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Biomedical subjects

M Naeije

Publications and source records attributed to M Naeije.

At least 55 records · Page 3Linked to original sources

The intra-articular distance within the TMJ during free and loaded closing movements.

Previous studies on free opening and closing movements of the mandible have demonstrated that the opening movement traces of the condylar kinematic center (i.e., the condylar point for which the protrusive and the opening movement traces coincide) lie closer to the articular eminence than the closing traces. This indicates the presence of an intra-articular distance within the joint during free closing. Since the mandible behaves like a class III biomechanical lever, a counteracting mechanical load on the mandible during closing will press the condyle-disc complex against the articular eminence. Therefore, in this study the hypothesis was tested that the difference between opening and closing movement traces of the kinematic center is reduced when the closing movements are counteracted by a mechanical load. From 10 healthy participants, 20-second movement recordings were obtained by a six-degrees-of-freedom opto-electronic jaw movement recording system (OKAS-3D) for three types of movements: (1) free opening and closing movements, (2) free opening and loaded closing movements (i.e., the participants closed against a small or high manually applied downward-directed force to the chin), and (3) gum chewing. Off-line, the opening and closing movement traces of the kinematic center were reconstructed, and the average difference between the traces (the intra-articular distance) was calculated. The average intraarticular distance was significantly smaller during loaded closing than during free closing, whereas no significant differences were found in the intra-articular distances between the loaded situations of low and high manual loading and contralateral chewing (ANOVA and post hoc Bonferroni multiple comparisons of means test, p<0.005). In conclusion, loading of the mandible during closing movements reduces the intra-articular distance within the temporomandibular joint.

Adult↗

Variation in movement traces of the kinematic center of the temporomandibular joint.

AIM: The purpose of this study was to compare the variation in movement traces of the kinematic center of the temporomandibular joint with that of 4 nearby condylar reference points. METHODS: Jaw movement recordings were made with an optoelectronic jaw movement recording system. Four asymptomatic participants performed 14 to 18 open-close mandibular movements. The movements were performed with deliberate alterations of the rotation/translation ratio during opening. The kinematic center of the condyle and 4 nearby condylar points (the corner points of a square placed in the condylar sagittal plane, centered around the kinematic center, and with an edge length of 10 mm) were used as reference points. The standard deviations in the downward displacements at the halfway point in the mandibular opening of these reference points were calculated as a quantification of the variation in the movement tracings of these points. RESULTS: The movement traces of the kinematic center showed the smallest variation in comparison to the traces of the 4 nearby reference points (2-way analysis of variance and subsequent contrast analysis; P = 0.0026). CONCLUSION: In comparison to 4 nearby condylar reference points, the movement traces of the kinematic center show the lowest sensitivity to variations in the way mandibular movements are performed.

Adult↗

Subjective pain report and the outcome of several orthopaedic tests in craniomandibular disorder patients with recent pain complaints.

A comparison between a subjective pain report and the outcome of the combined dynamic and static pain tests, and several other orthopaedic tests, was investigated in craniomandibular disorder (CMD) patients with recent pain complaints and in control subjects. Thirty-two CMD patients who clearly reported pain in the masticatory muscle region or in the temporomandibular joint region by means of a symptom report questionnaire (SRQ), participated in the study. The investigators performing the symptom report interview and the clinical tests were blinded to each other. A high correspondence was shown between the patients reporting joint or muscle pain (by means of SRQ) and the classification into arthrogenous and myogenous pain patients, based on the outcome of the dynamic and static pain tests (P = 0.0003). The outcome of four other orthopaedic tests: passive maximum mouth opening (PMMO; P = 0.0001), palpation of the temperomandibular joint (TMJ) and the masticatory muscles (P = 0.0002), TMJ-play (P = 0.0001), and TMJ-compression (P = 0.0138) demonstrated significant differences between the patients reporting joint and muscle pain.

Adult↗

Movements of the mandibular condyle kinematic center during jaw opening and closing.

Little is known about the detailed kinematics of the human temporomandibular condyle during jaw opening and closing. According to the rotate and swing model by Osborn (1989), the condyle is kept in close contact with the articular eminence during opening. Whether the condyle is in closer contact with the articular eminence during opening than during closing is unknown. Another consequence of the model is that the opening condylar movements are less variable than the closing movements. In this study, the hypothesis that the opening condylar path is closer to the articular eminence and also less variable than the closing condylar path is tested. Twenty subjects (10 males and 10 females with a mean age of 22) without signs or symptoms of a craniomandibular disorder performed 2 series of 4 protrusive movements and 2 series of 4 empty opening-closing movements. The movements were recorded by a six-degrees-of-freedom opto-electronic jaw movement recording system (OKAS-3D). The kinematic center of the condyle was used as a reference point for the reconstruction of condylar movement paths. Characteristics of the opening and closing paths were investigated by means of a displacement index (DI). This index is the quotient between the three-dimensional path length and the three-dimensional path distance between the start and the end point of an opening or closing movement of the kinematic center. The DI was smaller (p < 0.0001) and also less variable (p < 0.0001) during opening than during closing. The smaller DI value, in combination with the concave nature of the movement path, indicates that the opening path of the kinematic center lies above the closing path and thus closer to the articular eminence.

Adolescent↗

[Masticatory muscles. Part VI. Masticatory muscles and movement of the lower jaw].

The movement paths of the kinematic center of the temporomandibular joint were recorded by means of a jaw movement recording system (OKAS-3D) under 3 conditions: 1. free open and close movements; 2. free opening and loaded closing movements (subjects closed against a small, manually applied, downward directed force on the chin); and 3. during chewing of chewing gum. During free jaw movements, the opening path of the kinematic center lies above the closing path. During loaded closing movements, the opening and closing paths coincide. This indicates that during opening and loaded closing, the condyle-disc complex is slightly pressed against the articular eminence. However, during free closing, there is more space between the articulating surfaces. During gum chewing, the opening and closing paths of the condyle coincide on the balancing side, on the working side they don't. Thus, the joint on the balancing side is loaded and the joint on the working side is not.

Biomechanical Phenomena↗

[Temporomandibular joint cracking: background and diagnosis].

Although patients often report painless clicking of their temporomandibular joint, treatment is not required. However, sometimes a clicking joint leads to a painful limitation of the movements of this joint. Why this happens is unknown. It is therefore recommended to monitor the clicking joint over time. Opto-electronic recording of condylar movements might offer additional possibilities in the assessment of clicking joints.

Electronics, Medical↗

Influence of choice of reference point on the condylar movement paths during mandibular movements.

Series of four open-close, protrusive and lateral movements were recorded by the six degrees of freedom jaw movement recording system OKAS-3D in 20 healthy subjects. Consequently the movement paths of nine condylar points, the palpated lateral pole and eight points located on a square parallel to the sagittal plane with an edge of 10 mm and centred around the lateral pole were calculated. For all movements except the protrusive movements, the 3-D excursions of the condylar points strongly depended upon the choice of condylar reference point (ANOVA, P < 0.001). During laterotrusive movements the Bennett angle and the Bennett shift also varied significantly according to the position of the reference point (ANOVA, P < 0.001). The results of this study underline that comparison of condylar movements between different studies is only possible when the same condylar reference point is used. General consensus on the choice of condylar reference point is thus needed.

Adolescent↗

Craniomandibular stiffness in myogenous and arthrogenous CMD patients, and control subjects: a clinical and experimental investigation.

The purpose of this study was to compare active maximum mouth opening, endfeel distance, and craniomandibular stiffness values of three craniomandibular disorder (CMD) patient subgroups and a control group. The CMD patient subgroups consisted of myogenous pain patients and arthrogenous pain patients with a 'closed lock' and arthrogenous pain patients without a 'closed lock'. Both myogenous pain patients and the 'closed lock' patients showed great differences on all parameters (P < 0.05-P < 0.001). However, the arthrogenous pain patients without a 'closed lock' revealed no statistical differences with the control group on any of the tested parameters.

Adult↗

Relationship between condylar and incisor point displacement during habitual maximum open-close movements.

The relationship between condylar movements and incisor point movements during habitual maximum open-close movements were studied in 10 healthy male and 10 healthy female subjects. Jaw movements were recorded by means of an opto-electronic jaw movement recording system, OKAS-3D, capable of recording the six degrees of freedom at a sample frequency of 300 Hz. The lower jaw position of the lateral pole of the condyles was found by means of palpation. In order to analyse the movements, the opening and closing path of the incisor point were divided into ten equal intervals and the corresponding condylar displacement in each interval was calculated. A displacement index was obtained by normalizing the condylar displacement with respect to the maximum condylar displacement. Due to the normalization, the displacement index is not sensitive to possible errors in the location of the lateral condylar point. A clear condylar displacement was already recorded in the first movement interval, right at the start of opening (average displacement index in the first opening interval was significantly greater than zero, P < 0.0005). The condylar displacements in the start and the end interval of opening and closing were smaller than in the intermediate movement intervals (P < 0.00005).

Adolescent↗

Jaw movement responses to electrical stimulation of different parts of the human temporalis muscle.

Previous EMG studies have provided indications for the differential activation of the human temporalis muscle. However, in these studies the contribution of different parts of the temporalis muscle could not be separated from the contributions of other muscles, since contraction was performed by voluntary activation. Therefore, the aim of this study was to examine functional differences among various parts of the human temporalis muscle by means of recording the incisal point movement response to electrical stimulation of parts of the muscle. Five healthy male subjects participated in this study. Three locations (anterior, middle, and posterior temporalis muscle) were stimulated, by means of monopolar wire electrodes and rectangular pulses. The insertion depths of the stimulation electrodes were determined by means of magnetic resonance images. Stimulation was performed in four jaw positions (resting position, 50% maximum mouth opening, 1 cm to the left, and 1 cm to the right). Movement responses to stimulation of the different muscle parts were recorded with the OKAS-3D jaw movement analysis system. The movement responses were expressed in polar coordinates. The variation in the direction of the jaw movement response was partly explained by the factors 'stimulation location' and 'jaw position' (ANOVA, p < 0.001). When the stimulation location shifted in an antero-posterior direction, the response changed from a vertical-lateral incisal point movement to a lateral-posterior movement with a smaller vertical component. The jaw position during stimulation also influenced the movement response. A functional subdivision of the temporalis muscle into at least three parts is favored.

Adult↗

OKAS-3D: optoelectronic jaw movement recording system with six degrees of freedom.

OKAS-3D is a further development of the single floating circle target tracker. This tracker consists of a cathode ray tube display, a lens in front of the display and a circular light-sensitive photocell placed in the image field of the lens. A small circular trace generated on the screen is focused around the photocell. The sinusoidal electrical output of the photocell contains all the relevant information regarding the position of the photocell relative to the image of the circular light trace. This gives the tracker the properties of a servo-controller with position feedback. In OKAS-3D three pairs of photocells are located on two lightweight frames attached to the upper and lower frontal teeth by individually adapted clutches. By using the formulas of rigid body mathematics, the motion of any point of the mandible can be reconstructed. The system permits a high sampling frequency of at least 300 Hz per photocell co-ordinate. The noise, linearity and accuracy are better than 0.08 mm, 0.07 mm and 0.13 mm for points in the lower incisal region, and better than 0.25 mm, 0.17 mm and 0.27 mm for points in the condylar region. Thus jaw movements can be recorded with a high spatial and temporal resolution.

Biomedical Engineering↗

The temporal/masseter co-contraction: an electromyographic and clinical evaluation of short-term stabilization splint therapy in myogenous CMD patients.

The short-term effect (3-6 weeks) of the use of a stabilization splint was investigated in a group of 35 myogenous craniomandibular disorder patients. The patients were clinically examined and surface EMG recordings of the temporal and masseter muscles were made during clenching in the intercuspal position (ICP), immediately after the insertion of the splint (SSP), and after at least 3 weeks of splint treatment (SSP 3). With the use of the error variance of the activity index changes in EMG activity were investigated. Three groups of patients were then recognized. One group showed a decrease in temporal muscle activity during splint treatment. Another group did not show any significant change during splint treatment. The third group showed an increase of temporal muscle activity. In general, significant reductions in the amount of static pain were found. In the group with a significant reduction of temporal muscle activity (n = 15) there was a greater decrease in the amount of static pain (P < 0.05) than in the group (n = 4) with a significant increase of temporal muscle activity. The results may indicate that the temporal muscle plays an important role in the perception of static pain in the masticatory system.

Adolescent↗

EMG differences between weak and strong myogenous CMD patients and healthy controls.

Electromyographic and clinical characteristics of 42 myogenous craniomandibular disorder (CMD) patients were related to 40 healthy control subjects. Surface EMG recordings were obtained from the masseter and the temporal muscles. The clinical examination included active maximum mouth opening, endfeel distance, active laterotrusion and lateral endfeel distance, dental abrasion, the presence of a lateral slide (RCP-ICP) and the amount of static pain. Orthopantomographic X-rays were available from 32 CMD patients for measuring the condylar and ramus asymmetry. Compared to the control group lower masseter and temporal EMG amplitudes were found for myogenous CMD patients (P < 0.001). When the activity of the temporal muscle was compared with the activity of the masseter muscle, the CMD patients showed proportionally higher temporal muscle activities than the controls (P < 0.05, 50% clenching level). CMD patients also showed smaller mandibular excursions, larger endfeel distances and more dental abrasion than controls. The temporal muscle asymmetries showed significant negative correlations with the ramus asymmetries. The lower and upper quartile of the distribution of the mean masseter EMG amplitudes were used to distinguish weak and strong muscles in patients and controls. Weak patients showed proportionally high temporal muscle activities, larger masseter and temporal muscle asymmetries, and larger endfeel distances compared to strong CMD patients. These differences were not found between weak and strong controls. In conclusion, it can be said that the electromyographic and clinical findings of the myogenous CMD patients suggest a functional difference between weak and strong patients and indicate the need for more individually designed treatment modalities for functional muscle and joint CMD problems.

Adolescent↗

The kinematic center: a reference for condylar movements.

The kinematic center of the temporomandibular condyle is that condylar point which follows as much as possible the same movement path during different types of mandibular movements. In this study, the location of the kinematic center with respect to the palpated lateral pole of the condyle was investigated. Also, the lengths of the condylar movement path reconstructed by means of the kinematic center and the palpated condyle were compared. Mandibular movements were recorded with 6 degrees of freedom in 20 healthy subjects. A software procedure calculated the location of the kinematic center as that mandibular point for which the protrusive and opening movement path showed a minimal difference. For each subject, its average location was calculated on the basis of 16 pairs of protrusive and opening movements. The kinematic center was located posteriorly and superiorly with respect to the palpated condylar point (p < 0.0001). The standard deviation in the anterior-posterior coordinate of the average kinematic center was smaller than that in the superior-inferior coordinate (p < 0.0001). During opening, the path length of the kinematic center is longer than that of the palpated lateral pole of the condyle (p < 0.0001). In contrast to left-right differences found in the path lengths of the lateral pole of the condyle, no left-right differences were found for the kinematic center.

Adolescent↗

Masticatory electromyographic activity in healthy young adults and myogenous craniomandibular disorder patients.

UNLABELLED: The electromyographic (EMG) activity of the masseter and the anterior temporalis muscles were compared between 60 healthy controls and 61 myogenous craniomandibular disorder (CMD) patients. Subjects were asked to clench at 10% and at 50% of their maximum voluntary clenching level. The effects of CMD, age and gender were statistically analysed with the use of the analysis of covariance. The correlations between EMG asymmetries and the lateral slide from the retruded contact position to the intercuspal position and the asymmetry in the number of post-canine tooth contacts between the left and the right side were investigated. The CMD patients showed lower masseter EMG activities than the controls, whereas the anterior temporalis EMG activity was not different between the two groups. The activity index, relating the anterior temporalis EMG activity to the activity of the masseter muscles, confirmed the presence of a relatively high temporalis activity in the CMD group. No significant differences were found in the EMG asymmetries between the controls and the CMD patients. Males showed higher masticatory EMG activities than females. These gender effects were significant for the anterior temporalis at the 10% and 50% level and for the masseter muscle at the 10% level. The anterior temporalis EMG activity declined with age. No age related effects were observed in the masseter EMG. The lateral slide was larger and more prevalent in the CMD group. A significant correlation between the lateral slide and the anterior temporalis EMG was found for the CMD group at the 10% level. No correlation was found between the EMG asymmetry and the asymmetries in post-canine tooth contacts. IN CONCLUSION: significant CMD, age and gender effects were observed in the masticatory EMG activities of a group of myogenous CMD patients and a control group.

Adolescent↗

[Anxiety and depression in craniomandibular disorders; the use of the Symptom Checklist 90].

Anxiety and depression of CMD-patients in a Clinic for Special Dental Care were assessed with the Symptom Checklist-90. The results of the female patients did not differ from the general population; the men showed significantly higher scores. Approximately one third of the patients scored 'high' or 'very high' on anxiety or depression and may need special attention for psychological problems. The SCL-90 may be a useful instrument to assess the presence of clinically significant anxiety or depression. Psychological data should be interpreted with great care and always in combination with data from the dental examination.

Adolescent↗

Electromyographic evidence of local muscle fatigue in a subgroup of patients with myogenous craniomandibular disorders.

Ten female patients with myogenous craniomandibular disorders who had complete dentitions and mainly unilateral muscle pain and tenderness to palpation, and 10 healthy female controls, participated in the study. The surface electromyographic signals of masseter and anterior temporal muscles were recorded during 30-s test contractions at 50% of the maximum voluntary clenching effort. A force transducer placed between the central incisors recorded the maximum voluntary bite force. The patients exerted a lower maximum voluntary bite force than the controls (p less than 0.05). In the patients the electromyographic signals of the painful muscles were weaker than those of the painless muscles (p less than 0.01). The signals of the control subjects were stronger than those of the painless muscles of the patients (p less than 0.01). The mean power frequency of the signals, recorded at the start of the 30-s contractions, showed no differences between the painful and painless muscles and between the muscles of the patients and of the controls. The rate of mean power frequency shift in the electromyographic signal, as a response to the 30-s test contraction, was normalized with respect to the amplitude of that signal to account for its amplitude dependency. The painful muscles showed a higher normalized rate of mean power frequency shift than the painless muscles and the muscles of the control subjects (p less than 0.01). These results confirm the presence of an impaired condition in the painful muscles of this group of patients with myogenous craniomandibular disorders.

Adolescent↗