Reflex control of human jaw muscles

The Feel of Speech: Multisystem and Polymodal Somatosensation in Speech Production

PURPOSE

The oral structures such as the tongue and lips have remarkable somatosensory capacities, but understanding the roles of somatosensation in speech production requires a more comprehensive knowledge of somatosensation in the speech production system in its entirety, including the respiratory, laryngeal, and supralaryngeal subsystems. This review was conducted to summarize the system-wide somatosensory information available for speech production.

METHOD

The search was conducted with PubMed/Medline and Google Scholar for articles published until November 2023. Numerous search terms were used in conducting the review, which covered the topics of psychophysics, basic and clinical behavioral research, neuroanatomy, and neuroscience.

RESULTS AND CONCLUSIONS

The current understanding of speech somatosensation rests primarily on the two pillars of psychophysics and neuroscience. The confluence of polymodal afferent streams supports the development, maintenance, and refinement of speech production. Receptors are both canonical and noncanonical, with the latter occurring especially in the muscles innervated by the facial nerve. Somatosensory representation in the cortex is disproportionately large and provides for sensory interactions. Speech somatosensory function is robust over the lifespan, with possible declines in advanced aging. The understanding of somatosensation in speech disorders is largely disconnected from research and theory on speech production. A speech somatoscape is proposed as the generalized, system-wide sensation of speech production, with implications for speech development, speech motor control, and speech disorders.

Effects of occlusal conditions on masseter and temporalis muscle activity: An electromyographic evaluation

Introduction

Dental occlusion contributes to the development of temporomandibular disorder.

Objective

This case control study examined the influence of different occlusal conditions on the surface electromyography (sEMG) of the superficial part of the masseter muscle (MM) and anterior part of the temporalis muscle (TA) during clenching in the maximum intercuspal position (MIP).

Materials and methods

Twelve healthy subjects had their anterior, right posterior, or left posterior teeth added by composite resin to generate the bilateral posterior, unilateral left, or unilateral right posterior tooth losses, respectively. Muscle activity in the resting stage, MM's and TA's maximum voluntary clenching (MVC; µV) in MIP, each muscle activity's symmetry (%), and ipsilateral MM and TA synergy (%) were measured by sEMG. All parameters were analyzed by SPSS version 23.0, and the significance level was set at p < 0.05.

Results

The MM's and TA's sEMG activity at the resting stage significantly differed from those at the other occlusal conditions (p < 0.05). Both muscles' MVC were highest at the MIP during clenching but lowest during anterior clenching. During unilateral posterior clenching, such MVC was higher at the occluding than at the non-occluding sides. The TA's symmetry during clenching at the anterior and unilateral posterior teeth was lower than that at the MIP during clenching. No significant difference was seen in the ipsilateral MM and TA synergy.

Conclusion

Different occlusal conditions influenced the MM's and TA's sEMG activity. Each masticatory muscle responded differently to the same occlusal conditions.

Tactile sensation of natural teeth and dental implants in the somatosensory cortex

PURPOSE

This study aimed to investigate the cortical response characteristics evoked by natural teeth and implants.

METHODS

Five cats were subjected to intrinsic signal optical imaging to measure the cortical responses evoked by natural teeth and implants. The difference in tactile sensation between the implant and natural tooth was compared in detail at the cortical response level.

RESULTS

Some similarities were observed between the implants and natural teeth. The stimulating-response curves of the implants and natural teeth were generally S-curves, and both implants and natural teeth preferred labial-lingual direction stimulation. The implants and natural teeth differed in terms of their tactile sensitivity: implants were weaker than natural teeth in terms of both static and dynamic sensitivity. However, after saturation, there was no significant difference in tactile strength between implants and natural teeth.

CONCLUSIONS

Both natural teeth and implants are able to distinguish the tactile strength and stimulation direction. Although implants are less sensitive than the natural tooth, the maximal tactile function and directional preference of implants are similar to those of natural teeth.

Consensus on the terminologies and methodologies for masticatory assessment

A large number of methodological procedures and experimental conditions are reported to describe the masticatory process. However, similar terms are sometimes employed to describe different methodologies. Standardisation of terms is essential to allow comparisons among different studies. This article was aimed to provide a consensus concerning the terms, definitions and technical methods generally reported when evaluating masticatory function objectively and subjectively. The consensus is based on the results from discussions and consultations among world‐leading researchers in the related research areas. Advantages, limitations and relevance of each method are also discussed. The present consensus provides a revised framework of standardised terms to improve the consistent use of masticatory terminology and facilitate further investigations on masticatory function analysis. In addition, this article also outlines various methods used to evaluate the masticatory process and their advantages and disadvantages in order to help researchers to design their experiments.

Effects of preventing intercuspation on the precision of jaw movements

BACKGROUND

Closing movements are among the jaw's basic physiological motor actions. During functional movements, the jaw changes position continually, which requires appropriate proprioception. However, the significance of the various proprioceptive receptors involved and how they interact is not yet fully clear.

OBJECTIVES

This study's main objective was to test whether preventing intercuspation (IC) for 1 week would affect the precision of jaw-closing movements into IC and the functional space of habitual chewing movements (HCM). A secondary objective was to compare precision of jaw-closing movements into IC with the precision of movements into a target position (TP) far from IC.

METHODS

Fourteen participants' HCM and jaw-closing movements into IC were recorded on two sessions (T1 and T2) 1 week apart. Between sessions, participants wore posterior bite plates to prevent IC. They also received a 10-minute training session at T1 to guide their jaw-closing movements into TP. The precision of the closing movements into IC and TP was analysed. For HCM, the vertical amplitude, lateral width and area of chewing cycles were evaluated.

RESULTS

The precision of jaw movements into IC increased as the jaw gap decreased, but precision did not differ significantly between T1 and T2. For HCM, the vertical amplitude and area of chewing cycles increased significantly between T1 and T2. The precision of the closing trajectory into TP increased significantly during the training session.

CONCLUSION

Our results confirm the excellent adaptability of the craniomandibular system, controlled by stringent motor programmes that are supported by continuous peripheral sensory input.

The reciprocal jaw-muscle reflexes elicited by anterior- and back-tooth-contacts-a perspective to explain the control of the masticatory muscles

AIMS

Tooth-contact sensations are considered essential to boost jaw adductor muscles during mastication. However, no previous studies have explained the importance of the inhibitory reflex of human anterior-tooth (ANT)-contacts in mastication. Here I present the "reciprocal reflex-control-hypothesis" of mammalian mastication.

SUBJECTS AND SETTING OF THE STUDY

I demonstrate the hypothesis with the live kinematics of free jaw-closures as inferred from T-Scan recordings of dental patients.

RESULTS

The jaw-closures started with negligible force, predominantly with ANT-contacts (the AF-bites). The first ANT-contact inhibited the first kinematic tilt of the mandible, whereas the bites starting from a back-tooth (BAT)-contact (the BF-bites) accelerated the first tilt. The second tilt established a low-force static tripod of the ANT- and bilateral BAT-contacts for a fixed mandible-maxilla relation. Thereafter, semi-static bite force increased rapidly, relatively more in the BAT-area.

DISCUSSION AND CONCLUSIONS

In the vertical-closure phase of chewing, the primate joint-fulcrum (class 3 lever) conflicts with the food-bolus-fulcrum in the BAT-area (class 1 lever). The resilient class 3 and 1 lever systems are superseded by an almost static mechanically more advantageous class 2 lever with a more rigid fulcrum at the most anterior ANT-contact. For humans, the class 2 levered delivery of force also enables forceful horizontal food grinding to be extended widely to the BAT-area.

Exploring the receptor origin of vibration-induced reflexes

STUDY DESIGN

An experimental design.

OBJECTIVES

The aim of this study was to determine the latencies of vibration-induced reflexes in individuals with and without spinal cord injury (SCI), and to compare these latencies to identify differences in reflex circuitries.

SETTING

A tertiary rehabilitation center in Istanbul.

METHODS

Seventeen individuals with chronic SCI (SCI group) and 23 participants without SCI (Control group) were included in this study. Latency of tonic vibration reflex (TVR) and whole-body vibration-induced muscular reflex (WBV-IMR) of the left soleus muscle was tested for estimating the reflex origins. The local tendon vibration was applied at six different vibration frequencies (50, 85, 140, 185, 235, and 265 Hz), each lasting for 15 s with 3-s rest intervals. The WBV was applied at six different vibration frequencies (35, 37, 39, 41, 43, and 45 Hz), each lasting for 15 s with 3-s rest intervals.

RESULTS

Mean (SD) TVR latency was 39.7 (5.3) ms in the SCI group and 35.9 (2.7) ms in the Control group with a mean (95% CI) difference of -3.8 (-6.7 to -0.9) ms. Mean (SD) WBV-IMR latency was 45.8 (7.4) ms in the SCI group and 43.3 (3.0) ms in the Control group with a mean (95% CI) difference of -2.5 (-6.5 to 1.4) ms. There were significant differences between TVR latency and WBV-IMR latency in both the groups (mean (95% CI) difference; -6.2 (-9.3 to -3.0) ms, p = 0.0001 for the SCI group and -7.4 (-9.3 to -5.6) ms, p = 0.011 for Control group).

CONCLUSIONS

The results suggest that the receptor of origin of TVR and WBV-IMR may be different.

Mandibular prognathism attenuates brain blood flow induced by chewing

Mastication is closely related to brain function. Animal experiments have revealed that tooth loss has a negative influence on brain function. Clinical studies also suggest that normal occlusion is an essential factor for favorable brain function. Mandibular prognathism (MP) usually results in occlusal dysfunction. However, the relationship between MP and brain function remains unclear. In the present study, we examined the relationship between MP and brain function by measuring brain blood flow (BBF). Seventeen subjects with normal occlusion (NORM) and 25 patients with MP participated in this study. The number of occlusal contacts were counted. Electromyography of the masseter muscles during clenching was also recorded. BBF was measured with non-invasive functional near-infrared spectroscopy during calculation task and chewing task. The number of the occlusal contacts and masseter muscle activity were lower in MP compared with NORM. The calculation task increased BBF in both groups. The chewing task also increased BBF in the inferior frontal gyrus in both groups, although the increase in MP was smaller than in NORM. We discovered that patients with MP exhibited a smaller increase in BBF at the inferior frontal gyrus during chewing as compared with NORM. As such, MP would negatively affect brain function.

Effects of Chronic and Experimental Acute Masseter Pain on Precision Biting Behavior in Humans

Chronic pain in the orofacial region is common worldwide. Pain seems to affect the jaw motor control. Hence, temporomandibular disorders (TMD) are often accompanied by pain upon chewing, restricted mouth opening and impaired maximal bite forces. However, little is known on the effects of pain, in particular the effects of chronic jaw muscle pain on precision biting. The aim of the study was to investigate the effect of chronic and acute jaw muscle pain on oral motor control during precision biting in humans. Eighteen patients with chronic masseter muscle pain and 18 healthy participants completed the experiment. All participants were examined according to the Diagnostic Criteria for TMD. Experimental acute pain was induced by bilateral, simultaneous sterile hypertonic saline infusions into the healthy masseter muscles. A standardized hold and split biting task was used to assess the precision biting. The data was analyzed with non-parametric statistical tests. The results showed no significant differences in the hold forces, split forces, durations of split or peak split rates within or between the pain and pain-free conditions. The mean split rate increased significantly compared to baseline values both in the chronic patients and the pain-free condition. However, this increase was not evident in the experimental acute pain condition. Further, there were no significant differences in the mean split rates between the conditions. The data suggest that jaw muscle pain does not seem to alter precision biting in humans, however, the possibility that a nociceptive modulation of spindle afferent activity might have occurred but compensated for cannot be ruled out.

[Assessment of postural control and balance in persons with temporomandibular disorders: A systematic review]

The stomatognathic system is the anatomo-functional unit of the cranio-cervico-facial region. Some dysfunctions affect its motor control. The aim of this study was to analyse the clinical usefulness of the various scales and instruments used in the assessment of postural control in people with temporomandibular disorders. A systematic review was carried out by 2independent reviewers in the PubMed, Medline, Ebsco, Science Direct and PEDro databases, selecting observational studies published between January 2006 and March 2017. The risk of bias and methodological quality was analysed following Cochrane indications and the Downs and Black quality scale. Ten studies were included, of which 9used computerised platforms, one added photogrammetry and one used electromyography. Seven studies were classified as moderate quality and 3as low quality. Posturography was the most widely used assessment instrument. Methodological differences did not allow determination of their clinical implications or the relationship between balance and the presence of temporomandibular disorders.

Chiropractic Manipulation Increases Maximal Bite Force in Healthy Individuals

Recent research has shown that chiropractic spinal manipulation can alter central sensorimotor integration and motor cortical drive to human voluntary muscles of the upper and lower limb. The aim of this paper was to explore whether spinal manipulation could also influence maximal bite force. Twenty-eight people were divided into two groups of 14, one that received chiropractic care and one that received sham chiropractic care. All subjects were naive to chiropractic. Maximum bite force was assessed pre- and post-intervention and at 1-week follow up. Bite force in the chiropractic group increased compared to the control group (p = 0.02) post-intervention and this between-group difference was also present at the 1-week follow-up (p < 0.01). Bite force in the chiropractic group increased significantly by 11.0% (&plusmn;18.6%) post-intervention (p = 0.04) and remained increased by 13.0% (&plusmn;12.9%, p = 0.04) at the 1 week follow up. Bite force did not change significantly in the control group immediately after the intervention (&minus;2.3 &plusmn; 9.0%, p = 0.20), and decreased by 6.3% (&plusmn;3.4%, p = 0.01) at the 1-week follow-up. These results indicate that chiropractic spinal manipulation can increase maximal bite force.

Reevaluation of reflex responses of the human masseter muscle to electrical lip stimulation

We examined the reflex response of the human masseter muscle to electrical stimulation of the lip using both single motor unit and surface electromyogram based methods. Using the classical analysis methods, reflex response to mild electrical stimuli generated two distinct short-lasting inhibitions. This pattern may reflect the development of combinations of short- and long-latency inhibitory postsynaptic potentials as a result of the mildly painful electrical lip stimulation. However, this pattern appearing in the classical analysis methods may have developed as a consequence of earlier responses and may not be genuine. This study examined the genuineness of these responses using both the classical analysis methods and the discharge rate method to uncover the realistic postsynaptic potentials in human trigeminal motor nucleus. Using the discharge rate method, we found that the electrical lip stimulation only generated a long-lasting single or compound inhibitory response that is followed by late, long-lasting excitation. These findings have important implications on the redrawing of the neuronal pathways of the trigeminal nerve that are frequently used to judge neuromuscular disorders of the trigeminal region.NEW & NOTEWORTHY We examined the human masseter reflex response to electrical stimulation of lower lip to uncover realistic postsynaptic potentials in the trigeminal motor nucleus. We found that the stimulation generates a long-lasting single or compound inhibitory response that is followed by a late, long-lasting excitation. These findings have important implications on the redrawing of the neuronal pathways of the trigeminal nerve that are frequently used to judge neuromuscular disorders of the trigeminal region.

The influence of food consistency on chewing rate and muscular work

Food properties influence the parameters of the masticatory process, such as jaw movement, muscle activity and chewing rate. Firm foods will require more muscle activity than softer foods. However, the influence of food hardness on chewing rate is ambiguous as both slower and higher chewing rates have been reported for harder foods. Rheological characteristics of the food, such as plasticity and elasticity, may help to explain differences in chewing rate. The aim of our study was to determine the influence of food properties on chewing rate and muscular work in five phases of a chewing sequence. Eighty-four participants chewed on five foods, which strongly differed in consistency. Chewing gum was used as a reference food. The phase in the chewing sequence had a large significant effect on cycle duration for the five foods. A significant decrease in cycle duration at the beginning of chewing was followed by an increase in later phases, leading to U-shaped curves. Food type had a small effect on the average cycle duration. However, large significant differences in cycle duration were observed between the foods at the beginning of a chewing sequence. In that phase, the firm foods were chewed much slower than the soft foods. Muscular work was significantly influenced by both chewing phase and food type.

Natural mediotrusive contact: does it affect the masticatory and neck EMG activity during tooth grinding?

OBJECTIVES

There is scarce knowledge regarding the influence of a natural mediotrusive contact on mandibular and cervical muscular activity. The purpose of this study was to analyze the EMG activity of the anterior temporalis (AT) and sternocleidomastoid (SCM) muscles during awake grinding in healthy subjects with or without a natural mediotrusive occlusal contact.

METHOD

Fifteen subjects with natural mediotrusive occlusal contact (Group 1) and 15 subjects without natural mediotrusive occlusal contact (Group 2) participated. Bilateral surface EMG activity of AT and SCM muscles was recorded during unilateral eccentric or concentric tooth grinding tasks. EMG activity was normalized against the activity recorded during maximal voluntary clenching in intercuspal position (IP) for AT muscles and during maximal intentional isometric head-neck rotation to each side, for SCM muscles.

RESULTS

EMG activity of AT and SCM muscles showed no statistical difference between groups. EMG activity of AT muscle was higher in the working side (WS) than in the non-WS (NWS) in Group 1 during concentric grinding (0.492 vs 0.331, p = 0.047), whereas no difference was observed in Group 2. EMG activity of SCM was similar between working and NWSs in both groups and tasks. Asymmetry indexes (AIs) were not significantly different between groups.

DISCUSSION

These findings in healthy subjects support the assumption that during awake tooth grinding, central nerve control predominates over peripheral inputs, and reinforce the idea of a functional link between the motor-neuron pools that control jaw and neck muscles.

Markerless three-dimensional tracking of masticatory movement

Conventional methods for measuring mandibular movement are expensive and require headgear and a marker attached to the mandibular incisors. These make assessment of normal chewing difficult. The aim of the present study was to test the validity of a markerless three-dimensional system for tracking masticatory movement by comparing it with a conventional method using an incisal marker. The study investigated 100 chewing cycles in 10 participants. The jaw tracking system consisted of a camera capable of recording depth and red, green, and blue data simultaneously, a laptop computer, and data analysis software. Depth data for each participant's face, tracked in real time, produced a computed 3D mask. The most prominent point of the soft tissue under the lip was defined as the chin point. A dental clasp cemented to the labial surface of the mandibular incisors was defined as the incisal point. The movement of these two measuring points was simultaneously recorded during mastication of chewing gum for 20s. To conduct the same analysis on each cycle from the two measuring points, all cycles were normalized by dividing by the corresponding vertical displacement because of their size variation. The findings showed excellent intramethod correlation for normalized horizontal displacement at every level (>0.9; except for 2 out of 19 levels; 0.896 and 0.898), and a lack of proportional bias. These findings suggest a correlation between the chewing cycles from two measuring points, the incisor and the chin, further suggesting the feasibility of a markerless system for tracking masticatory movement.

Static balancing behaviour of the mandible

The objective of this study was to investigate the mechanisms of physiological control of the craniomandibular system during force-controlled biting: in intercuspation, restricted by predetermined anatomic-geometrical conditions [i.e. biting in intercuspation (BIC)]; and on a hydrostatic system [i.e. auto-balanced static equilibrium of the mandible (BAL)], in which the mandible is balanced under unrestricted occlusal conditions. For 20 healthy subjects, the spatial positions of the condyles, the lower molars, and the incisal point were measured, and the electromyographic (EMG) activity of the musculus masseter and musculus temporalis anterior were recorded bilaterally, during force-controlled biting (50, 75, 100 N) on a hydrostatic device. The results were compared with those obtained during BIC. During BAL, the neuromuscular system stabilizes one condyle, so it behaves as a virtual fulcrum, and all available biomechanical degrees of freedom of the opposite side are used to achieve a bilaterally equal vertical distance between the upper and lower dental arches. The variability of the positions of the molars was significantly smaller than for the condyles. The EMG co-contraction ratios calculated for homonymous muscle regions revealed significant differences between BIC and BAL, specifically, greater symmetry during BAL with substantial asymmetry of approximately 25% remaining. In conclusion, the results revealed precise neuromuscular control of the position of the lower dental arch; this information might form the basis for interference-free tracking of the mandible in intercuspation under different conditions.

Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis

BACKGROUND

Temporomandibular joint disorder (TMD) requires a complex diagnostic and therapeutic approach, which usually involves a multidisciplinary management. Among these treatments, musculoskeletal manual techniques are used to improve health and healing.

OBJECTIVES

To assess the effectiveness of musculoskeletal manual approach in temporomandibular joint disorder patients.

DESIGN

A systematic review with meta-analysis.

METHODS

During August 2014 a systematic review of relevant databases (PubMed, The Cochrane Library, PEDro and ISI web of knowledge) was performed to identify controlled clinical trials without date restriction and restricted to the English language. Clinical outcomes were pain and range of motion focalized in temporomandibular joint. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) and overall effect size were calculated at every post treatment. The PEDro scale was used to demonstrate the quality of the included studies.

RESULTS/FINDINGS

From the 308 articles identified by the search strategy, 8 articles met the inclusion criteria. The meta-analysis showed a significant difference (p < 0.0001) and large effect on active mouth opening (SMD, 0.83; 95% CI, 0.42 to 1.25) and on pain during active mouth opening (MD, 1.69; 95% CI, 1.09 to 2.30) in favor of musculoskeletal manual techniques when compared to other conservative treatments for TMD.

CONCLUSIONS

Musculoskeletal manual approaches are effective for treating TMD. In the short term, there is a larger effect regarding the latter when compared to other conservative treatments for TMD.

Effect of natural mediotrusive contact on electromyographic activity of jaw and cervical muscles during chewing

OBJECTIVE

This study evaluated the effect of a natural mediotrusive contact on the electromyographic (EMG) activity of the anterior temporalis and sternocleidomastoid muscles during chewing in healthy subjects.

MATERIALS AND METHODS

The study sample included two groups of 15 subjects each (Group 1: with natural mediotrusive contact; Group 2: without natural mediotrusive contact). Bilateral surface EMG activity was recorded on anterior temporalis and sternocleidomastoid muscles during unilateral chewing of a half cookie and unilateral chewing of a piece of apple. Anterior temporalis and sternocleidomastoid muscle activity was normalized against activity recorded during maximal voluntary clenching in intercuspal position and maximal intentional isometric head-neck rotation to each side, respectively. The partial and total asymmetry indexes were also calculated. Data were analyzed using Mann-Whitney, Wilcoxon and unpaired t-test.

RESULTS

EMG activity of anterior temporalis and sternocleidomastoid muscles showed no significant difference between the groups. EMG activity of anterior temporalis was similar between working and non-working sides during chewing in both groups. EMG activity of sternocleidomastoid muscle was higher in the working side than in the non-working side in Group 2 subjects. Asymmetry indexes were not significantly different between groups.

CONCLUSIONS

The similar EMG pattern and asymmetry indexes observed suggest the predominance of central nervous control over peripheral inputs on anterior temporalis and sternocleidomastoid motor neuron pools.

To see bruxism: a functional MRI study

OBJECTIVE

Since the pathophysiology of bruxism is not clearly understood, there exists no possible treatment. The aim of this study is to investigate the cerebral activation differences between healthy subjects and patients with bruxism on behalf of possible aetiological factors.

METHODS

12 healthy subjects and 12 patients with bruxism, a total of 24 right-handed female subjects (aged 20-27 years) were examined using functional MRI during tooth-clenching and resting tasks. Imaging was performed with 3.0-T MRI scanner with a 32-channel head coil. Differences in regional brain activity between patients with bruxism and healthy subjects (control group) were observed with BrainVoyager QX 2.8 (Brain Innovation, Maastricht, Netherlands) statistical data analysis program. Activation maps were created using the general linear model: single study and multistudy multisubject for statistical group analysis. This protocol was approved by the ethics committee of medical faculty of Kirikkale University, Turkey (02/04), based on the guidelines set forth in the Declaration of Helsinki.

RESULTS

The group analysis revealed a statistically significant increase in blood oxygenation level-dependent signal of three clusters in the control group (p<0.005), which may indicate brain regions related with somatognosis, repetitive passive motion, proprioception and tactile perception. These areas coincide with Brodmann areas 7, 31, 39 and 40. It is conceivable that there are differences between healthy subjects and patients with bruxism.

CONCLUSIONS

Our findings indicate that there was a decrease of cortical activation pattern in patients with bruxism in clenching tasks. This indicates decreased blood flow and activation in regional neuronal activity. Bruxism, as an oral motor disorder concerns dentistry, neurology and psychiatry. These results might improve the understanding and physiological handling of sleep bruxism.

Jaw tremor as a physiological biomarker of bruxism

OBJECTIVE

To determine if sleep bruxism is associated with abnormal physiological tremor of the jaw during a visually-guided bite force control task.

METHODS

Healthy participants and patients with sleep bruxism were given visual feedback of their bite force and asked to trace triangular target trajectories (duration=20s, peak force <35% maximum voluntary force). Bite force control was quantified in terms of the power spectra of force fluctuations, masseter EMG activity, and force-to-EMG coherence.

RESULTS

Patients had greater jaw force tremor at ∼8 Hz relative to controls, along with increased masseter EMG activity and force-to-EMG coherence in the same frequency range. Patients also showed lower force-to-EMG coherence at low frequencies (<3 Hz), but greater coherence at high frequencies (20-40 Hz). Finally, patients had greater 6-10 Hz force tremor during periods of descending vs. ascending force, while controls showed no difference in tremor with respect to force dynamics.

CONCLUSION

Patients with bruxism have abnormal jaw tremor when engaged in a visually-guided bite force task.

SIGNIFICANCE

Measurement of jaw tremor may aid in the detection/evaluation of bruxism. In light of previous literature, our results also suggest that bruxism is marked by abnormal or mishandled peripheral feedback from the teeth.

Biting intentions modulate digastric reflex responses to sudden unloading of the jaw

Reflex responses in jaw-opening muscles can be evoked when a brittle object cracks between the teeth and suddenly unloads the jaw. We hypothesized that this reflex response is flexible and, as such, is modulated according to the instructed goal of biting through an object. Study participants performed two different biting tasks when holding a peanut half stacked on a chocolate piece between their incisors. In one task, they were asked to split the peanut half only (single-split task), and in the other task, they were asked to split both the peanut and the chocolate in one action (double-split task). In both tasks, the peanut split evoked a jaw-opening muscle response, quantified from electromyogram (EMG) recordings of the digastric muscle in a window 20-60 ms following peanut split. Consistent with our hypothesis, we found that the jaw-opening muscle response in the single-split trials was about twice the size of the jaw-opening muscle response in the double-split trials. A linear model that predicted the jaw-opening muscle response on a single-trial basis indicated that task settings played a significant role in this modulation but also that the presplit digastric muscle activity contributed to the modulation. These findings demonstrate that, like reflex responses to mechanical perturbations in limb muscles, reflex responses in jaw muscles not only show gain-scaling but also are modulated by subject intent.

Task-dependent control of the jaw during food splitting in humans

Although splitting of food items between the incisors often requires high bite forces, rarely do the teeth harmfully collide when the jaw quickly closes after split. Previous studies indicate that the force-velocity relationship of the jaw closing muscles principally explains the prompt dissipation of jaw closing force. Here, we asked whether people could regulate the dissipation of jaw closing force during food splitting. We hypothesized that such regulation might be implemented via differential recruitment of masseter muscle portions situated along the anteroposterior axis because these portions will experience a different shortening velocity during jaw closure. Study participants performed two different tasks when holding a peanut-half stacked on a chocolate piece between their incisors. In one task, they were asked to split the peanut-half only (single-split trials) and, in the other, to split both the peanut and the chocolate in one action (double-split trials). In double-split trials following the peanut split, the intensity of the tooth impact on the chocolate piece was on average 2.5 times greater than in single-split trials, indicating a substantially greater loss of jaw closing force in the single-split trials. We conclude that control of jaw closing force dissipation following food splitting depends on task demands. Consistent with our hypothesis, converging neurophysiological and morphometric data indicated that this control involved a differential activation of the jaw closing masseter muscle along the anteroposterior axis. These latter findings suggest that the regulation of jaw closing force after sudden unloading of the jaw exploits masseter muscle compartmentalization.

Cutaneous and periodontal inputs to the cerebellum of the naked mole-rat (Heterocephalus glaber)

The naked mole-rat (Heterocephalus glaber) is a small fossorial rodent with specialized dentition that is reflected by the large cortical area dedicated to representation of the prominent incisors. Due to naked mole-rats’ behavioral reliance on the incisors for digging and for manipulating objects, as well as their ability to move the lower incisors independently, we hypothesized that expanded somatosensory representations of the incisors would be present within the cerebellum in order to accommodate a greater degree of proprioceptive, cutaneous, and periodontal input. Multiunit electrophysiological recordings targeting the ansiform lobule were used to investigate tactile inputs from receptive fields on the entire body with a focus on the incisors. Similar to other rodents, a fractured somatotopy appeared to be present with discrete representations of the same receptive fields repeated within each folium of the cerebellum. These findings confirm the presence of somatosensory inputs to a large area of the naked mole-rat cerebellum with particularly extensive representations of the lower incisors and mystacial vibrissae. We speculate that these extensive inputs facilitate processing of tactile cues as part of a sensorimotor integration network that optimizes how sensory stimuli are acquired through active exploration and in turn adjusts motor outputs (such as independent movement of the lower incisors). These results highlight the diverse sensory specializations and corresponding brain organizational schemes that have evolved in different mammals to facilitate exploration of and interaction with their environment.

Precision of jaw-closing movements for different jaw gaps

Jaw-closing movements are basic components of physiological motor actions precisely achieving intercuspation without significant interference. The main purpose of this study was to test the hypothesis that, despite an imperfect intercuspal position, the precision of jaw-closing movements fluctuates within the range of physiological closing movements indispensable for meeting intercuspation without significant interference. For 35 healthy subjects, condylar and incisal point positions for fast and slow jaw-closing, interrupted at different jaw gaps by the use of frontal occlusal plateaus, were compared with uninterrupted physiological jaw closing, with identical jaw gaps, using a telemetric system for measuring jaw position. Examiner-guided centric relation served as a clinically relevant reference position. For jaw gaps ≤4 mm, no significant horizontal or vertical displacement differences were observed for the incisal or condylar points among physiological, fast, and slow jaw-closing. However, the jaw positions under these three closing conditions differed significantly from guided centric relation for nearly all experimental jaw gaps. The findings provide evidence of stringent neuromuscular control of jaw-closing movements in the vicinity of intercuspation. These results might be of clinical relevance to occlusal intervention with different objectives.

Reflex responses of human masseter motor units to mechanical stimulation of the teeth

Our aim was to investigate the jaw reflexes using both the probability- and the discharge rate-based analysis methods. Twelve consenting volunteer subjects participated in this study. Subjects bit gently on bite bars that carried the impression of their teeth. Surface and intramuscular electrical activity of the masseter was recorded. With the help of audio feedback from one motor unit, each subject bit to discharge the unit at a fixed rate. While the subject continuously activated the selected motor unit, 4-N stimuli were delivered to the upper right central incisor either at a rapid or a slow rate. For each trial, ≥300 stimuli were delivered, and, once a trial was completed, local anesthetic block was applied around the stimulated tooth, and the experiment was repeated. While preceding local anesthesia, the rapid-rate stimuli ("tap") induced substantial inhibitory reflex responses; during local anesthetic block, the same stimulus induced excitatory and inhibitory reflex responses. Slow-rate stimuli ("push"), on the other hand, usually generated a combination of inhibitory and excitatory responses that disappeared completely during the local anesthetic block. This study discovered that the strength of the inhibitory reflex response to a tooth-tap stimulus was much larger than previously reported. This study also found that whereas the probability-based analyses were better for illustrating the existence and latency of small earlier responses, the discharge rate-based method was better for indicating the duration of earlier responses and the existence, sign, and duration of later responses.

Stable tooth contacts in intercuspal occlusion makes for utilities of the jaw elevators during maximal voluntary clenching

Data are inconsistent concerning whether the level of the surface electromyographic (SEMG) activity of jaw-closing muscles increases when biting forces elevated during maximal voluntary clenching (MVC). In this study, T-Scan III system and BioEMG III system were used to record bite force, occlusal contacts and SEMG activity of the anterior temporalis (TA) and of the masseter muscles (MM) simultaneously. Recordings were obtained from 16 healthy young adult males during different conditions: (i) a fast MVC from resting position to intercuspal position (ICP); (ii) mandibular movements from ICP to protrusive or lateral edge-to-edge positions with teeth in contact with biting; (iii) a fast MVC in protrusive and lateral edge-to-edge positions. A higher level of SEMG activity was associated with a higher bite force during occluding movements (P < 0.05). However, during fast MVC from rest to ICP, the largest number of occlusal contacts was achieved and distributed more symmetrically, the highest level of biting force was obtained, but the SEMG activity of the jaw elevator muscles was reduced compared with its maximum level (P < 0.05). This phenomenon was not observed during the fast MVC in protrusive or lateral edge-to-edge positions. The present results that a lower SEMG activity was associated with the largest number of occlusal contacts and the highest level of bite force during centric MVC demonstrated a complex integration of jaw-closing muscles when a stable occlusion is present.

Jaw-opening reflex and corticobulbar motor excitability changes during quiet sleep in non-human primates

STUDY OBJECTIVE

To test the hypothesis that the reflex and corticobulbar motor excitability of jaw muscles is reduced during sleep.

DESIGN

Polysomnographic recordings in the electrophysiological study.

SETTING

University sleep research laboratories.

PARTICIPANTS AND INTERVENTIONS

The reflex and corticobulbar motor excitability of jaw muscles was determined during the quiet awake state (QW) and quiet sleep (QS) in monkeys (n = 4).

MEASUREMENTS AND RESULTS

During QS sleep, compared to QW periods, both tongue stimulation-evoked jaw-opening reflex peak and root mean square amplitudes were significantly decreased with stimulations at 2-3.5 × thresholds (P < 0.001). The jaw-opening reflex latency during sleep was also significantly longer than during QW. Intracortical microstimulation (ICMS) within the cortical masticatory area induced rhythmic jaw movements at a stable threshold (≤ 60 μA) during QW; but during QS, ICMS failed to induce any rhythmic jaw movements at the maximum ICMS intensity used, although sustained jaw-opening movements were evoked at significantly increased threshold (P < 0.001) in one of the monkeys. Similarly, during QW, ICMS within face primary motor cortex induced orofacial twitches at a stable threshold (≤ 35 μA), but the ICMS thresholds were elevated during QS. Soon after the animal awoke, rhythmic jaw movements and orofacial twitches could be evoked at thresholds similar to those before QS.

CONCLUSIONS

The results suggest that the excitability of reflex and corticobulbar-evoked activity in the jaw motor system is depressed during QS.

The relationship between bite force and oral sensation during biting in molars

BACKGROUND

In prosthodontic treatment, the occlusal form should be designed such that bite force is applied at the position that has higher load-bearing capacity and is comfortable for the patient. The purpose of this study was to clarify the differences in bite force and occlusal sensation with different loading positions on the occlusal surface.

METHODS

Twelve healthy subjects were recruited for this study. Bite force and occlusal sensation were measured at five loading points on the upper and lower left first molars. Occlusal sensation was evaluated using a Visual Analogue Scale (VAS).

RESULTS

Bite forces on the lingual side of the upper first molar and the buccal side of the lower first molar were significantly higher and VAS scores were significantly lower, i.e. the subjects felt less discomfort during biting on the buccal side of the upper first molar and the lingual side of the lower first molar compared to the other side of each molar.

CONCLUSIONS

Loading on the occlusal surfaces of the functional cusps of the upper and lower first molars produces more load-bearing capacity and is more comfortable than loading on the non-functional cusps.

Time-Frequency Analysis of Chewing Activity in the Natural Environment

The aim of this observational study was to investigate the features of the chewing activity and the variability of the human chewing pace, as assessed in the natural environment. It was hypothesized that the chewing pace is relatively constant within individuals across different days but is variable across individuals. Electromyographic surface activity was recorded unilaterally from the masseter in 21 participants for 3 hours over 3 recording days, in the natural environment, by means of portable recorders. The time-frequency properties of chewing activity were assessed with a previously validated algorithm. Repeated-measurements ANOVA was used for statistical analysis. Chewing activity mainly occurred in the range of 0.94 Hz (5th percentile) and 2.17 Hz (95th percentile). Mean and median chewing frequencies were 1.57 Hz and 1.58 Hz, respectively (95% confidence intervals: 1.45-1.68 Hz). The mean duration of chewing episodes was 13.0 sec, the 5th and 95th percentiles being 2.7 sec and 34.9 sec, respectively. Variability of the mean chewing frequency between individuals was much greater than that within individuals (F = 29.8; p < 0.001). The individual chewing paces were stable across different days (intraclass correlation coefficient = 0.88; 95% confidence intervals = 0.79-0.94). Our findings provide evidence that each individual, in the natural environment, chews with a consistent pace across different days.

Abbreviations: ANOVA, analysis of variance; CPG, central pattern generator; EMG, electromyography; ICC, Intra-class Correlation coefficient; SD, standard deviation.

Objective assessment of mandibular motor control using a 'reach-and-hold' task

Mandibular motor function is well known to be impaired in the presence of temporomandibular disorders. However, while a vast literature is available concerning accuracy of motor control in limbs, quantitative and objective assessment of mandibular motor control has been seldom performed, also because of the lack of adequate investigative tools. Aim of this work is to present a technique for reliable evaluation of the motor performance of the mandible based on a kinesiography-monitored reach-and-hold task. Nineteen healthy subjects were engaged in a task in which they had to drive a cursor on a screen by corresponding movements of the mandible in the frontal plane and reach 30 random targets sequentially displayed on the screen. The whole task was repeated three times per session in two different days. The individual performance was assessed by different indices evaluating precision and steadiness of target matching. The performance progressively improved in the three trials of the first session, further improved and stabilised in the second session, with an average positioning error of 0·59 ± 038 mm and was slightly correlated with the horizontal dimension of the mandible border movement (r = 0·55). Intraclass correlation coefficient ranged between 0·76 and 0·94 for the different indices indicating good repeatability. The kinesiographic technique allowed for objective and reliable assessment of the voluntary control of the mandible position. Its potential applications include support to the characterisation of temporomandibular disorders and to motor training and progress monitoring in rehabilitation treatments.

Masseter length determines muscle spindle reflex excitability during jaw-closing movements

INTRODUCTION

The masticatory muscles are considered to be important determinants of facial form, but little is known of the muscle spindle reflex characteristics and their relationship, if any, to face height. The aim of this study was to determine whether spindle reflexes, evoked by mechanical stimulation of an incisor and recorded on the masseter muscle, correlated with different facial patterns.

METHODS

Twenty-eight adult volunteers (16 women; ages, 19-38 years) underwent 2-N tap stimuli to their maxillary left central incisor during simulated mastication. Reflexes were recorded during local anesthesia of the stimulated tooth to eliminate the contribution from periodontal mechanoreceptors. Surface electromyograms of the reflex responses of the jaw muscles to these taps were recorded via bipolar electrodes on the masseter muscle and interpreted by using spike-triggered averaging of the surface electromyograms. Lateral cephalometric analysis was carried out with software (version 10.5, Dolphin, Los Angeles, Calif; and Mona Lisa, Canberra, Australia).

RESULTS

Two-newton tooth taps produced principally excitatory reflex responses beginning at 17 ms poststimulus. Correlation analysis showed a significant relationship between these muscle spindle reflexes and facial heights: specifically, shorter face heights were associated with stronger spindle reflexes. This correlation was strongest between the derived measure of masseter length and the spindle reflex strength during jaw closure (r = -0.49, P = 0.008).

CONCLUSIONS

These results suggest that a similar muscle spindle stimulus will generate a stronger reflex activation in the jaw muscles of patients with shorter faces compared with those with longer faces. This finding might help to explain the higher incidence of clenching or bruxism in those with short faces and also might, in the future, influence the design of orthodontic appliances and dental prostheses.

Quantification of jaw reflexes evoked by natural tooth contact in human subjects

Inhibitory jaw reflexes are believed to be important for protecting the teeth and temporo-mandibular structures from damage during sudden or forceful biting or mastication. Accordingly, alterations in these reflexes are sometimes implicated in aetiologies proposed for oro-facial pain syndromes, although the association is not well-established. We now aim to develop a method for quantifying objectively inhibitory jaw reflexes evoked by natural tooth contact. In the longer term, this may provide a new approach to examining the association of altered reflexes and clinical conditions. Eighteen subjects gave their written, informed consent, and were recruited to participate in this study. They were instructed to clench their teeth together in response to visual cues. They performed two such tasks twenty times: from the jaw postural position and from a more open position with the jaws set 10mm apart. Both tasks produced a rapid rise then stabilisation in electromyographic activity in the masseter muscle. This was always interrupted by a large inhibitory reflex starting 11.1±1.5 ms (mean±SD) after tooth contact. The inhibitions produced during the second task were similar but of significantly longer duration (24.3±6.4 vs 18.4±6.5 ms, P=0.0003, paired t-test) and greater magnitude (measured as an integral of the waveform: 1577±478 vs 1279±425%.ms, P=0.007, paired t-test). Interestingly, in a minority (13%) of the tasks, a second inhibition with a longer latency (50.9±0.9 ms) was also observed. Thus reflex responses in the masseter muscle to natural tooth contact usually consist of single inhibitory periods. In this respect they are like those induced by externally applied tooth pushing although occasionally there is a second inhibition, reminiscent of that seen with externally applied tooth taps.

Interrelationships between dental occlusion and plantar arch

OBJECTIVE

The aim of this study was to evaluate the influence of different jaw relationships on the plantar arch during gait.

METHODS

168 subjects, participating in this study, were distributed into two groups: a control (32 males and 52 females, ranging from 18 to 36 years of age) and a Temporomandibular joint disorders group (28 males and 56 females, ranging from 19 to 42 years of age). Five baropodometric variables were evaluated using a baropodometric platform: the mean load pressure on the plantar surface, the total surface of feet, forefoot vs rearfoot loading, forefoot vs rearfoot surface, and the percentage of body weight on each limb. The tests were performed in three dental occlusion conditions: mandibular rest position (REST); voluntary teeth clenching (VTC); and cotton rolls placed between the upper and the lower dental arches without clenching (CR). The variables were analyzed through repeated measures ANOVA. The Mann-Whitney test was used to compare the postural parameters of the two groups. The level of significance was p < 0.05.

RESULTS

As to the intra-group analysis of TMD group, all posturographic parameters in both lower limbs showed a significant difference between REST vs CR (P < 0.001) and between VTC vs CR (p < 0.001), except for the percentage of body weight on each limb. The control group showed a significant difference between REST vs VTC, REST vs CR and VTC vs CR (p < 0.001) in the mean load pressure on the plantar arch, forefoot surface, rearfoot surface and total surface of feet. The mean load pressure on the plantar arch in VTC, and the forefoot and total surfaces of feet in CR (p < 0.05) were significantly higher in the TMD group in both limbs. The results of this study indicate that there are differences in the plantar arch between the TMD group and control group and that, in each group, the condition of voluntary tooth clenching determines a load reduction and an increase in surface on both feet, while the inverse situation occurs with cotton rolls. The results also suggest that a change in the load distribution between forefoot and backfoot when cotton rolls were placed between the dental arches can be considered as a possible indicator of a pathological condition of the stomatognathic system (SS) which could influence posture. Therefore the use of posture monitoring systems during the treatment of stomatognathic system is justified.

Intraspecific scaling of chewing cycle duration in three species of domestic ungulates

In mammals, chewing cycle duration (CCD) increases with various measures of size, scaling with body mass0.13–0.28 and jaw length0.55. Proposed explanations for these scaling relationships include the allometry of body size, basal metabolic rate and tooth size, on the one hand, and pendular mechanics treating the jaw as a gravity-driven pendulum, on the other. Little is known, however, about the relationship between CCD and size within species. Recent research in dogs demonstrates altogether different scaling exponents and weaker correlations. This research suggests that breed-specific growth rates influence the maturation of the neural networks generating chewing rhythm, which may be altered because of changes in jaw mass during early postnatal growth. Here, we explored the intraspecific scaling of CCD within a sample of adult horses ranging from miniatures to draft breeds and an ontogenetic sample of goats and alpacas from infants to adults. In horses, CCD scales with body mass0.19 and jaw length0.57, although in neither case is the correlation significant. In the ontogenetic samples of goats and alpacas, CCD is significantly correlated with body mass, scaling as CCD∝body mass0.37 in both species. In goats, but not alpacas, CCD is also significantly correlated with jaw length, scaling as jaw length1.032. As in dogs, the scaling of CCD in horses may reflect the influence of selective breeding on growth trajectories of different breeds, resulting in reduced body and jaw size differences among infants, when CCD is established, compared with adults. However, the allometric scaling of tooth size in horses of different breeds may be a potential influence on the scaling of CCD. The scaling of CCD with body and jaw size in goats, and to a lesser extent in alpacas, also suggests that the development of peripheral masticatory structures such as the teeth and occlusal relations may play a role in changes in CCD during the earliest stages of postnatal ontogeny.

Brain Activations in Response to Vibrotactile Tooth Stimulation: a Psychophysical and fMRI Study

The tactile sensitivity of the teeth, and associated periodontium, serves important sensory and motor functions. Microneurographic recordings from human periodontal ligament mechanoreceptor (PDLM) nerves, in response to tooth loading, reveal discharge patterns with sole slowly adapting (SA) II-type characteristics, highlighting the unique role of PDLMs in oral sensory processes. Here we investigate these receptors' properties, psychophysically and with neuroimaging (fMRI), in response to varying frequencies of dynamic (vibrotactile) stimulation. The finding of increased activity in primary (SI) and secondary (SII) somatosensory cortices (SI and SII) at low frequencies of stimulation (20 Hz) as compared with higher frequencies (50 and 100 Hz), shows an increased entrainment of the PDLMs at this lower frequency in line with expected SA II-type response properties. At the highest frequency (100 Hz), no significant activity was found in SI or SII, suggesting this frequency is outside the range of activity of PDLMs. An activation matrix is mapped that includes SI, SII, insular, inferior frontal gyrus, inferior parietal lobe and supplementary motor area as well as middle frontal gyrus and cerebellum. We compared the responses to tooth stimulation with those produced by identical vibrotactile stimulation of the finger. The results strongly suggest that the PDLMs play a significant role in the specification of the forces used to hold and manipulate food between teeth, and in these respects, the masticatory system appears analogous to fine finger-control mechanisms used during precision manipulation of small objects. Because fMRI reveals activations in posterior insular cortex, we also speculate that PDLMs, and SA II-type receptors in general, may be involved in one aspect of the feeling of body ownership.

Threshold for Detection of Incisal Forces Is Increased by Jaw Movement

Current knowledge regarding the sensitivity of the teeth to forces is based on psychophysical experiments that measured touch detection thresholds under static jaw conditions. It is not known whether jaw movements alter the perception of forces applied to the teeth, but, based on limb movement studies, it is hypothesized that the perception of mechanoreceptor outputs will be downwardly modulated by jaw movements. We predicted that, compared with static jaw conditions, rhythmic jaw movements would be associated with significantly higher psychophysical thresholds for the detection of incisally applied forces. In eight participants, mechanical pulses were delivered to an incisor during static jaw holding or during cyclic jaw opening and closing. Analogous to findings in human limbs, the psychophysical salience of periodontal mechanoreceptor feedback was downwardly modulated by physiologically relevant movements; detection thresholds for mechanical pulses applied to a central incisor were significantly higher during jaw-closing movements than during static jaw positioning.

Chewing variation in lepidosaurs and primates

Mammals chew more rhythmically than lepidosaurs. The research presented here evaluated possible reasons for this difference in relation to differences between lepidosaurs and mammals in sensorimotor systems. Variance in the absolute and relative durations of the phases of the gape cycle was calculated from kinematic data from four species of primates and eight species of lepidosaurs. The primates exhibit less variance in the duration of the gape cycle than in the durations of the four phases making up the gape cycle. This suggests that increases in the durations of some gape cycle phases are accompanied by decreases in others. Similar effects are much less pronounced in the lepidosaurs. In addition, the primates show isometric changes in gape cycle phase durations, i.e. the relative durations of the phases of the gape cycle change little with increasing cycle time. In contrast, in the lepidosaurs variance in total gape cycle duration is associated with increases in the proportion of the cycle made up by the slow open phase. We hypothesize that in mammals the central nervous system includes a representation of the optimal chew cycle duration maintained using afferent feedback about the ongoing state of the chew cycle. The differences between lepidosaurs and primates do not lie in the nature of the sensory information collected and its feedback to the feeding system, but rather the processing of that information by the CNS and its use feed-forward for modulating jaw movements and gape cycle phase durations during chewing.