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Biomedical subjects

I J Klineberg

Publications and source records attributed to I J Klineberg.

At least 19 recordsLinked to original sources
PubMed1999

Trajectories of condylar points during working-side excursive movements of the mandible.

STATEMENT OF PROBLEM: Trajectories of different condylar points provide different interpretations of condylar movement during open-close jaw movements. Movement of the working-side condyle is often assessed clinically by recording the trajectory of a single arbitrary condylar point. PURPOSE: This study examined the effect of the differences in condylar point location on condylar point movement trajectories during a working-side movement. METHODS: Different points exhibited different trajectories during a single working-side movement in each of 44 subjects. RESULTS: Up to 40% of a point's displacement could be attributed simply to the location of the point. CONCLUSIONS: Interpretation of condylar movement on the working side within a subject depends on the point chosen.

Adult↗
PubMed1998

An association of membrane-damaging toxins from coagulase-negative staphylococci and chronic orofacial muscle pain.

Forty-six patients presenting with chronic orofacial muscle pain and eight age- and sex-matched control subjects were investigated for the carriage prevalence of, and exotoxin production by, coagulase-negative staphylococci (CNS). The eight control subjects were selected from an initial group of 41 subjects on the basis of the absence of musculoskeletal symptoms. There was a significantly higher prevalence and multiple carriage of four or more strains of CNS in patients with chronic muscle pain than in control subjects (23 versus 9 isolates/10 subjects). Two of the 103 CNS isolates from patients with muscle pain and none from the control subjects produced toxic shock syndrome toxin 1 (TSST-1), suggesting that pyrogenic toxins do not significantly contribute to the aetiology of chronic muscle pain. There was a significantly higher prevalence of delta-haemolysin (41 of 114) and 'horse'-haemolysin (56 of 114) production by CNS isolates from patients with chronic muscle pain compared with those from control subjects. None of the control subjects was colonised with CNS that produced significant amount of either delta- or 'horse'-haemolysin, whereas 35 of 44 patients with chronic orofacial muscle pain were colonised with CNS that produced significant amounts of 'horse'-haemolysin, 37 that produced delta-haemolysin and 33 that produced both delta- and horse-haemolysin. This study suggests that membrane-damaging toxins, like delta- and 'horse'-haemolysin, may play a role in the aetiology of chronic orofacial muscle pain.

Adolescent↗
PubMed1998

A volumetric study of guided bone regeneration around titanium implants in the New Zealand white rabbit.

Previous studies have shown the ability for bone to grow under occlusive membranes. This study was undertaken to determine the time required for bone to form in the space created under the membrane and to determine the amount of bone that may be grown under the membrane. Thirty-two New Zealand white rabbits were divided into three groups. A Brånemark implant, having a diameter of 3.75 mm with a length of 7 mm, was placed in each tibia and Gore-Tex membrane was draped over the implant on the experimental side and tethered to the wound margin. Sixteen rabbits were sacrificed at six weeks, eight at twelve weeks, and eight at eighteen weeks. At six weeks the available space under the membrane was filled to 68 per cent, at twelve weeks it was 45 per cent, and at eighteen weeks 54 per cent. A comparison of bone height measurements on test and control sides showed a significant difference (p = 0.0001) at the three time intervals. A comparison of grown bone volumes (test vs control) was also statistically significant (p = 0.0001). The ability to grow bone under an occlusive membrane was confirmed but the long-term survival rate and ability to support load needs to be investigated.

Analysis of Variance↗
PubMed1997

The variability of condylar point pathways in open-close jaw movements.

STATEMENT OF PROBLEM: Clinical assessments of condylar movement often rely on the movement of a single clinically determined or average value condylar point. PURPOSE: The aim of this investigation was to study the effect of differences in condylar point location on recorded movement trajectories with an open-close jaw movement. METHODS: Recordings were made of the movements of various condylar points in 44 subjects. The points were identified clinically (average value points) and radiographically. RESULTS: The trajectory of each condylar point, whether average value or radiographically determined, was different in form and dimension from any other condylar point within a subject for the same open-close jaw movement. CONCLUSIONS: Depending on the point chosen in the vicinity of the condyle, quite different interpretations of condylar movement within a subject could be made. The data underscore the caution that must be exercised when interpreting condylar movement from the movement of a single condylar point.

Adult↗
PubMed1997

The effect of posterior tooth guidance on non-working side arbitrary condylar point movement.

Occlusal form is frequently modified in clinical practice and yet we do not have detailed knowledge of the possible effects of these changes on condylar movement. The aim of this study was to quantify the effects of an alteration in the occlusion on condylar movement during a lateral excursive jaw movement. Posterior tooth guidances (i.e. metal overlays) were attached to both maxillary first molars. The movement of arbitrary condylar points on the non-working side was recorded in seven subjects during lateral excursion under natural tooth guidance (control) and was compared with that after placement of the overlays (guidance). The guidance resulted in statistically significant changes to the displacement of the arbitrary condylar points on the non-working side. For example, at a standardized (3 mm) displacement along the mid-incisor point trajectory during the lateral excursion for both control and guidance in all subjects, the corresponding displacements of the condylar points were statistically significantly decreased under the guidance situation in comparison with the control situation. These data suggest that, for the same magnitude of mandibular displacement during lateral excursion, the introduction of a posterior tooth guidance limits condylar displacement on the non-working side.

Adult↗
PubMed1996

Preliminary determination of a molecular basis of chronic fatigue syndrome.

Chronic fatigue syndrome (CFS/ME) is a debilitating fatigue illness that has an unknown etiology. We studied 20 chronic fatigue syndrome (CFS) patients, who complied with the Oxford and American CDC definitions, and 45 non-CFS subjects. Participants completed questionnaires, were clinically examined, and had first morning urine specimens collected, which were screened by gas chromatography-mass spectrometry for changes in metabolite excretion. Multivariate analysis of the urinary metabolite profiles differed significantly in the CFS patients compared to the non-CFS patients (P < 0.004). The CFS patients had increases in aminohydroxy-N-methylpyrrolidine (P < 0.00003, referred to as chronic fatigue symptom urinary marker 1, or CFSUM1), tyrosine (P < 0.02), beta-alanine (P < 0.02), aconitic acid (P < 0.05), and succinic acid (P < 0.05) and reductions in an unidentified urinary metabolite, CFSUM2 (P < 0.0007), alanine (P < 0.005), and glutamic acid (P < 0.02). CFSUM1, beta-alanine, and CFSUM2 were found by discriminant function analysis to be the first, second, and third most important metabolites, respectively for discriminating between CFS and non-CFS subjects. The abundances of CFSUM1 and beta-alanine were positively correlated with symptom incidence (P < 0.01 and P < 0.001, respectively), symptom severity, core CFS symptoms, and SCL-90-R somatization (P < 0.00001), suggesting a molecular basis for CFS.

Aconitic Acid↗
PubMed1996

Preliminary determination of the association between symptom expression and urinary metabolites in subjects with chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) patients have a urinary metabolite labeled CFSUM1 with increased incidence (P < 0.004) and relative abundance (P < 0.00003). The relative abundances of urinary CFSUM1 and beta-alanine were associated with alterations in metabolite excretion and symptom incidence. In 20 CFS patients and 45 non-CFS subjects, symptom/metabolite associations were investigated by assessing symptom sensitivity and specificity, and symptom indices of total symptom incidence, CFS core symptoms, cognitive, neurological, musculoskeletal, gastrointestinal, infection-related and genitourinary symptom indices, as well as a visual analogue pain scale of average pain intensity. Thirty-three symptoms had significant (P < 0.005) sensitivity and specificity in the CFS patients compared to that in the non-CFS controls. Severe fatigue was the only symptom with 100% sensitivity and specificity and CFSUM1 excretion was the primary metabolite for expression of this symptom. All nine symptom indices had elevated responses in the CFS patients (all P < 0.0000001). Multiple regression analyses indicated that all the symptom indices had significant correlations (R) with changes in the urinary excretion of metabolites (P < 0.0001). CFSUM1 and beta-alanine were the first and second metabolites correlated with the CFS core symptom index and CFSUM1 was primarily associated with infection-related and musculoskeletal indices whereas beta-alanine was primarily associated with gastrointestinal and genitourinary indices. The strong associations of CFSUM1 and beta-alanine with CFS symptom expression provide a molecular basis for developing an objective test for CFS.

Adolescent↗
PubMed1996

Placement and verification of recording electrodes in the superior head of the human lateral pterygoid muscle.

Previous studies in man have relied only on electromyographic (EMG) activity patterns and anatomical landmarks to confirm electrode placement in the superior head of the lateral pterygoid. Computed tomography (CT) was used here to determine whether indwelling fine wires could be visualized in that muscle head in man and thus provide evidence for correct placement before EMG. Two imaging sessions were conducted in six individuals. First, a series of contiguous axial CT slices was obtained to calculate the trajectory of insertion of fine wire electrodes into the superior head. For each individual, the trajectories for the location of the fine wires in the approximate mediolateral and anteroposterior centre of the superior head were different. Further axial CT slices were taken after electrode insertion; in each case, these slices clearly showed the wire ends located within the muscle. It was concluded that fine wires in the lateral pterygoid can be imaged by CT. Furthermore, imaging is necessary to accommodate interindividual anatomical variations and to confirm the position of the electrodes within the muscle.

Adult↗
PubMed1996

Assessment of pain (distribution and onset), Symptoms, SCL-90-R Inventory responses, and the association with infectious events in patients with chronic orofacial pain.

A visual analog pain scale and scalar responses to 13 pain/symptom indicator Symptom Checklist-90-Revised (SCL-90-R) questions were used to assess symptom prevalence and pain severity in 43 chronic orofacial muscle pain patients and 40 control subjects. The orofacial muscle pain group reported pain in an axial skeletal distribution; neurocognitive, gastrogenitourinary, and musculoskeletal symptoms; infectious events at or preceding onset; similar symptoms in sexual partners; and low prevalence of trauma. Sudden onset was reported by 30.2% of pain patients. Strong associations were found between chronic orofacial muscle pain and (1) onset-related infectious-like events (67.4%); (2) a higher prevalence of history of respiratory and gastrogenitourinary infectious events; and (3) high prevalences of similar pain symptoms in long-term sexual partners. The SCL-90-R somatization scores (> 62) had a higher prevalence in the chronic pain group. No prevalence differences or associations with pain/symptom indicators were found for depression or anxiety dimension scores. These data suggest that patients with recurrent systemic infectious events have a higher prevalence of reporting of chronic orofacial muscle pain compared with control subjects, and these infectious events are associated with the onset of chronic orofacial muscle pain in 67% of patients.

Adolescent↗
PubMed1994

A new approach for accurate pre-planned occlusal adjustment.

Occlusal adjustment is important in prosthodontic pre-treatment procedures and in the management of some cases of craniomandibular disorders. This may involve tooth surface reduction and tooth surface addition with an appropriate restorative material. Occlusal adjustment must be distinguished from occlusal equilibration and selective grinding with clear indications and aims. A systematic pre-clinical and clinical protocol has clear advantages and the use of a thermoplastic vacuum-formed template greatly increases the clinical accuracy of a pre-planned adjustment.

Dental Occlusion, Balanced↗
PubMed1994

Management of craniomandibular disorders. Part II: Clinical assessment of patients with craniocervical dysfunction.

Comprehensive evaluation of mandibular function requires a broader assessment of the head, neck, and jaws than is normally performed. Examining only the teeth and periodontium will fail to assess problems in muscles and joints, which should be considered in the management plan. Recognition of function-related symptoms is important in the prediction of treatment outcomes. Stress-induced muscle tension and traumatic oral habits may be linked with reported symptoms of headache, earache, and temporomandibular joint problems, and the significance of these symptoms should be assessed through detailed clinical examination.

Craniomandibular Disorders↗
PubMed1993

Isokinetic exercise management of temporomandibular joint clicking in young adults.

Temporomandibular joint clicking is frequently a sign of craniomandibular disorders, and the etiologic predisposing, initiating, and perpetuating factors must be considered in its management. The present study assesses the usefulness of isokinetic exercises in the treatment of temporomandibular joint clicking. At the end of a 6-month test period, 18 of 22 subjects (approximately 82%) with clicks no longer had clicking, but four subjects (approximately 18%) with bilateral reciprocal clicking did not lose their clicks. A number of proposals have been suggested in the past as an explanation of the cause of temporomandibular joint clicking, but the present study has shown that clicking in young adults is predominantly neuromuscular in origin and may be a reversible condition that can be treated successfully with a conservative exercise regimen.

Adult↗
PubMed1993

Management of craniomandibular disorders. Part 1: A craniocervical dysfunction index.

A craniocervical dysfunction index has been developed (based on the Helkimo Dysfunction Index) to comprehensively assess craniocervical dysfunction and to objectively monitor the management of patients who present with these clinical problems. The close functional interrelationship of temporomandibular joints, jaw muscles, and cervical joints and muscles is reviewed, and a mechanism is proposed to explain dysfunctional relationships between these structures. This is the first of three papers stemming from a clinical study that investigated craniomandibular disorders and assessed the effect of routine dental management on craniomandibular and craniocervical dysfunction.

Craniomandibular Disorders↗
PubMed1991

Severe abrasion of composite and amalgam restorations in a patient with lupus erythematosus systemic. Case report.

A case of repeated severe abrasion of amalgam and composite resin restorations in a patient under treatment for Lupus erythematosus systemic is reported. The patient had a history of audible nocturnal bruxism. Severe roughening occurred within three weeks of placement of the restorations and was related precisely to surfaces in contact with the opposing restored dentition. Examination by SEM revealed an unusual wear pattern of the amalgam restorations.

Adult↗
PubMed1984

Electromyographic recordings of human jaw-jerk reflex characteristics evoked under standardized conditions.

A device for imparting reproducible chin taps was employed to evoke monosynaptic jaw-closing reflexes in subjects without (group A) and with (group B) overt muscle-joint pain dysfunction. Latency, duration and amplitude values obtained were consistent within an individual at constant tap force at a single-recording session but varied among subjects. Latency differences between sides were greater in subjects exhibiting mild to moderate dysfunction (group B) than in group A, but there were not corresponding differences in duration and amplitude. Stimuli were delivered in 5 subjects whilst the jaw was firmly held at postural jaw position with the aid of acrylic resin indices secured with adhesive to the maxillary and mandibular teeth. Recordable reflex responses were evoked in the masseter muscles of one subject only, indicating that vibration alone was not an adequate stimulus consistently to evoke a jaw-closing reflex at postural jaw position. Spindle stretch is needed, unless postural motoneurone excitability is at a sufficiently high level. Reproducible jaw-closing reflexes were evoked following standardized stimuli; subtle variations in motoneurone excitability, such as reflected by differences in jaw-jerk latency between sides, may then become apparent.

Electromyography↗
PubMed1984

A standardized system for evoking reflexes in human jaw elevator muscles.

A standardized reproducible system for evoking jaw reflexes following chin tap is described. It represents an improvement over non-standardized and other standardized forms of instrumentation in that characteristics of the associated jaw displacement and parameters of the evoked jaw jerk reflexes recorded using this system have been shown to be reproducible. The need for standardized instrumentation to evoke jaw reflexes of any kind is emphasized by the influence of graded variations in tap force on the parameters of the evoked jaw jerk reflex response. Thus, higher levels of tap force correlate with an increased jaw jerk duration and amplitude and a decreased latency.

Electromyography↗