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The effect of sustained submaximal clenching on maximum bite force in myofascial pain dysfunction patients.

The effect of a sustained (30% maximum) isometric clenching task on the maximum voluntary bite force level was evaluated on normal jaw function subjects as well as on abnormal jaw function subjects (MPD patients). The results indicate that the MPD subjects had a lower maximum voluntary bite force level and a shorter endurance time when compared to normal subjects. Neither the control subjects nor the MPD subjects demonstrated a change in their brief MVBF after a 'fatigue inducing' task. These results suggest a lack of contractile element failure in the jaw closing muscles following sustained submaximal isometric clenching on a force transducer.

Adult↗

Using sensitivity analysis to validate the predictions of a biomechanical model of bite forces.

Biomechanical modelling has become a very popular technique for investigating functional anatomy. Modern computer simulation packages make producing such models straightforward and it is tempting to take the results produced at face value. However the predictions of a simulation are only valid when both the model and the input parameters are accurate and little work has been done to verify this. In this paper a model of the human jaw is produced and a sensitivity analysis is performed to validate the results. The model is built using the ADAMS multibody dynamic simulation package incorporating the major occlusive muscles of mastication (temporalis, masseter, medial and lateral pterygoids) as well as a highly mobile temporomandibular joint. This model is used to predict the peak three-dimensional bite forces at each teeth location, joint reaction forces, and the contributions made by each individual muscle. The results for occlusive bite-force (1080N at M1) match those previously published suggesting the model is valid. The sensitivity analysis was performed by sampling the input parameters from likely ranges and running the simulation many times rather than using single, best estimate values. This analysis shows that the magnitudes of the peak retractive forces on the lower teeth were highly sensitive to the chosen origin (and hence fibre direction) of the temporalis and masseter muscles as well as the laxity of the TMJ. Peak protrusive force was also sensitive to the masseter origin. These result shows that the model is insufficiently complex to estimate these values reliably although the much lower sensitivity values obtained for the bite forces in the other directions and also for the joint reaction forces suggest that these predictions are sound. Without the sensitivity analysis it would not have been possible to identify these weaknesses which strongly supports the use of sensitivity analysis as a validation technique for biomechanical modelling.

Anatomy↗

Bite force and occlusal load distribution in normal complete dentitions of young adults.

The aim of this study was to investigate the bite force and its distribution over the maxillary dentition in completely dentate subjects. Twenty-three dental students (14 Danish, 9 Japanese) with complete dentitions, but without occlusal contact on the third molars participated and their maximal bite forces were measured using the Dental Prescale System close to intercuspation. The antero-posterior location of the occlusal load centre, i.e. the centre of balance of distributed occlusal load, was a little posterior of the centre of the upper first molar. These results could be used as a basic model for evaluation of occlusion.

Adult↗

Mandibular function in children with a lateral forced bite.

Open-close-clench cycles have been studied in 12 children with a lateral forced bite in order to investigate how the neuromuscular system of the mandible adapts itself in the presence of occlusal interferences. The mandibular movements were registered in a frontal plane at the central incisors with an opto-electronic registration technique. Series of 35 cycles were recorded to intercuspal position, against flat occlusal splints constructed in intercuspal raised and retruded positions, and against splints with occlusal stops in a retruded position. Average lateral displacements of the mandible during cycle series against flat occlusal splints were measured relative to cycle series to intercuspal position and relative to series against splints with occlusal stops in the retruded position. The lateral mandibular displacements were registered at maximal tooth-tooth or tooth-splint contact and at 7, 14, and 21 mm mouth-opening. It was found that the mandible in the subjects investigated is displaced to the forced bite side both during cycle series into intercuspal position as well as when occlusal contacts are eliminated by the use of flat occlusal splints.

Child↗

[Effect of bite force on parotid secretion in human].

To determine the physiological roles of periodontal mechanoreceptors in parotid salivary secretion, we studied the effects of strength and frequency of unilateral bites on the salivary secretion from both sides of human parotid glands. Parotid saliva was collected bilaterally via modified Lashley cups, and the flow rate of parotid saliva was measured with a device using a strain gauge. The bite force was monitored with a pressure transducer. In the first experiment, subjects were constantly occluded for one minute at 80 strokes per minute at strengths of 5, 10, and 20 kg. In the second experiment, subjects were occluded for one minute at a constant force of 10 kg at frequencies of 20, 40, 80, and 120 strokes per minute, or subjects were continuously clenching for one minute. The flow rate of parotid saliva gradually increased with increasing bite strength, while it gradually decreased with increasing bite frequency. In unilateral bites, the salivary flow rate of the ipsilateral parotid gland was greater than that of contralateral parotid gland, at any strength and frequency. These results suggest that periodontal mechanoreceptors are involved in parotid salivary reflexes initiated by bite force stimuli.

Bite Force↗

Bite-force variation related to occlusal variation in rural and urban Punjabis (North India).

Occlusal variation from defined norms was much less in traditional rural youths eating a rough unprocessed diet. Bite forces were significantly higher in the rural youths; their habitual harder chewing may help to being about their better occlusal development. Rural youths showed stronger increase with age and sex dimorphism than urban youths in bite force; thus, rurally the development of masticatory and facial structures may depend on functional masticatory demand.

Adolescent↗

Implant-tooth-supported fixed partial prostheses: correlations between in vivo occlusal bite forces and marginal bone reactions.

PURPOSE: To evaluate maximal occlusal bite forces (MOF) and marginal bone level (MBL) changes in patients with implant-tooth-supported fixed partial prostheses (FPP). MATERIAL AND METHODS: Twenty nine partially edentulous patients consecutively who received 34 three-occlusal unit FPP with terminal implant and tooth support were subjected to quantification of MOFs using a sub-miniature load cell connected to a data acquisition system and measurement of the MBL changes around implants in digitalized periapical radiographs obtained at prostheses delivery and 24-month follow-up. RESULTS: MOFs for implant support (mean: 353.61 N) significantly differed from tooth support (mean: 275.48 N) (P < 0.05), while gender did not influence MOFs (P > 0.05). MBL changes at mesial and distal sites of the implants at 24 months of functional loading were 0.28 and 0.097 mm respectively. CONCLUSION: Although MOFs under functional loading might indicate an increase in load participation for supporting implant, the rigid connection between implant and natural tooth via three-occlusal unit FPP does not jeopardize the time-dependent MBL stability of the implant under functional loads.

Adult↗

The association among occlusal contacts, clenching effort, and bite force distribution in man.

The contact area during habitual biting can vary according to the activity of the jaw musculature. Forceful masticatory muscle activity may also induce deformations of the dento-alveolar tissues and the supporting skeleton, yielding various tooth loads despite an apparently even distribution of tooth contacts. To investigate this variability, we measured bite forces simultaneously at multiple dental sites during maximum-effort clenching tasks. In each of four healthy adults with complete natural dentitions, four strain-gauge transducers in the right side of an acrylic maxillary appliance occluded with the lower canine, second premolar, and first and second molars. These, and matching contralateral contacts, were balanced by means of articulating paper and a force monitor (type F appliance). Bite forces were recorded when the subjects, without visual feedback, clenched maximally on the appliance. Similar recordings were made when contralateral molar and all contralateral contacts were removed (type R and type U appliances, respectively). Although the relation between individual forces often changed during the initial increase in force, it was generally constant around the maximum. The maximum forces at the four dental locations varied in distribution between subjects, but were characterized by posteriorly increasing forces. Forces in the anterior region (especially at the canine) significantly increased (up to 10 times) when clenching took place on unilateral contacts only (type U) as compared with fully balanced ones (type F). Bite force distribution thus changed with biting strength and the location of occlusal contacts. Increased force in the canine region during unilateral clenching seems related to the pattern of jaw muscle co-activation and the physical properties of the craniomandibular and dental supporting tissues which induce complex deformations of the lower jaw.

Adult↗

Maximal bite force and its association with signs and symptoms of TMD, occlusion, and body mass index in a cohort of young adults.

The purpose of this population-based cohort was to measure maximal bite force (MBF) in the molar and incisal regions and to examine whether MBF was associated with TMD, gender, occlusion (in terms of overjet, overbite, and total number of occluding contacts), and body mass index (BMI). MBF in the molar and incisal regions was measured using a calibrated method in 384 (196 males, 188 females) and 357 (181 males, 176 females) subjects, respectively. Two attempts in each region (right molar, left molar, and incisal) were made in random order. The subjects completed a multiple-choice questionnaire including subjective symptoms of TMD and were subsequently clinically examined. Helkimo's clinical dysfunction index and BMI were calculated. The mean MBF value in the molar region was significantly higher in males (878 N, SD 194) than in females (690 N, SD 175) (p < 0.001). The incisal forces were 283 N (SD 95) and 226 N (SD 86) (p < 0.001), respectively. According to multiple linear regression, TMJ discomfort was significantly negatively associated with MBF in the molar region (p < 0.05) and overjet was significantly negatively associated with maximal incisal bite force (p < 0.05). No significant associations between MBFs and body mass were found. The results demonstrate that in a population-based cohort of young adults signs, and symptoms of TMD and studied occlusal factors, unlike body mass, associate independently with MBF.

Adult↗

Measurement of bite force variables related to human discrimination of left-right hardness differences of silicone rubber samples placed between the incisors.

This study was designed to examine human subjects' ability to discriminate between spatially different bite pressures. We measured actual bite pressure distribution when subjects simultaneously bit two silicone rubber samples with different hardnesses using their right and left incisors. They were instructed to compare the hardness of these two rubber samples and indicate which was harder (right or left). The correct-answer rates were statistically significant at P < 0.05 for all pairs of different right and left silicone rubber hardnesses. Simultaneous bite measurements using a multiple-point sheet sensor demonstrated that the bite force, active pressure and maximum pressure point were greater for the harder silicone rubber sample. The difference between the left and right was statistically significant (P < 0.05) for all pairs with different silicone rubber hardnesses. We demonstrated for the first time that subjects could perceive and discriminate between spatially different bite pressures during a single bite with incisors. Differences of the bite force, pressure and the maximum pressure point between the right and left silicone samples should be sensory cues for spatial hardness discrimination.

Adult↗

The effect of bite force on the duration and latency of the menton tap silent period.

The purpose of this research was to investigate the effect of bite force changes on the duration and latency of the menton tap silent period and particularly whether a decrease in bite force can increase the duration of the silent period to the extent which may be found in dysfunctional patients. The menton tap silent period was recorded from both anterior temporal and masseter muscles while the subject was clenching at different force levels. A bilaterally stable force transducer was used to monitor the clenching force. The results indicated no statistically significant differences in the mean durations and latencies of silent periods at different clenching forces. They suggest that duration and latency are not related to the degree of clenching force.

Adult↗

Maximal bite force and surface EMG in patients with myasthenia gravis.

Masticatory muscle strength was quantified in patients with bulbar myasthenia gravis and compared with that of patients with ocular myasthenia gravis, patients in clinical remission (whether or not pharmacological) who previously suffered from bulbar myasthenia gravis, and healthy subjects. Maximal bite force and maximal activity of the masseter and temporalis muscles and of the submental muscle complex were measured. Bite force was decreased in the patients with bulbar myasthenia gravis, but was normal in the patients in the clinical remission group and in the ocular group. These findings were consistent with the results of electromyographic data. Although subjective reports of masticatory muscle weakness provide valuable information, quantitative measurements provide more information about the degree of muscle weakness of individual muscles. This is especially important for longitudinal evaluation of therapy in individual patients and for pharmacotherapeutic research.

Adult↗

An investigation into the effect of denture fixatives in increasing incisal biting forces with maxillary complete dentures.

The effect of denture fixatives on incisal biting forces was investigated in five subjects wearing maxillary complete dentures. Forces required to displace new and old dentures with and without fixatives were measured up to six hours post-insertion using a force transducer. The results showed that incisal forces were greater with new dentures than with old dentures when only saliva was present. After the application of fixative to the old dentures, the difference from the new dentures without fixative became insignificant. It is concluded that the improvement in retention of complete dentures with the use of fixatives allowed patients to increase their incisal biting capability.

Adhesives↗

Posterior occlusal support and bite force influence on the mandibular position.

Three-dimensional mandibular displacement related to loss of posterior occlusal support was investigated. Five subjects, whose mandibular premolars and molars needed to be restored, were selected. Their experimental prostheses were removed in sequence from the most posterior to anterior. The more the absence of posterior occlusal support increased, the more condylar displacements were increased. On the other hand, maximum bite forces were decreased, by removing each prosthesis in sequence from posterior to anterior. These results suggest that condylar position would be easily displaced with low level bite force following loss of posterior occlusal support.

Adult↗

[Can bite force be predicted from the shape of the face?].

The relationships between maximum bite force (MBF) and facial architecture have been tested in a sample of 118 dental students. The strongest correlations were seen with the variables representative of posterior face height and facial divergence. No correlation could be seen between MBF and incisor's position. MBF allowed only partial discrimination of the individuals in different subgroups constituted by cluster analysis. MBF is to consider as a representation of the individual aptitude to develop more or less powerful forces. It summarises only part of the functional information influencing facial form.

Adult↗

Bite-force development, metabolic and circulatory response to electrical stimulation in the canine and porcine masseter muscles.

The development of fatigue was investigated by electrical stimulation in 15 domestic pigs (1 yr old, 70-90 kg body weight) and seven adult dogs (3 yr old, 45 kg body weight). After anaesthesia, silver electrodes were implanted in the anterior and posterior parts of the right masseter muscles. The contralateral muscle was used as control. The bite force was measured. Muscle biopsies were obtained from the anterior, central and posterior parts, and were immediately frozen in liquid nitrogen. A fluorometrical analysis by enzymatic methods for glycogen, glucose, creatine phosphate, NAD, NADH, lactate and pyruvate was made. Blood flow was measured by 133Xe wash-out; oxygen consumption was monitored with an oxygen electrode. The porcine masseter was continuously stimulated for 60 min (100 V, 4 Hz and 2 ms). The canine masseter was intermittently stimulated (100 V, 20 Hz and 2 ms). The contraction was repeated four times, with a 10-min rest between. The porcine masseter could sustain longer endurance times than the canine masseter, which was easily fatigued. A marked substrate depletion was evident. The precontractional contents of glycogen, glucose and creatine phosphate were reduced. Lactate accumulation was evident (2-4 times more in the porcine and 4-8 times more in the canine masseter). The NADH concentration increased and the NAD content decreased. Blood-flow impairment (80% reduction in the dog, 60% in the pig) was observed. After the contraction phase, there was a hyperaemia (58% elevation of blood flow in the pig masseter, 45% in the canine). The oxygen tension followed in magnitude and time the blood-flow changes. These circulatory variables returned to normal after recovery. The high degree of substrate depletion, blood-flow impairment and a simultaneous decrease in oxygen transport to the contracted muscle, in combination with a prominent lactate accumulation, may induce a decrease in bite-force production.

Animals↗

Predicted pattern of human muscle activity during clenching derived from a computer assisted model: symmetric vertical bite forces.

A computer assisted three-dimensional model of the jaw, based on linear programming, is presented. The upper and lower attachments of the muscles of mastication have been measured on a single human skull and divided into thirteen independent units on each side--a total of 26 muscle elements. The direction (in three dimensions) and maximum forces that could be developed by each muscle element, the bite reaction and two joint reactions are included in the model. It is shown for symmetrical biting that a model which minimizes the sum of the muscle forces used to produce a given bite force activates muscles in a way which corresponds well with previous observations on human subjects. A model which minimizes the joint reactions behaves differently and is rejected. An analysis of the way the chosen model operates suggests that there are two types of jaw muscles, power muscles and control muscles. Power muscles (superficial masseter, medial pterygoid and some of temporalis) produce the bite force but tend to displace the condyle up or down the articular eminence. This displacement is prevented by control muscles (oblique temporalis and lateral pterygoid) which have very poor moment arms for generating usual bite forces, but are efficient for preventing condylar slide. The model incorporates the concept that muscles consist of elements which can contract independently. It predicts that those muscle elements with longer moment arms relative to the joint are the first to be activated and, as the bite force increases, a ripple of activity spreads into elements with shorter moment arms. In general, the model can be used to study the three-dimensional activity in any system of joints and muscles.

Bite Force↗

Marginal failure of amalgam. Effect of alloy selection and bite forces.

Four amalgam alloys were used in a two and a half year study. 163 class II restorations were made and the marginal breakdown was studied. The biting forces of the patients were estimated and divided in three groups. The result indicated that the conventional amalgam showed more breakdowns than the high copper amalgams. Among these a dispersed and a ternary amalgam had least marginal failures. The amount of defects tended to be correlated to the biting force for the conventional and the dispersed amalgam.

Adult↗