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Biomedical subjects

I Klineberg

Publications and source records attributed to I Klineberg.

At least 37 records · Page 2Linked to original sources
PubMed1988

Occlusion as the cause of undiagnosed pain.

The teeth provide precise skeleto-motor influences for the stomatognathic system. This unique guidance mechanism characterizes each individual's chewing pattern. It controls the activity of jaw muscles to ensure that appropriate tooth contacts within the limits of existing tooth relationships occur at the end of each chewing cycle. This acts as a means of re-setting the neuromuscular system in anticipation of the next jaw opening movement. The absence of stable centric occlusion at the end point of each chewing cycle alters neuromuscular co-ordination and predisposes to muscle dysfunction. Tooth and jaw or craniomandibular relationships are associated with craniocervical relationships and especially tongue posture. This is also directly influenced by the need for airway maintenance as the predominant influence on tongue-muscle function. The susceptibility to pain and dysfunction is further influenced by individual stereognathic sensitivity or the variable awareness of tooth contour and tooth contacts. These special features are present within the framework of the psycho-physiological and psycho-social significance of the face and mouth, which directly bears on the individual response to and appreciation of pain and dysfunction. Tooth guidance also influences condyle-disc function. Anterior and posterior teeth provide primary and secondary lateral guidance in function, directing the jaw into centric occlusion. If this guidance tends to direct the jaw posteriorly along distal, rather than mesial tooth inclines, it restricts the antero-posterior 'function' of jaw movement at tooth contact. This predisposes to condyle-disc dysfunction and the development of internal derangements, by increasing the likelihood of the posterior thick band of the disc being displaced anteriorly and the condyle posteriorly.(ABSTRACT TRUNCATED AT 250 WORDS)

Facial Pain↗
PubMed1984

Short and long-latency responses in human masseter muscle evoked by chin taps.

Ten healthy subjects received downward, backward and upward chin taps with standardized force and direction. Taps in all three directions elicited short (M1) and long (M2 and M3)-latency excitatory EMG responses in the masseter muscle. M1 (mean latency 8.9 ms, amplitude 150 microV) occurred more frequently and with shorter latency during clenching than during relaxation or opening. Downward taps were more efficient in evoking jaw-jerks (25 per cent) than upward (14 per cent) and backward ones (16 per cent). M2 was a weak biphasic deflection occurring during the silent period (mean latency 42 ms, amplitude 87 microV) and M3 was an EMG burst following the silent period (mean latency 69.3 ms, amplitude 169 microV). No long-latency evoked responses were obtained from the relaxed masseter. Thus, muscle stretch increases M1 response frequency but is not a necessary prerequisite. The hypothesis that vibratory transmission plays an important role was confirmed. Voluntary activation of the stimulated muscle (clenching) increases M1-response frequency and shortens response latency.

Adult↗
PubMed1983

The masseter muscle: the silent period and its clinical implications.

Standardized solenoid chin taps were delivered downward and upward as parallel as possible to the fibers of the superficial part of the masseter muscle and backward at a right angle to this direction. Each one of the 10 healthy subjects received 10 taps in each direction during isometric masseter muscle activity (clenching the teeth). Taps in all three directions evoked the classic jaw jerk response, M1, a short latency (mean, 8.3 msec) excitation followed by an SP (mean latency, 15.9 msec; mean duration, 42.6 msec). The SP duration varied considerably not only between subjects but also within individuals. Forty-nine percent of the SPs were divided into two parts by an EMG peak, M2, with mean latency 42 msec and mean amplitude 78 microV. Sometimes this peak marked the end of the SP. The SP duration has been claimed to be of diagnostic significance because it is longer in patients with mandibular dysfunction. It is concluded that the large variations of the parameter found in this as well as in other studies make it impossible to establish criteria for a healthy or pathologic SP duration. A carefully obtained history and thorough clinical examination are probably more reliable means to establish a correct diagnosis.

Adult↗
PubMed1982

Reflex responses to taps in various directions from the human digastric muscle.

Reflex responses to standardized solenoid chin taps were studied on 21 subjects with electromyographic (EMG) recordings from two jaw muscle antagonists, the masseter and the digastric. Taps were delivered downward and upward as parallel as possible to the masseter fibre direction and also backwards at right angles to these directions. Taps were delivered during isometric masseter and digastric activity as well as during relaxed postural position. Reflex excitation of the digastric muscle with a latency of 25-35 ms was recorded during all three situations after taps in all three directions. When this response was superimposed on ongoing digastric isometric activity after downward and upward taps, it was followed by a period of inhibition (mean duration 31 ms) and directly followed by a second EMG burst (mean latencies 73 and 75 ms, respectively). Responses were significantly (p less than 0.001) more often obtained during digastric background activity than during postural position and clench. Upward and downward taps were equally efficient in evoking the responses, significantly (p less than 0.001) more so than backward taps. The concurrent recordings of the masseter EMG imply the possibility of a reciprocal interplay between the two antagonists. The results accord with reports of the capability of the digastric muscle to produce reflex responses despite lack of anatomically-defined muscle spindles.

Adult↗
PubMed1980

Influences of temporomandibular articular mechanoreceptors in functional jaw movements.

Contributions of temporomandibular (TM) articular mechanoreceptors to the control of jaw movement in man were investigated by tracking functional jaw movements. Functional envelopes were recorded by monitoring spatial changes of the lower incisor tooth, before and during unilateral and bilateral anaesthesia of the TM articular capsule. Regional anaesthesia provided reversible blockade of afferent impulse transmission from articular mechanoreceptors, thus reducing their contributory effects on jaw muscle motoneurone pools. Subsequent variations in the size and shape of the envelope of function occurred and were quantified by measuring the area changes. The results suggest that articular mechanoreceptors make a continuous contribution to reflex control of jaw movement.

Adult↗
PubMed1980

Regional nerve block of the temporomandibular joint capsule: a technique for clinical research and differential diagnosis.

In previous studies in which regional anesthesia of the temporomandibular joint capsule was used to examine the role of the joint in mandibular movement and distinguish it from muscle control, the anesthetic techniques used have not been satisfactorily described. The accuracy of the injection technique described in this paper was determined by dissection and radiogrphic examination of fixed and fresh specimens. Using this technique, trial patient studies were made using an anesthetic solution to which a radiopaque medium was added. Radiographic examination of the patients affirmed the location of the injected material, while clinical assessment determined its functional effectiveness. Using the described technique, anesthetic solution was accurately and reproducibly introduced posteriorly and laterally to the temporomandibular joint to achieve anesthesia of the joint.

Humans↗
PubMed1978

Occlusion and facial pain.

The role of the occlusion in the aetiology of reflex jaw muscle hyperactivity and myofacial pain is analysed. Neurological mechanisms are proposed to explain how variations in occlusal morphology of sufficient magnitude (segmental influences), and the presence of anxiety states (suprasegmental influences) affect jaw muscle activity and contribute to myofascial pain. Controlled occlusal therapy may alter the segmental neurological control of jaw muscle activity to facilitate resolution of muscle hyperactivity in acute myofascial pain. Chronic myofascial pain dysfunction is not primarily related to occlusal factors and a complex psychophysiological mechanism is involved in this type of pain problem.

Acute Disease↗