SEM data, Well bite teeth showed a significantly higher mechanical strength compared to other groups. However, no considerable difference was observed in Vickers hardness of all groups. Graphical abstract.

Masticatory Myofascial Pain Syndrome: Implications for Endodontists

INTRODUCTION

Masticatory myofascial pain syndrome can present similarly to other dental conditions in odontogenetic structures. Endodontists should be familiar with the symptomology and pathophysiology of masticatory myofascial pain syndrome to avoid misdiagnosis, incorrect treatment, and medicolegal repercussions. The aim of this review was to provide a foundational summary for endodontists to identify and correctly manage masticatory myofascial pain syndrome.

METHODS

A narrative review of the literature was performed through a MEDLINE search and a hand search of the major myofascial pain textbooks.

RESULTS

Masticatory myofascial pain syndrome is a musculoligamentous syndrome that can present similarly to odontogenic pain or refer pain to the eyebrows, ears, temporomandibular joints, maxillary sinus, tongue, and hard palate. Currently, the most comprehensive pathophysiology theory describing masticatory myofascial pain syndrome is the expanded integrated hypothesis. The most widely accepted diagnostic guidelines for masticatory myofascial pain syndrome are the Diagnostic Criteria for Temporomandibular Disorders; however, their diagnostic capability is limited. There is no hierarchy of treatment methods because each patient requires a tailored and multidisciplinary management aimed at regaining the muscle's range of motion, deactivating the myofascial trigger points, and maintaining pain relief.

CONCLUSIONS

The pain patterns for masticatory myofascial pain syndrome are well-known; however, there is a lack of consensus on the most proper method of trigger point diagnosis or pain quantification. The diagnostic strategies for masticatory myofascial pain syndrome vary, and the diagnostic aids are not well developed.

The path from trigeminal asymmetry to cognitive impairment: a behavioral and molecular study

Trigeminal input exerts acute and chronic effects on the brain, modulating cognitive functions. Here, new data from humans and animals suggest that these effects are caused by trigeminal influences on the Locus Coeruleus (LC). In humans subjects clenching with masseter asymmetric activity, occlusal correction improved cognition, alongside with reductions in pupil size and anisocoria, proxies of LC activity and asymmetry, respectively. Notably, reductions in pupil size at rest on the hypertonic side predicted cognitive improvements. In adult rats, a distal unilateral section of the trigeminal mandibular branch reduced, on the contralateral side, the expression of c-Fos (brainstem) and BDNF (brainstem, hippocampus, frontal cortex). This counterintuitive finding can be explained by the following model: teeth contact perception loss on the lesioned side results in an increased occlusal effort, which enhances afferent inputs from muscle spindles and posterior periodontal receptors, spared by the distal lesion. Such effort leads to a reduced engagement of the intact side, with a corresponding reduction in the afferent inputs to the LC and in c-Fos and BDNF gene expression. In conclusion, acute effects of malocclusion on performance seem mediated by the LC, which could also contribute to the chronic trophic dysfunction induced by loss of trigeminal input.

Immunofluorescence Evaluation of Myf5 and MyoD in Masseter Muscle of Unilateral Posterior Crossbite Patients

A unilateral posterior crossbite is a malocclusion where the low activity of the affected masseter muscle is compensated by the contralateral muscle hypertrophy. It is still unknown if, in the same condition, myogenesis with new fibre formation takes place.

AIM

the aim of the present study was to evaluate the expression of myogenesis markers, such as Myf5 and MyoD, in masseter muscles of unilateral posterior crossbite patients.

MATERIALS AND METHODS

biopsies from fifteen surgical patients with unilateral posterior crossbites have been analysed by immunofluorescence reactions. The results show the expression of Myf5 and MyoD in the contralateral muscle but not in the ipsilateral one. Moreover, statistical analysis shows the higher number of satellite cells in the contralateral side if compared to the ipsilateral one.

CONCLUSIONS

these results suggest that in contralateral muscle, hyperplastic events take place, as well as hypertrophy.

Newly developed mastication activity reduction procedure rapidly induces abnormal atrophic change of the mandibular condyle in young and elder experimental animal models

This study was performed to develop a new rat model of reduced masticatory activity in order to assess the effect of this reduction on the morphology of the temporomandibular joint (TMJ) over time. Female rats were used, and ovariectomy was performed to simulate aged/postmenopausal status. Twenty-four SD rats aged 6 weeks were divided into four groups: ovariectomy/sham procedure (Ov/S); ovariectomy/reduced masticatory activity (Ov/RMA); non-Ov/S (NO/S); and non-Ov/RMA (NO/RMA). The RMA procedure involved grinding down the edges of the upper and mandibular incisors by about 3 mm and supplying the rats with a powdered diet. The bilateral TMJ was examined by micro-computed tomography at 0, 1, 2, 4, 6, and 8 weeks after the start of RMA. Condylar width was greater in the NO/S group than in the Ov/S group after the 2nd week, showing that ovariectomy reduced the width of the condyle. After the 2nd week, significant differences in condylar width were apparent between the NO/S and NO/RMA groups, and between the Ov/S and Ov/RMA groups. This RMA procedure appeared to provide a good model of reduced masticatory activity. The present findings in female rats suggest that reduction of appropriate mastication activity in the growth period results in poor growth of the mandibular condyle and immediately induces atrophy of the mandibular condyle under conditions simulating aged/postmenopausal status.

Wear resistance of 3D-printed denture tooth resin opposing zirconia and metal antagonists

STATEMENT OF PROBLEM

Additive manufacturing technology can be used for denture bases and also denture teeth. Therefore, the mechanical properties of 3D-printed resin denture teeth should be evaluated.

PURPOSE

The purpose of this in vitro study was to compare the wear resistance of 3D-printed denture tooth resin with that of conventionally prefabricated denture teeth.

MATERIAL AND METHODS

Eighty substrate specimens were prepared with 5 kinds of resin denture teeth: 3D-printed denture tooth resin (DENTCA denture tooth resin; DENTCA, Inc), Artic 6 (Kulzer GmbH), Preference (Candulor AG), Premium 6 (Kulzer GmbH), and Surpass (GC Corp). The 3D-printed denture tooth specimens were made of methacrylate-based photopolymerized resin by stereolithography 3D printing. Antagonistic surfaces were made from zirconia by milling and from cobalt-chromium (Co-Cr) alloy by 3D printing and casting. The specimens were loaded at 49 N for 30 000 cycles under thermocycling conditions in a mastication simulator. Wear resistance was measured by calculating the volume of substance lost. Wear surface characteristics were observed by using a scanning electron microscope (SEM). Two-way ANOVA was used to analyze the data (α=.05).

RESULTS

The influence of the resin denture teeth and the type of antagonist were both statistically significant. The wear volume loss of the 3D-printed denture tooth resin was higher than that of Artic 6 and Preference when opposing the zirconia and the metal antagonists (P<.05). The 3D-printed denture tooth resin did not show a significant difference from Premium 6 with the zirconia and the metal antagonists or Surpass with the zirconia antagonist. From the SEM images, the specimens of the 3D-printed denture tooth resin showed a relatively smooth surface with the zirconia antagonist and exhibited cracks when opposed by the metal antagonist.

CONCLUSIONS

The results suggest that 3D-printing by using resin materials provides adequate wear resistance for denture tooth use.

Evaluating the Wear of Resin Teeth by Different Opposing Restorative Materials

The aim of this study was to evaluate the wear properties of resin teeth with different opposing dental restorative materials. One type of resin tooth (Trubyte Biotone) was tested against six types of restorative materials including type III gold alloy (GO), monolithic zirconia (MZ), lithium disilicate glass ceramic (LD), nickel-chromium alloy (NC), feldspathic ceramic (FC), and steatite (ST). Two-body wear tests were performed under a vertical load of 5 kgf and thermo-cycling at 5/55 °C with a total of 120,000 cycles. The wear amount was quantified by measuring the volume loss of the resin teeth and the vertical substance loss of the opposing materials using three-dimensional images. The FC group showed a significantly greater amount of wear of the resin teeth, followed by the ST, NC, LD, MZ, and GO groups. The GO group showed significantly less wear of resin teeth than the other groups. There were no statistically significant differences in the wear of opposing restorative materials between groups. Within the limits of this study, it is recommended that zirconia, rather than feldspathic ceramic, should be used for restorations in the esthetic zone, and gold alloy should be used for areas with little or no esthetic demand.

Advancements in all-ceramics for dental restorations and their effect on the wear of opposing dentition

Tooth wear is a process that is usually a result of tooth to tooth and/or tooth and restoration contact. The process of wear essentially becomes accelerated by the introduction of restorations inside the oral cavity, especially in case of opposing ceramic restorations. The newest materials have vastly contributed toward the interest in esthetic dental restorations and have been extensively studied in laboratories. However, despite the recent technological advancements, there has not been a valid in vivo method of evaluation involving clinical wear caused due to ceramics upon restored teeth and natural dentition. The aim of this paper is to review the latest advancements in all-ceramic materials, and their effect on the wear of opposing dentition. The descriptive review has been written after a thorough MEDLINE/PubMed search by the authors. It is imperative that clinicians are aware of recent advancements and that they should always consider the type of ceramic restorative materials used to maintain a stable occlusal relation. The ceramic restorations should be adequately finished and polished after the chair-side adjustment process of occlusal surfaces.

The ultrastructural anatomy of the nuclear envelope in the masseter muscle indicates its role in the metabolism of the intracellular Ca+

Specific ultrastructural anatomy of masticatory muscles is commonly referred to a general pattern assigned to striated muscles. Junctional feet consisting of calcium channels of the sarcoplasmic reticulum (i.e. the ryanodine receptors, RyRs) physically connected to the calcium channels of the t-tubules build triads within striated muscles. Functional RyRs were demonstrated in the nuclear envelopes of pancreas and of a skeletal muscle derived cell line, but not in muscle in situ. It was hypothesized that ryanodine receptors (RyRs) could also exist in the nuclear envelope in the masseter muscle, thus aiming at studying this by transmission electron microscopy. There were identified paired and consistent subsarcolemmal clusters of mitochondria, appearing as outpockets of the muscle fibers, usually flanking an endomysial microvessel. It was observed on grazing longitudinal cuts that the I-band-limited mitochondria were not strictly located in a single intermyofibrillar space but continued transversally over the I-band to the next intermyofibrillar space. It appeared that the I-band-limited transverse mitochondria participate with the column-forming mitochondria in building a rather incomplete mitochondrial reticulum of the masseter muscle. Subsarcolemmal nuclei presented nuclear envelope-associated RyRs. Moreover, t-tubules were contacting the nuclear envelope and they were seemingly filled from the perinuclear space. This could suggest that nucleoplasmic calcium could contribute to balance the cytosolic concentration via pre-built anatomical routes: (i) indirectly, via the RyRs of the nuclear envelope and (ii) directly via the communication of t-tubules and sarcoplasmic reticulum through the perinuclear space.

Occlusal interference induces oxidative stress and increases the expression of UCP3 in the masseter muscle: A rat model

OBJECTIVE

To determine whether occlusal alteration contributes to masticatory muscle damage by inducing oxidative stress.

DESIGN

Thirty Sprague-Dawley rats were randomly divided into six groups, including occlusal interference groups (3 days, 7 days, 14 days, 21 days, and removal for 3 days) and a sham group. A rat experimental model of occlusal interference was generated by a 0.6-mm unilateral bite-raise. The rats were euthanised for evaluation of histologic changes in the masseter muscles using haematoxylin-eosin staining. To further investigate the role of oxidative stress and uncoupling protein (UCP3) in the development of occlusal dysfunction-induced masseter damage, levels of UCP3 protein were measured by western blot analysis.

RESULTS

Compared with the sham group, the connective tissue of the masseter muscle was extended partially and inflammatory cells appeared following the induction of malocclusion. With respect to the oxidative stress markers, there were increases in malondialdehyde (MDA) content but decreases in superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities; furthermore, the expression of UCP3 was upregulated. After eliminating the occlusal interference for 3 days, the degree of inflammation was substantially alleviated, the MDA content decreased, and SOD and GPX activities increased. The expression of UCP3 decreased.

CONCLUSIONS

Occlusal interference induces oxidative stress in the masseter muscle, regulated by UCP3. Overall, these findings have significant implications for the understanding of how occlusal dysfunction causes muscle fatigue and pain.

Exodontia-induced muscular hypofunction by itself or associated to chronic stress impairs masseter muscle morphology and its mitochondrial function

Stress is associated with orofacial pain sensitivity and is qualified as a temporomandibular disorder risk factor. During stressful periods, painful thresholds of masticatory muscles in individuals suffering muscle facial pain are significantly lower than in controls, but the exact physiologic mechanism underlying this relation remains unclear. Our hypothesis is that chronic unpredictable stress and masticatory hypofunction induce morphologic and metabolic masseter muscle changes in rats. For test this hypothesis, adult Wistar rats were submitted to chronic unpredictable stress and/or exodontia of left molars and the left masseter muscle was removed for analysis. The parameters evaluated included ultrastructure, oxidative level, metabolism activity and morphological analysis in this muscle. Our data show by histological analysis, that stress and exodontia promoted a variation on diameters and also angled contours in masseter fibers. The masticatory hypofunction increased oxidative metabolism as well as decreased reactive species of oxygen in masseter muscle. The ultrastructural analysis of muscle fibers showed disruption of the sarcoplasmic reticulum cisterns in certain regions of the fiber in stress group, and the disappearance of the sarcoplasmic reticulum membrane in group with association of stress and exodontia. Our findings clarify mechanisms by which chronic stress and masticatory hypofunction might be involved in the pathophysiology of muscular dysfunctions. Masticatory hypofunction influenced oxidative stress and induced oxidative metabolism on masseter muscle, as well as altered its fiber morphology. Chronic stress presented malefic effect on masseter morphology at micro and ultra structurally. When both stimuli were applied, there were atrophic fibers and a complete mitochondrial derangement.

Effect of zirconia polycrystal and stainless steel on the wear of resin composites, dentin and enamel

This study evaluated the effect of two antagonist substrates (Y-TZP/zirconia or stainless steel) on the wear rate and surface alterations of different composite materials and bovine tooth substrates (enamel and dentin). The wear rate of different composite materials (n = 20; two direct composite resins: HelioMolar - HM; Clearfil AP-X - CAP, three indirect composite resins: Estenia C&B - EST; Adoro - ADO; Sinfony - SFY, and one composite resin for direct/indirect restorations: Filtek Z250 - Z250), bovine enamel and dentin against two different antagonist materials (zirconia or stainless steel) into two mediums (two-body and three-body wear) were collected. After wear tests on ACTA wear machine, Scanning Electron Microscopy (SEM) analysis was performed to access the surface alterations. The wear data were evaluated by three-way ANOVA and Tukey post-hoc test (α = 0.05). The factors 'antagonist', 'medium', 'restorative materials', and the interaction of all factors grouped by two and integrated showed statistical significance on the wear rates. A two-body test depicted no difference among all composites and enamel for wear rate, while a three-body test depicted differences among composites directly related to the filler content: EST < Z250 = CAP < ADO = HM < SFY. Dentin always showed the highest wear rates and enamel the lowest rates. The presence of food bolus (three-body test) led to higher wear rates in comparison to an only aqueous medium (two-body test). SEM analysis showed that different materials present specific wear patterns, regardless of the medium and the antagonist considered. Differently from enamel, dentin substrate was intensively prone to wear, regardless of the antagonist/medium. Resin composite substrates presented intermediate wear rates, depending directly on their filler content (% in weight).

Botulinum neurotoxin effects on masseter muscle fibre in WNIN obese rats-Scanning electron microscope analysis

WNIN/Ob obese mutant rats are unique in comparison to similar rodent models of obesity established in the West. The present study is aimed to evaluate the masticatory function and histological changes in masseter muscle fibres treated with botulinum toxin type A (BoNT/A) in WNIN/Ob rats. Twelve WNIN/Ob obese rats and 12 lean rats at 35 days of age were taken and divided into four groups (6 rats in each group): Group-I (WNIN/Ob) and Group-II (lean) rats were injected with BoNT/A (1 unit) into right side of masseter muscle. For control left masseter of both phenotypes was injected with saline. Group-III (WNIN/Ob) and Group-IV (lean) rats were without any treatment. Growth and food intake was monitored daily for 45 days. Rats were euthanized and gross necropsy was carried out to check any abnormalities. Masseter muscles were dissected and mean muscle mass was recorded. Small portion of muscle was stored in 10% formalin for hematoxylin-eosin (H&E) staining and remaining tissue stored in gluteraldehyde for scanning electron microscopy (SEM). There is a significant decrease in the body weights and food intake of BoNT/A treated obese rats. The H&E staining of the masseter muscle in both groups showed normal morphology and orientation. The SEM analysis showed that, fibre size in BoNT/A treated masseter muscle of obese rats increased more than the saline treated side and in control rats. The increase in the muscle fibre size and transition of muscle fibre subtypes may be due to the reduced masticatory function of the masseter muscle. SCANNING 38:396-402, 2016. © 2015 Wiley Periodicals, Inc.

Morphofunctional compensation of masseter muscles in unilateral posterior crossbite patients

Unilateral posterior crossbite is a widespread, asymmetric malocclusion characterized by an inverse relationship of the upper and lower buccal dental cusps, in the molar and premolar regions, on one side only of the dental arch. Patients with unilateral posterior crossbite exhibit an altered chewing cycles and the crossbite side masseter results to be less active with respect to the contralateral one. Few studies about morphological features of masticatory muscle in malocclusion disorders exist and most of these have been performed on animal models. The aim of the present study was to evaluate morphological and protein expression characteristics of masseter muscles in patients affected by unilateral posterior crossbite, by histological and immunofluorescence techniques. We have used antibody against PAX-7, marker of satellite cells, and against α-, β-, γ-, δ-, ε- and ζ-sarcoglycans which are transmembrane glycoproteins involved in sarcolemma stabilization. By statistical analysis we have evaluated differences in amount of myonucley between contralateral and ipsilateral side. Results have shown: i) altered fibers morphology and atrophy of ipsilateral muscle if compared to the contralateral one; ii) higher number of myonuclei and PAX-7 positive cells in contralateral side than ipsilateral one; iii) higher pattern of fluorescence for all tested sarcoglycans in contralateral side than ipsilateral one. Results show that in unilateral posterior crossbite hypertrophic response of contralateral masseter and atrophic events in ipsilateral masseter take place; by that, in unilateral posterior crossbite malocclusion masticatory muscles modify their morphology depending on the function. That could be relevant in understanding and healing of malocclusion disorders; in fact, the altered balance about structure and function between ipsilateral and contralateral muscles could, long-term, lead and/ or worsen skeletal asymmetries.

Tooth wear against ceramic crowns in posterior region: a systematic literature review

The objective of this systematic review was to assess tooth wear against ceramic crowns in posterior region in vitro and in vivo. An electronic PubMed search was conducted to identify studies on tooth wear against ceramic crowns in posterior region. The selected studies were analyzed in regard to type of crowns, natural antagonist, measuring protocol and outcome. From a yield of 1 000 titles, 43 articles were selected for full-text analysis; finally, no in vitro and only five in vivo studies met the inclusion criteria. As there is heterogeneity in design, used measuring method, ceramics and analysis-form, a meta-analysis was not possible. Results of these studies are very controversial which makes a scientifically valid comparison impossible. This review indicated that some all-ceramic crowns are as wear friendly as metal-ceramic crowns. Up to now, it has been impossible to associate tooth wear with any specific causal agent. The role of ceramic surface treatment that might be responsible for the changing in rate of tooth wear seems undetermined as yet through clinical trials. The literature reveals that studies on this topic are subject to a substantial amount of bias. Therefore, additional clinical studies, properly designed to diminish bias, are warranted.

Influence of unilateral tooth loss in the temporomandibular joint and masseter muscle of rabbits

OBJECTIVE

The purpose of this study was to evaluate the influence of the masticatory system in patients with missing teeth.

STUDY DESIGN

The influence of tooth loss on the masticatory system was analyzed with the use of bone scintigraphy ((99m)Tc-MDP) and histochemistry. Eight white rabbits (New Zealand, 12 weeks old) were used. The rabbits were divided into 2 groups: 6 weeks and 12 weeks. Teeth were extracted unilaterally in each rabbit under general anesthesia. Six and 12 weeks after extraction, scintigraphy was conducted, and the rabbits were killed and their masseter muscles removed for histochemical analysis.

RESULTS

The results of bone metabolism (relative ratio) measured by bone scintigraphy were 48.27% at extraction sites and 51.73% at nonextraction sites at 6 weeks and 39.96% at extraction sites and 60.04% at nonextraction sites at 12 weeks. There was a significant difference at 12 weeks (P < .05). Tissue calcium contents and osteoclast counts showed different results between the extraction and nonextraction sites, but these differences did not reach statistical significance.

CONCLUSIONS

The bone metabolism of temporomandibular joints and histochemical aspects of masticatory muscles may be associated with occlusal alterations following tooth loss.

Age-related adaptation of bone-PDL-tooth complex: Rattus-Norvegicus as a model system

Functional loads on an organ induce tissue adaptations by converting mechanical energy into chemical energy at a cell-level. The transducing capacity of cells alters physico-chemical properties of tissues, developing a positive feedback commonly recognized as the form-function relationship. In this study, organ and tissue adaptations were mapped in the bone-tooth complex by identifying and correlating biomolecular expressions to physico-chemical properties in rats from 1.5 to 15 months. However, future research using hard and soft chow over relevant age groups would decouple the function related effects from aging affects. Progressive curvature in the distal root with increased root resorption was observed using micro X-ray computed tomography. Resorption was correlated to the increased activity of multinucleated osteoclasts on the distal side of the molars until 6 months using tartrate resistant acid phosphatase (TRAP). Interestingly, mononucleated TRAP positive cells within PDL vasculature were observed in older rats. Higher levels of glycosaminoglycans were identified at PDL-bone and PDL-cementum entheses using alcian blue stain. Decreasing biochemical gradients from coronal to apical zones, specifically biomolecules that can induce osteogenic (biglycan) and fibrogenic (fibromodulin, decorin) phenotypes, and PDL-specific negative regulator of mineralization (asporin) were observed using immunohistochemistry. Heterogeneous distribution of Ca and P in alveolar bone, and relatively lower contents at the entheses, were observed using energy dispersive X-ray analysis. No correlation between age and microhardness of alveolar bone (0.7 ± 0.1 to 0.9 ± 0.2 GPa) and cementum (0.6 ± 0.1 to 0.8 ± 0.3 GPa) was observed using a microindenter. However, hardness of cementum and alveolar bone at any given age were significantly different (P<0.05). These observations should be taken into account as baseline parameters, during development (1.5 to 4 months), growth (4 to 10 months), followed by a senescent phase (10 to 15 months), from which deviations due to experimentally induced perturbations can be effectively investigated.

Assessment of the effect of the use of laser light or dantrolene on facial muscle under occlusal wear: a Raman spectroscopic study in a rodent model

OBJECTIVE

The aim of the present study was to use Raman spectroscopy to measure levels of CaPi in muscles under occlusal wear and treated with laser phototherapy (LPT) or muscle-relaxant therapy or both on rodents.

BACKGROUND

The etiology of temporomandibular disorders is multifactorial. Malocclusion may influence the masticatory muscles, causing fatigue. A major type of fatigue is the metabolic, caused by the increased accumulation of metabolites such as inorganic phosphate. Raman spectroscopy allows nondestructive analysis of the biochemical composition of tissues.

METHODS

The 30 male Wistar rats were randomly divided into three groups: occlusal wear (G-1), occlusal wear + LPT (G-2), and occlusal wear + muscle relaxant (G-3). Ten untreated animals were used for baseline data. Under intraperitoneal general anesthesia, animals of groups 1, 2, and 3 had unilateral amputation of molar cusps to simulate an occlusal-wear situation. The masseter muscle of G-2 received LPT (lambda830 nm, 4 J/cm(2), 40 mW, phi approximately 2 mm) after the procedure and repeated every other day for 14-30 days. Animals of G-3 were treated with a daily injection of dantrolene (2.5 mg/kg in 0.5 ml of H(2)O) beginning 24 h after cusp removal. Animals were killed with an overdose of general anesthetics at days 14 and 30 after cusps removal, and the ipsilateral masseter muscle was excised and divided into two parts. One part was routinely processed and underwent histologic analysis; the other was kept in liquid nitrogen for Raman spectroscopy. The mean value of the intensity of the peak 958 per centimeter was determined.

RESULTS

No morphologic changes were seen. Raman analysis showed significantly less Raman intensity in the laser group at 30 days (p < 0.01).

CONCLUSION

Occlusal wear did not caused morphologic alterations in the masseter muscle but resulted in changes of the levels of CaP(i) that were less compromising when the laser light was used.

Two-body wear of artificial acrylic and composite resin teeth in relation to antagonist material

STATEMENT OF PROBLEM

Wear resistance is one of the most important physical properties of artificial resin teeth, and its dependence on the antagonist material has not been clearly established.

PURPOSE

The purpose of this in vitro study was to investigate the wear resistance of representative artificial resin teeth in relation to antagonist material.

MATERIAL AND METHODS

Twenty-four standardized specimens were prepared for each of 8 tooth types representative of anterior and posterior artificial acrylic and composite resin teeth (Gnathostar, SR Orthosit PE, Condyloform II NFC, SR Postaris DCL, SR Vivodent PE, VITA Physiodens, SR Antaris DCL, Bioplus), for a total of 192 specimens. Each specimen was prepared to a diameter of 5 mm and a thickness of 2 mm on the buccal/facial tooth surfaces. The specimens were then polished and subjected to simulated mastication (50 N, 1.2 x 10(5) cycles, 1.2 Hz) using a pin-on-block design and additional thermocycling (600 cycles, 5/55 degrees C, 2 min/cycle). Three antagonists (artificial resin teeth, steel, steatite) were prepared, and 8 specimens per tooth type were tested for each antagonist. Vertical substance and volume loss were analyzed using cast replicas and an optical 3-dimensional (3-D) surface profilometer, as well as scanning electron microscopy. Data were analyzed using 2- and 1-way ANOVA and the Games-Howell test (alpha=.05).

RESULTS

For both vertical substance and volume loss, significant differences were found for the various antagonists. Lowest overall mean values (SD) for vertical substance and volume loss were measured for artificial tooth antagonists (26 (10) microm to 95 (46) microm, 1.5 (1.5) microm(3) to 10.5 (9) microm(3)), and the highest values were measured for steatite antagonists (95 (23) microm to 723 (168) microm, 8 (4) microm(3) to 245 (109) microm(3)). Intermediate mean values (SD) for vertical substance and volume loss were measured for steel antagonists (118 (88) microm to 205 (120) microm, 9 (7) microm(3) to 28 (24) microm(3)). Using artificial teeth and steel antagonists, few significant differences in wear resistance were found between the various resin teeth. In contrast, significant differences were observed with steatite antagonists.

CONCLUSIONS

The use of steatite antagonists allowed for significantly better differentiation of wear behavior between various artificial teeth than the use of artificial resin teeth or steel antagonists.

Experimental occlusal interference induces long-term masticatory muscle hyperalgesia in rats

Temporomandibular joint or related masticatory muscle pain represents the most common chronic orofacial pain condition. Patients frequently report this kind of pain after dental alterations in occlusion. However, lack of understanding of the mechanisms of occlusion-related temporomandibular joint and muscle pain prevents treating this problem successfully. To explore the relationship between improper occlusion (occlusal interference) and masticatory muscle pain, we created an occlusal interference animal model by directly bonding a crown to a maxillary molar to raise the masticating surface of the tooth in rats. We raised the occlusal surface to three different heights (0.2, 0.4, and 0.6mm), and for one month we quantitatively measured mechanical nociceptive thresholds of the temporal and masseter muscles on both sides. Results showed a stimulus-response relationship between the height of occlusal interference and muscle hyperalgesia. Removal of the crown 6 days after occlusal interference showed that the removal at this time could not terminate the 1 month duration of mechanical hyperalgesia in the masticatory muscles. Lastly, we systemically administered NMDA antagonist MK801 (0.2, 0.1, and 0.05 mg/kg) to the treated rats and found that MK801 dose dependently attenuated the occlusal interference-induced hyperalgesia. These findings suggest that occlusal interference is directly related to masticatory muscle pain, and that central sensitization mechanisms are involved in the maintenance of the occlusal interference-induced mechanical hyperalgesia.

Wear of feldspathic ceramic, nano-filled composite resin and acrylic resin artificial teeth when opposed to different antagonists

The aim of this study was to evaluate the wear of denture teeth and their antagonists produced by two-body and three-body wear tests. Three types of denture teeth, namely feldspathic ceramic (FC), nano-filled composite resin (NCR), and experimental acrylic resin teeth (AR), were tested. For each type two groups of eight upper premolars each were prepared. The first group was tested against cusps from the same material and the second group was tested against human enamel cusps. Each group was loaded with a total of 200,000 chewing cycles (two-body wear 100,000 cycles and three-body wear 100,000 cycles). Wear was analyzed by measuring the maximum depth and volume loss of the denture teeth using a laser scanner and by measuring the vertical loss of the antagonists using an optical macroscope. Statistically, there was no significant difference between the following combinations: FC-FC and NCR-NCR regarding the vertical and volume loss; and FC-enamel and NCR-enamel regarding the total vertical substance loss. The combinations AR-AR and AR-enamel showed higher wear values than the other combinations. For complete dentures, composite resin and ceramic teeth showed similar vertical and volume loss, whereas composite resin teeth seemed to be more suitable for partial dentures opposing natural teeth in terms of wear of teeth and antagonists.

Ultrastructural and biochemical changes of the medial pterygoid muscle induced by unilateral exodontia

The aim of the present study was to investigate the histological, biochemical and ultrastructural effects of occlusal alteration induced by unilateral exodontia on medial pterygoid muscle in guinea pigs, Cavia porcellus. Thirty (n=30) male guinea pigs (450g) were divided into two groups: experimental-animals submitted to exodontia of the left upper molars, and sham-operated were used as control. The duration of the experimental period was 60 days. Medial pterygoid muscles from ipsilateral and contralateral side were analyzed by histological (n=10), histochemical (n=10), and ultrastructural (n=10) methods. The data were submitted to statistical analysis. When the ipsilateral side was compared to the control group, it showed a significantly shorter neuromuscular spindle length (P<0.05), lower oxidative metabolic activity, and microvessel constriction, in spite of the capillary volume and surface density were not significantly different (P>0.05). In the contralateral side, the neuromuscular spindles showed significantly shorter length (P<0.05), the fibers reflected a higher oxidative capacity, the blood capillaries showed endothelial cell emitting slender sprouting along the pre-existing capillary, and significantly higher blood capillary surface density, and volume density (V(v)=89% Mann-Whitney test, P<0.05). This finding indicated a complex morphological and functional medial pterygoid muscle adaptation to occlusal alteration in this experimental model. Considering that neuromuscular spindles are responsible for the control of mandibular positioning and movements, the professional should consider if these changes interfere in the success of clinical procedures in medical field involving stomatognathic structures.

Occlusal tooth wear in female F344/N rats with aging

OBJECTIVES

This study was conducted to ascertain whether laboratory rats are an adequate animal model for aging oral cavity research, especially on occlusal tooth wear (OTW), which progresses with aging and causes abnormal occlusions. Mastication has been reported to relate to cognition in the elderly. Thus, it is important to care for the oral cavity, especially in the frail elderly, for the maintenance of all-round quality of life. Adequate and appropriate animal models are essential for basic and clinical research on the oral cavity.

METHODS

Dried maxilla and mandible specimens from 98 young, aging or aged female F344/N rats were used.

RESULTS

The levels of OTW of all molars were monitored with aging. The molar tooth began to wear at 1-month old (M) and progressed rapidly till 12M. Subsequently, OTW progressed slowly till 30M, and then rapidly again after 35M.

CONCLUSIONS

This study showed that progress of OTW is well correlated with the entire life span of the rat, and suggested that the rat aged over 12M would be an adequate animal model for research on OTW in middle-aged and elderly people.

Heterogeneous activation of the medial pterygoid muscle during simulated clenching

The aim of this study was to investigate whether the medial pterygoid muscle shows differential activation under experimental conditions simulating force generation during jaw clenching. To answer this question, the electromyographic activity of the right medial pterygoid was recorded with two intramuscular electrodes placed in an anterior and posterior muscle region, respectively. Intraoral force transfer and force measurement were achieved by a central bearing pin device equipped with strain gauges. The activity distribution in the muscle was recorded in a central mandibular position during generation of eight different force vectors at a constant amount of force (F=150 N). The investigated muscle regions showed different amounts of EMG activity. The relative intensity of the activation in the two regions changed depending on the task. In other words, the muscle regions demonstrated heterogeneous changes of the EMG pattern for various motor tasks. The results indicate a heterogeneous activation of the medial pterygoid muscle under test conditions simulating force generation during clenching. This muscle behaviour might offer an explanatory model for the therapeutic effects of oral splints.

In vitro wear resistance of three types of composite resin denture teeth

STATEMENT OF PROBLEM

The wear resistance of artificial teeth is important to the life of the removable prosthesis for the edentulous patient. The ability of artificial teeth to maintain a stable occlusal relationship over time may be influenced by this property.

PURPOSE

The purpose of this in vitro study was to evaluate the wear resistance of artificial teeth based on composite resin filler content when opposed by a denture tooth antagonist.

MATERIAL AND METHODS

The right first molars (both maxillary and mandibular) of 3 composite resin denture teeth (Endura, 47% organic filler; Duradent, 42% organic and inorganic filler; and Duracross, 68% organic filler) were secured in an in vitro 2-body wear-testing apparatus that simulated masticatory function (60 strokes/min, grinding distance of 2 mm, under 37 degrees C flowing water). Wear resistance was assessed as volume loss (mm3) and height loss (mm) at 5 kgf (grinding force) after 50,000 strokes (6 pairs for each type). The Vickers microhardness (VHN) of the occlusal surfaces was measured with a load of 50 g and a loading time of 30 seconds. After testing, the worn surfaces were observed with a scanning electron microscope (SEM). Mean values were analyzed using a 1-way analysis of variance followed by the Fisher test (alpha=.05).

RESULTS

The volume loss of Duradent teeth (0.87 +/- 0.03 mm3) was significantly higher than of the 2 other types of teeth tested (P<.001). The Duracross teeth (0.22 +/- 0.08 mm3 and 0.11 +/- 0.04 mm) exhibited the best wear resistance of the denture teeth tested. The wear resistance of the materials tested was consistent with their hardness (Endura 27.54 +/- 0.67 VHN, Duradent 24.00 +/- 0.60 VHN, Duracross 39.64 +/- 3.11 VHN). SEM observation showed that many filler particles were missing from the matrix of Duradent.

CONCLUSION

The wear resistance among the 3 types of teeth was significantly different; Duracross and Endura were more wear resistant than Duradent. Although the densities as reported by the manufacturer were similar, hardness and microstructure were the primary factors affecting the wear resistance of artificial teeth. Hardness appears to correlate with wear resistance since the wear resistance of Duradent with a lower VHN of 24 was greater than the other 2 types of teeth with greater hardness.

Effects of soft diet on rat masseter muscle mitochondrial development

There is not fine information regarding the influence of diet on development of masseter muscle and its mitochondria. Objective of this study is to compare mitochondrial enzyme activity, and morphology of masseter muscle fiber cells and its mitochondria prepared from rats fed soft diet to those fed hard diet. Cross-sectional area of fiber cells and number of mitochondria per unit area prepared from rats fed hard diet were greater than those of animals fed soft diet on postnatal day 60, and these differences decreased under both feeding conditions on days 120. Structure of mitochondrial cristae of rat fed hard diet was clear but that of fed soft diet ambiguous and contains many halos. Mitochondrial succinate-O2 and NADH-O2 oxidoreductase activities isolated from rats fed hard diet were higher than those of soft diet group over the period from days 30, and differences in both diet groups became the largest on days 60, and decreased on days 120. Our results indicated that development of masseter muscle fiber cells and mitochondria is hindered when rats are fed soft diet, but recover partially later, and hard diet is required for normal development of masseter muscle.

Nicotine Effects on Alveolar Bone Changes Induced by Occlusal Trauma: A Histometric Study in Rats

BACKGROUND

The aim of the present study was to verify nicotine effects on alveolar bone changes induced by occlusal trauma during a periodontitis experimental model in rats.

METHODS

Thirty adult male rats were used. The animals were randomly assigned to one of three groups receiving daily intraperitoneal injections: A, nicotine solution (0.44 mg/ml) and occlusal overload; B, saline solution and occlusal overload; or C, saline solution. Rats from groups A and B underwent bilateral amputation of the second and third molar cusps to simulate an occlusal overload. The first molars were then randomly assigned to receive a cotton ligature in the sulcular area, while the contralateral tooth was left unligated. The animals were sacrificed 30 days later. The resected mandibles were processed, and histomorphometric measurements were performed in the alveolar bone adjacent to the furcation area of the first molars.

RESULTS

Nicotine enhanced the bone loss induced by occlusal trauma (P<0.001) on the ligated teeth of group A (12.27 +/- 4.4 mm2), when compared to groups B (8.43 +/- 3.51 mm2) and C (4.43 +/- 2.17 mm2). Alveolar bone loss (P<0.01) was also observed in the contralateral teeth of groups A (nicotine + trauma) and B (saline + trauma), when compared to group C (saline only).

CONCLUSION

Within the limits of the study, it is concluded that nicotine may influence the alveolar bone changes induced by occlusal trauma by enhancing bone loss.

Antero-posterior activity changes in the superficial masseter muscle after exposure to experimental pain

The aim of this randomized, controlled, double-blind study was to examine how the activation pattern of the masseter muscle changes during natural function when experimental pain is induced in a discrete anterior area of the muscle. In 20 subjects, three bipolar surface electrodes and three intramuscular fine-wire electrodes (antero-posterior mapping) were simultaneously attached above and in the right masseter muscle to record the electromyographic (EMG) activity during unilateral chewing before and after infusion of a 0.9% isotonic and 5% hypertonic saline bolus in the anterior area of the muscle. The activity of the contralateral masseter muscle was registered by surface electrodes. In addition, the development of pain intensity was quantitatively measured with a numerical rating scale (NRS). While both saline concentrations caused pain, the hypertonic solution evoked stronger pain. The experiments also provided evidence of a significant although differential activity reduction of the ipsilateral masseter muscle in the antero-posterior direction. The activity reduction decreased with increasing distance from the location of the infusion. The results support the idea that the strategy of differential activation protects the injured muscle while simultaneously maintaining optimal function.

Dantrolene counteracts the masseter muscle damage induced by artificial occlusal wear: studies in a rat model

In previous studies, we showed that the introduction of occlusal alterations to rats results in masseter muscle abnormalities. Here, we investigate whether administration of the muscle relaxant dantrolene to rats with occlusal alteration could counteract the occurrence of such abnormalities. Rats underwent unilateral amputation of molar cusps to cause malocclusion. Some rats received dantrolene (10 mg/kg/day subcutaneously). The masseter muscles ipsilateral to the amputated molars were excised 26 days later. Sham-operated rats were used as controls. The tissue samples were studied by light and electron microscopy and morphometry. Moreover, tissue Ca2+ content, an index of muscle injury, was determined. In the absence of dantrolene, occlusal alteration leads to microvessel constriction, morphologic damage of masseter muscle fibers and blood capillaries, and elevation of tissue Ca2+ content. These changes were nearly abrogated by dantrolene, thus supporting it as a possible new therapeutic tool for the treatment of malocclusion-induced muscle diseases.