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Biomedical subjects

S Palla

Publications and source records attributed to S Palla.

At least 37 records · Page 2Linked to original sources
PubMed2000

Reproducibility of temporomandibular joint clicking.

AIMS: To investigate the stability of temporomandibular joint (TMJ) clicking over a 10-day period and the effect of different open/close velocities on sound amplitude and power spectra in a group of subjects with subjectively stable unilateral clicking during the 3 months preceding the recordings. METHODS: Ten volunteers were recorded with a self-developed microcomputer-based system used in a previous study on asymptomatic subjects. The recordings were performed during 4 different sessions at 3 different open/close rates in each session. The subjective sound intensity was measured with a 100-mm visual analog scale (VAS). The VAS scores, the maximum amplitudes, and the power spectra of the signals were tested for statistical differences among the different open/close rates and over the sessions. The reliability of measurements was also calculated. RESULTS: The maximum amplitude and the power spectra of the TMJ clicking varied between subjects in a broad range that differed from those reported for asymptomatic subjects. No statistically significant differences were found within subjects for the subjective VAS scores for the maximum signal amplitudes or for the power spectrum parameters among the open/close rates and over the 4 sessions. For all 3 open/close rates and for the 4 sessions, a good to excellent reliability of measurements was determined, the values of r being mostly over 0.75. CONCLUSION: Within the limits of the experiment, TMJ clicking was subjectively and objectively stable over a period of 10 days. Therefore, the constant subjective perception of sound intensity was supported by the objective measurements.

Adult↗
PubMed1999

Nocturnal masseter EMG activity of healthy subjects in a natural environment.

Facial pain of patients with craniomandibular disorders might be caused by muscle overload. However, the activity of masticatory muscles of healthy individuals is still unknown. The aim of this study was therefore a first attempt to clarify this question by recording the masseter muscle activity of healthy subjects during sleep by means of portable recorders. The study was performed on 21 healthy subjects selected after telephone and questionnaire screenings and clinical examination from among randomly selected inhabitants of Zürich. The masseter EMG was recorded during seven nights in each subject's natural environment with the electrodes in reproducible position. The signal was analyzed for number, amplitude, and duration of contraction periods defined as signal portions above a threshold which could contain sub-threshold signal portions shorter than the standby time of 5 sec. The signal amplitude was expressed in percent of the amplitude recorded during maximum voluntary clenches (%MVC). An average of 71.9 +/- 28.7 contraction episodes per night (men, 74.7 +/- 30.1; women, 65.0 +/- 23.8; p = 0.043), i.e., of 10.5 +/- 3.8 per hour (men, 11.0 +/- 4.0; women, 9.3 +/- 3.0; p = 0.005), was found. The average mean amplitude was 26.2 +/- 6.4% MVC (men, 27.0 +/- 6.8; women, 24.4 +/- 4.5; p = 0.009). The duration of the episodes had a mode of 0.5 sec, and the group mean of the integral of the amplitude over time was 123.7 +/- 157.9% MVC (men, 138.9 +/- 184.0; women, 85.9 +/- 28.2; p = 0.005). Healthy subjects showed intermittent periods of masseter activity during sleep which, on average, were of rather low intensity and short duration.

Adult↗
PubMed1998

Automatic on-line one-channel recognition of masseter activity.

The etiology of myoarthropathies of the masticatory system (MAP) is not fully understood. For the hypothetical association between the myogenous pain of MAP patients and masticatory muscle overuse to be proved, functional and parafunctional behavior of the masticatory muscles should be analyzed in normal and diseased subjects. The aim of this study was to test on-line the validity and reliability of an algorithm, applied to the electromyographic signal, to recognize various oral activities. The surface electromyogram of the masseter muscle was recorded in 12 subjects (seven females and five males, from 18 to 32 years old) who performed a series of functional and parafunctional activities (chewing soft food, chewing hard food, swallowing, laughing, speaking, and tooth grinding and clenching), as well as no activity. During the computer training phase, intra-individual classification functions of a multivariate discriminant analysis were calculated while each subject performed the described activities. During the test phase, each subject repeated the same activities, and the computer continuously classified them on-line. The percentage of correctly recognized activities was calculated for each activity and for each subject. No activity, chewing hard food, swallowing, laughing, grinding, and clenching were recognized correctly > 99% of the time. Chewing soft food was recognized correctly 97% and speaking 86% of the time. The sensitivity values for the recognition rates of the complete oral activities were, with one exception, > 0.82; the specificity values were > 0.95, and the kappa-values > 0.80. These results show that the algorithm had high sensitivity, specificity, and reliability in the classification of different oral activities under laboratory conditions.

Adolescent↗
PubMed1997

Reliability of scoring EMG orofacial events: polysomnography compared with ambulatory recordings.

The study of sleep bruxism is usually based on clinical history, signs and symptoms. The recording of electromyographic signals with either ambulatory portable home recorders or with polysomnographic techniques in the laboratory environment allows collection of objective data. The present study showed a 100% agreement with clinical evaluation in the recognition of bruxism episodes from the masseter electromyogram recorded with portable recorders and using the polysomnographic technique. On the contrary, scorers had difficulties in discriminating between different types of episodes (phasic, tonic and mixed), the between-scorers agreement varied between 62% and 63% and the kappa-values between 0.43 and 0.33. The ideal time base at which electromyographic signals should be integrated to allow for a good discrimination of bruxism patterns is 0.06 s. The results indicate that portable electromyography recorders are a valuable complement to polysomnographic recordings of orofacial motor activities as they provide a very good recognition rate with adequate time base data collection.

Adult↗
PubMed1997

The functional status of the masticatory system of 11-16-year-old adolescents: classification and validity.

Epidemiological studies to assess the prevalence and course of functional disturbances of the masticatory system should be based on a valid and reliable measure of the functional status of the masticatory system. NIELSEN et al. (2, 3) proposed a classification method that included three different classes of dysfunction. This classification was used to compare the results of a sample of 447 11-16-year-old Swiss adolescents with those of the Danish study and to test the validity of this classification method. The two studies showed similar prevalences in two of the three dysfunction classes and a similar pattern of dysfunction categories. Concurrent and construct validity analyses showed significant correlations between the assessment from clinical examination and the subjective judgments of the adolescents. The results demonstrated cross- and concurrent validation of the "Nielsen index" but also stressed the necessity of a careful re-evaluation of the "severe" class criterion. The limitations of the Nielsen index led to the construction of a "Zurich-MAP index". The potential applications of both indices are discussed.

Adolescent↗
PubMed1997

Description of mandibular finite helical axis pathways in asymptomatic subjects.

Despite wide use of systems to record jaw motion with six degrees of freedom, most studies have analyzed only the movement of a single mandibular point. The finite helical axis (FHA) is a mathematical model which can be used to describe comprehensively the movements of a rigid body. The aim of this investigation was to describe the FHA of the mandible during habitual jaw movements. Thirty subjects (13 females, 17 males; mean age, 26 years; range, 18 to 34 years) without myoarthropathies of the masticatory system participated in the study. Opening and closing movements, performed at 1-Hz frequency, were recorded with the optoelectronic system Jaws-3D. Three opening and closing movements were recorded from the right side and three from the left side of the jaw. The movement data were low-pass-filtered for noise reduction prior to the computation of the finite helical axis by means of a software program developed in our laboratory. The following parameters were calculated: the rotation of the FHA, its spatial orientation, and the translation along it, as well as its position and distance relative to an intracondylar point. In addition, methodological errors of the model were calculated. During opening and closing, the group mean FHA rotation was 24.3 degrees +/- 4.2 degrees. The group mean of the maximum total translation along the FHA was 0.9 +/- 0.7 mm. The group mean distance between the FHA and the intracondylar point was 48.9 +/- 9.9 mm. The FHA pathways were smooth and varied between individuals. Furthermore, the finite helical axes were never localized within the condyle, and often were located outside of the mandible. The analysis of the FHA pathways yields more information on whole mandibular movements than simply the movements of a single condylar point.

Adolescent↗
PubMed1997

[Headache and teeth].

Headache, facial pain and toothache are poorly localized and irradiate in distant areas. Thus, toothache often causes facial pain and headache, but, in turn, it can also be mimicked by several forms of these disorders, in particular by a myoarthropathy of the masticatory system, a migraine, a tension-type headache, a neuropatic pain and a trigeminal neuralgia. The atypical odontalgia is a nonodontogenic form of toothache that is difficult to diagnose; therefore, it leads to a number of invasive dental procedures which normally worsen the pain condition. The atypical odontalgia can often be solely diagnosed by means of a diagnostic block. Headache and facial pain can also be caused by a myoarthropathy of the masticatory system. This disorder is often misdiagnosed, because the signs and symptoms are not pathognomonic, and they are frequently present also in healthy individuals. The disorder has a good prognosis, the therapy is generally simple and follows the treatment principles for chronic musculoskeletal disorders. The burning-mouth syndrome is an other poorly understood form of intraoral pain that occurs primarily in postmenopausal females. Several etiologic factors have been described, but treatment based on one or more of these factors is often ineffective. Spontaneous remission occurs in about half of the patients after several years.

Facial Pain↗
PubMed1995

Activity recognition in long-term electromyograms.

Long-term electromyography with portable recorders allows the study of muscle activity in the natural environment to investigate whether muscle overuse or oral habits may contribute to initiate or perpetuate a myoarthropathy of the masticatory system. At present, little is known about the behaviour of masticatory muscles over long time periods. The aim of this preliminary study was to define parameters which allow the automatic recognition of different types of oral activities from the electromyogram form. A programme with functional and parafunctional activities was performed by four volunteers (total of 333 functional and 82 parafunctional recordings). Electromyograms of the masseter and temporal muscles were recorded by means of a self-developed portable intelligent solid state recorder. Signal mean level (mw) and dynamics (dw) within a sliding window were determined. Temporal muscle recordings allowed better discrimination between function and simulated parafunction. The average of mw for clenching was 51.4 +/- 3.5% and for tooth grinding 21.2 +/- 2% of the peak electromyogram value at maximum voluntary clench. At 0.96 s sliding window duration, clenching, tooth grinding and chewing signals had maximum separation, using dw/mw as parameters (average: 0.16 +/- 0.01 for clenching, 0.39 +/- 0.01 for teeth grinding and 0.88 +/- 0.01 for chewing).

Adult↗
PubMed1995

A new method for three-dimensional reconstruction and animation of the temporomandibular joint.

The aim of this project was to develop a new method for the three-dimensional reconstruction and animation of the temporomandibular joint (TMJ). Magnetic resonance (MR) tomograms of the TMJ were combined, using an extraorally placed reference system, with jaw motion data, recorded with six degrees of freedom, by means of the opto-electronic tracking system Jaws-3D. The three-dimensional reconstruction of the TMJ was calculated and animated on a graphics workstation by means of kinematic transformations. A subject without any past or present history of myoarthropathies of the masticatory system, performed jaw opening and closing and chewed chewing gum. The animation provided a three-dimensional visualisation of the movements of the entire condyle within the fossa. The condyle-fossa distance was computed for every condylar point and represented by shading the surface of the condyle with pseudo-colours. The position of the minimum distance between condyle and fossa was calculated and displayed in a plane graph representing the condylar surface.

Humans↗
PubMed1994

Precision of the jaw tracking system JAWS-3D.

The purpose of this study was to measure, under laboratory conditions, the noise level of the optoelectronic jaw-tracking system JAWS-3D, which records the movement of the whole mandible from extraorally placed landmarks. Also, an assessment was made of its accuracy in measuring positions, angles, and velocities. The results showed that the accuracy of JAWS-3D decreased when the distance between the recorded point and the extraoral landmarks increased. The path of a point near to the landmarks was estimated with an error of 0.11%, whereas the error increased to 1.33% when the point was far from the landmarks. The maximum error in angle computation was 0.7 degrees. The velocities calculated by JAWS-3D corresponded closely to the actual ones: mean error of 3 mm/s for velocities up to 80 mm/s. Thereafter, the error increased to reach 26 mm/s at a speed of 210 mm/s.

Artifacts↗
PubMed1994

Condylar rotation and anterior translation in healthy human temporomandibular joints.

Mouth opening is achieved by a combined rotatory and translatory movement of the disc-condyle complex within the fossa. The aim of this investigation was to analyse the relationship between condylar rotation and anterior condylar translation during deliberate opening and closing movements. Three consecutive opening and closing movements were recorded by means of the opto-electronic system Jaws-3D in 61 individuals (28 females and 33 males), aged 12 to 76 years, without a past or present history of myoarthropathies of the masticatory system. The computer provided the numeric values as well as the plots of the movement of an intracondylar point in three planes and of the relationship between condylar rotation (opening angle, OA) and anterior translation (AT). The OA/AT curves were also analysed visually for differences in shape. A marked inter- and intraindividual (left/right) variability was found for the ratio between opening angle and anterior condylar translation. Visual analysis of the OA/AT curves allowed them to be classified into five main groups. The groups differed statistically with respect to maximum opening angle and maximum mouth opening. The two groups with a more pronounced rotatory component at the end of opening had a significantly larger mouth opening than most of the other groups.

Adolescent↗
PubMed1993

Power spectral analysis of temporomandibular joint sounds in asymptomatic subjects.

Very little has been done to quantify temporomandibular joint (TMJ) sound amplitudes and background noise and to determine the spectrum from healthy TMJs. Thus, the aim of this study was to record acoustically the sounds emitted by healthy TMJs with and without mandibular movements, for determination of baseline spectra. TMJ sounds were recorded bilaterally from 40 subjects with healthy joints by means of a self-developed recording system using miniature capacitor microphones inserted into the earpieces of a medical stethoscope placed in the meatus of the auditory canal. The recordings were performed without mandibular movements and during three consecutive opening and closing movements. The signals were high-pass-filtered at 50 Hz, low-pass-filtered at 2 kHz, and analyzed by fast Fourier transform computation on a 1024-point window (fs = 5 kHz). The linearly weighted average baseline spectrum recorded without motion showed maximum values of 31 dBSPL (sound pressure level) with a standard error of +2 to -3 dB. The linearly weighted average movement spectrum had a peak of 66 dBSPL at 156 Hz and decreased almost linearly by about 40 dB/decade to 25 dBSPL at 2000 Hz with a standard error of +/- 2 dB. Thus, the TMJ sound spectrum of mandibular movements in asymptomatic subjects differed at low frequencies by up to 35 dB from the baseline spectrum in absence of motion.

Adolescent↗
PubMed1992

A comparative study of two methods for the orientation of the occlusal plane and the determination of the vertical dimension of occlusion in edentulous patients.

The aim of this study was to compare two methods used to orientate the occlusal plane (OP) and to determine the vertical dimension of occlusion (VDO). In method A the VDO was established by means of the rest position, the minimal speaking distance, and the patient's profile. Method B used a newly developed registration pin assembly. The VDO was registered using a silicone occlusion rim and the swallowing technique. The results were compared to the values of the new dentures. Three standardized lateral radiographs were taken at the VDO obtained with methods A, B, and at that of the final dentures. On each radiograph the orientation of the OP to the Camper plane and the VDO were measured by two investigators independently. The results indicated no statistically significant differences between the mean VDO with method A and B compared with the new dentures (P greater than 0.05). With both methods it was not possible to orientate the OP parallel to the Camper plane. None of the occlusal planes of the new dentures were parallel either. Their OP diverged on average by 7 degrees dorso-caudally. The time spent with method B to orient the OP and to determine the VDO was significantly lower than with method A (17-50 min).

Adult↗
PubMed1991

Condylar movements in clicking joints before and after arthrography.

The aim of this study was to investigate whether anaesthesia and contrast medium injection alter the biomechanics of the TMJ, thus influencing the arthrographic diagnosis in patients with anterior disc displacement with reduction. Opening and closing movements were recorded in nine patients by means of an opto-electronic motion recorder (Jaws 3D) before anaesthesia, after anaesthesia and after arthrography. The system computed the trajectories of a condylar point in the sagittal, frontal and horizontal plane. Data were analysed for changes in the position of the clicks, for the amount of condylar translation and for changes of the trajectories between recording conditions. The results indicated that arthrography had a significant effect on the position of the opening clicks in all nine patients. After injection, the clicks occurred on average 1.6 mm later than before injection. This was probably due to the excursive movements required for defusion of the contrast medium in the joint. The other parameters examined were not affected by the joint anaesthesia and the arthrographic procedure. The interventions influenced the shape and the incline of the sagittal condylar movement in three of the nine patients. In conclusion, arthrography altered the joint biomechanics, but not sufficiently to invalidate the arthrographic diagnosis.

Adult↗