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Response patterns of craniomandibular muscles with and without alterations in sensory feedback.

1. Surface EMG recordings were made bilaterally from the anterior part of the temporal muscle, superficial masseter muscle, and the suprahyoid complex of muscles while tracking mandibular incisor movement in three planes. This was done in 20 normal subjects with 16 different responses. Some responses involved clenching whereas other responses occurred with actual mandibular movement. 2. Each muscle demonstrated a probability of recruitment dependent on the response that correlated with the intensity of recruitment. The higher the probability of recruitment, the greater the intensity of muscle activity. 3. The anterior temporal muscle demonstrated no statistically significant difference in any of the responses between the left and right muscles. The masseter muscle also demonstrated bilateral symmetry. 4. The anterior part of the temporal muscle was recruited in more than 60% of its trials (60% to 100%) in ipsilateral laterotrusion, retrusion, fast vertical raising, clenching on the ipsilateral or intercuspal position, and mastication. The temporal muscle was recruited in less than 60% of its trials in contralateral and incisor clenching, and less than 30% in contralateral laterotrusion, protrusion, and opening. 5. The superficial masseter muscle was recruited in more than 60% of its trials in protrusion, vertical raising, all clenches, and mastication. The masseter muscle was recruited less than 60% in retrusion, ipsilateral laterotrusion, and opening. 6. The suprahyoid group of muscles was recruited in more than 60% of its trials in protrusion, opening, and mastication. This group of muscles was recruited less than 60% of the time in clenching, lateral movements, and rapid vertical raising of the mandible. 7. Applying a maxillary splint to seven subjects significantly decreased the recruitment of the anterior temporal and masseter muscles during mastication. The splint also modified the use of the masseter muscle during protrusion so that it was less active, but increased its recruitment during contralateral clenching. The suprahyoid muscle group was unaffected by the maxillary splint. 8. These data support the concept that movement of the mandible from the intercuspal or rest position develops a coactivation pattern that will excite or inhibit a given muscle regardless of whether clenching with occlusal contacts or no occlusal contact is involved. 9. The data also demonstrate that the maxillary splint can alter the use of the jaw elevator muscles, predominantly in mastication.

Adult↗

Enhancement effects of test injection with a small amount of MR contrast medium in the oral and maxillofacial region.

PURPOSE: To examine whether the signal intensity of dynamic contrast-enhanced MRI (DCE-MRI) is altered by test injection of 1 ml of contrast medium, and if so, whether this change affects the DCE-MRI analysis. MATERIALS AND METHODS: Six healthy volunteers were examined by DCE-MRI using a Magnevist syringe and/or an Omniscan syringe for the injection of contrast medium. Each scan was performed 10 times using steady-state free precession (3D-FISP), a sequence for DCE-MRI, before and after intravenous injection of 1 ml of the contrast medium. The internal pterygoid muscle, masseter muscle, tongue, parotid gland, submandibular gland, bone marrow of the mandible, subcutaneous adipose tissue, and common carotid artery were determined to be regions of interest (ROI), and the ROI internal average signal intensity was measured. The 10 data sets obtained before or after contrast medium administration for each ROI were evaluated using the paired t-test. RESULTS: The test injection increased the signal intensities of six of eight ROIs, with all 20 experiments in the submandibular gland showing significant differences. There was no significant difference in the two ROIs corresponding to the carotid artery and subcutaneous adipose tissue of the cheek. CONCLUSIONS: The enhanced signal intensity in the tissue might have been caused by the small amount of contrast medium in the test injection. To eliminate this discrepancy caused by the test injection, a pre-contrast scan should be performed when the average signal intensity of an ROI is measured. We therefore believe that the data obtained before a test injection may be important in the analysis of DCE-MRI.

Adult↗

Prediction of TMJ arthralgia according to clinical diagnosis and MRI findings.

PURPOSE: The aim of this study was to investigate the ability of clinical and magnetic resonance imaging (MRI) diagnoses to predict pain in the temporomandibular joint (TMJ). MATERIALS AND METHODS: One hundred forty-nine patients were examined by 2 calibrated examiners in strict accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All patients who presented with a defined clinical RDC/TMD diagnosis were included and underwent bilateral coronal and sagittal MRI of the TMJ. Two raters blinded to the clinical diagnosis interpreted the MRI scans for TMJ pathology. The results were tested against the clinical diagnosis according to the RDC/TMD, including pain-related disability and psychosocial status, for associations to TMJ arthralgia using logistic regression analysis (GENMOD procedure, P < .05). RESULTS: MRI-depicted anatomic changes, such as joint effusions, disc displacement, and osteoarthrosis, were not significantly correlated with the presence of pain in the TMJ. However, a significant relationship between pain on palpation of the masseter muscle origin (P = .0050) and psychosocial factors (P = .0452) and pain in the TMJ was demonstrated. CONCLUSIONS: Pain in the TMJ caused by the anatomic proximity of the muscle masseter origin and the lateral TMJ pole and the possible existence of trigger points in the musculature may lead to a false-positive or a false-negative diagnosis of arthralgia. Additionally, clinicians must consider the psychosocial aspects of pain in ideal treatment planning.

Adolescent↗

X-ray microanalysis of elements in the masticatory muscle after paresis of the right masseter.

Muscle activity and function appear to be related to ionic concentrations in the muscle. We investigated whether muscle paresis induced by injection of Botulinum toxin A (Botox) in 16-week-old pigs over a 56-day period is associated with ionic changes in the affected muscles. Tissue samples were taken from the masseter, temporalis, medial pterygoid, and geniohyoid muscles by a standardized method and used for energy-dispersive x-ray microanalysis in an environmental scanning electron microscope. The largest increase in Na(+) was measured in the right and left sides of the masseter muscle in treated animals. Additionally, a significant elevation of Na(+) was measured in the anterior part of the temporalis muscle and in the pterygoid muscle (P < 0.05). In temporalis and pterygoid muscles, an increase in sulfur in both sides of treated pigs' heads was observed. Botox((R)) has an indirect impact on ion concentrations, resulting in changes in muscle functional capacity and adaptive compensation of paretic muscle function by other muscles.

Animals↗

Associations among four modalities of experimental pain in women.

UNLABELLED: The aim of this study was to investigate the associations among 4 measures of pain induction procedures in 244 healthy women. The procedures were (1) pressure pain threshold assessed over the temporalis muscles, masseter muscles, temporomandibular joints, and the wrists; (2) C fiber-mediated heat pain threshold/tolerance assessed on the skin over the forearm, cheek, and dorsal aspect of the foot; (3) temporal summation of C fiber-mediated heat pain; and (4) ischemic pain threshold/tolerance. Strong associations among pressure pain thresholds at the 4 sites examined (rho = 0.7 to 0.8, P values < or = .001) and among heat pain threshold/tolerance values at the 3 sites examined (rho = 0.6 to 0.9, P values < or = .001) were observed. Pressure pain threshold was moderately correlated with each of the heat pain threshold/tolerance values (rho = 0.2 to 0.4, P values < or = .001). Ischemic pain threshold/tolerance was moderately associated with each of the pressure and heat pain measures (rho = 0.2 to 0.3, P values < or = .05 to .001). Derived measures of the temporal summation of heat pain did not correlate strongly with threshold or tolerance measures of pressure, ischemic, or heat pain. We concluded (1) that for a specific pain modality, the correlation between threshold and tolerance values across anatomic sites is high, and (2) that measures of pressure, ischemic, and thermal pain threshold/tolerance are significantly correlated, although the strength of these associations is moderate. These findings demonstrate that a battery of pain-assessing procedures is required to determine an individual's pain sensitivity profile or phenotype. PERSPECTIVE: By investigating the relationship between pain sensitivity produced by different forms of stimuli, this study demonstrates that a battery of tests should be used to assess an individual's pain sensitivity and one should be careful in making inferences about an individual's sensitivity to pain by using only one pain modality.

Adolescent↗

Pain and dental implantology: sensory quantification and affective aspects. Part I: At the private dental office.

After an extensive review of the dental literature, few articles were found related to pain and implantology. Management of orofacial pain has traditionally been a difficult challenge for the dental-medical profession. Patients may be afraid of dental pain, particularly in cases of dental implantology. Therefore, a study to obtain more conclusive data was developed. Taking into account that the perception of pain and the threshold of pain vary among individuals, a 2-year clinical study was established in private practice utilizing a verbal method (double-blind). The study was used to quantify sensory and affective aspects of pain associated with dental implantology on 75 patients in a private dental office. All of the implants were placed by the same clinician. Data were recorded following a Pain Data Sheet designed for this particular study. The aim of this study was to obtain different aspects of data as follows: 1) Fear of the dentist and fear of dental implant procedures utilizing a descriptive scale of 1 to 10, with 1 indicative of no fear. 2) Dental areas and ridges: Dental pain, pain in edentulous areas, and pain in the implanted area utilizing a scale of 0 to 8, with 0 indicative of no pain. 3) Function and pain: during mastication, swallowing, speech, yawning, opening, closing, and lateral excursions and indication of cervical pain or back pain, each calibrated by the presence or absence of pain. 4) Palpation and pain of the temporomandibular joint, the temporal muscle, the area of the pterygoid muscles, masseter muscle, and sternocleidomastoid muscle, all calibrated on the indication of presence or absence of pain. 5) Others: ear pain, neuralgia, headaches, edema, and hematoma, calibrated on the basis of presence or absence. The aforementioned factors were evaluated immediately before surgery and after surgery, at 24 hours, and during a follow up for a period of 2 years at intervals of 1 week; 1, 2, 3, 4, and 6 months; and 1 and 2 years after surgery. Also recorded were the uses of presurgical and postsurgical medication at the first and second surgical phases, age, sex, buccal opening, number and position of implants, previous dental experiences, and the psychological preparation for dental implant treatment. The results of the statistical analysis indicate no correlation between pain and dental implantology procedures, in a private dental practice, at the level of significance of P > .001.

Adolescent↗

The influence of dental status on masticatory muscle activity in elderly patients.

PURPOSE: The objective of this study was to determine whether elevator and depressor muscle activity during 5 minutes of mastication is affected by the presence of a prosthetic appliance in elderly patients. MATERIALS AND METHODS: Thirty edentulous subjects (EG) and 30 age-matched dentate subjects (DG) were studied. Surface electromyographic (EMG) recordings were obtained from the anterior temporal muscle, masseter muscle, and the submandibular group in the region of the anterior belly of the digastric muscle on the left and right sides. Muscle activity was recorded during maximal voluntary contraction (MVC) in the intercuspal position, maximal opening (Omax), and during 5 minutes of mastication. Elevator muscle activity during mastication was expressed as a percentage of maximal muscle activity in the intercuspal position (%MVC), and depressor muscle activity was expressed as a percentage of maximal opening (%Omax). The effect of 3 factors was investigated using a mixed analysis of variance design: the factor of muscle, with 6 muscles involved; the factor of time (5 minutes of mastication); and the factor of dental status, where some participants had their own natural dentition and others had complete dentures. RESULTS: The results revealed significant effects for the factors "muscle" and e" (P < .001 for the factor "muscle"; P < .001 for the factor "time"). The time by group interaction was significant (P = .046). In the EG, muscle activity gradually decreased during the 5-minute interval of mastication, while in the DG it decreased more rapidly from the first to the third minute and then increased until the fifth minute. There was also a significant effect regarding the presence of natural teeth or complete dentures (P < .034). Complete denture wearers had higher muscle activity relative to %MVC or %Omax than dentate subjects. CONCLUSIONS: Muscle activity during 5 minutes of mastication depended greatly on the presence of the prosthetic appliance, since edentulous subjects had to use higher potentials of muscle activity (%MVC or %Omax) than age-matched dentate subjects, and were unable to increase activity at the end of mastication. The difference in chewing patterns and activity between complete denture wearers and dentate subjects should be explained to patients prior to prosthetic treatment to help them adjust their expectations.

Aged↗

The effects of zygomatic complex fracture on masseteric muscle force.

The masseter muscle often has been implicated as a primary cause of postreduction displacement of the fractured zygomatic complex. However, this contention has never been proved. This study compared masseter muscle force in 10 male controls with that in 10 male patients who had sustained unilateral zygomaticomaxillary complex (ZMC) fractures. Calculation of muscle force was based on measured bite force, electromyogram, and radiographic determination of muscle vectors. It was found that the masseter muscle in patients with ZMC fractures developed significantly less force than masseter muscle in controls. Following fracture, the masseter force slowly increased, but at 4 weeks following surgery the majority of patients were still well below control levels. The results of this study cast uncertainty on the role of the masseter muscle in postreduction displacement of the fractured ZMC.

Adult↗

[Observation of motorneuron after recovery from experimental facial nerve paralysis].

The localization of the motor neurons innervating facial muscles and the masseter muscle was examined by the retrograde horseradish peroxidase (HRP) technique. Ten microliters of 50% HRP was injected into the orbicularis oculi muscle, the orbicularis oris muscle, the zygomaticus muscle and the masseter muscle of rabbits. At 48 hours after the HRP injection, perfusion fixation was done through the left ventricule of the heart under general anesthesia. The brain stem was removed and reacted with diaminobenzidine. The nucleus of the orbicularis oculi muscle was distributed in the medial-dorsal portion of the facial nerve nucleus. On the other hand, the nucleus of the orbicularis oris muscle and the nucleus of the zygomaticus muscle were located in the lateral-ventral, and medial-ventral portions, respectively. The nucleus of the masseter muscle (trigeminal motor nucleus) was located about 1.1mm proximal to the facial nucleus. Experimental facial nerve palsy was produced by the following procedures. The intratemporal facial nerve was exposed under local anesthesia and crushed for 20 sec. using a hemostatic forceps. Recovery from the facial nerve palsy was evaluated by evoked electromyography 3 months later. After another 3 months, HRP was injected into the zygomaticus muscle. In animals that had recovered from the facial palsy, motor neurons labeled with HRP were found not only in the medial-ventral portion but also partially in the medial-dorsal portion, which was the position of the labeled nucleus of the orbicularis oculi muscle in control animals. However, there was no significant difference in the size or number labeled motor neurons between the control and recovered animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Gain and threshold of the jaw-jerk reflex in man during isometric contraction.

The control of mandibular posture has been related to the activity of the anterior temporal muscles, whereas the masseter muscles have been viewed mainly as force producers. However, these groups of muscles, especially in the deep layers, are highly endowed with muscle spindles, so that a difference in function should imply a difference in the reflex sensitivity. By studying the jaw-jerk reflex by means of bipolar surface electromyogram, the reflex sensitivity was determined from relationships between reflex amplitude and jaw displacement from both groups of muscles in eight subjects. At a constant level of background muscle activity, and hence with a constant excitability of the alpha motoneurons, the reflex sensitivity can be determined from these relationships in terms of gain and threshold. In order to account for differences in thickness of the soft tissues overlying the various muscles studied, the reflex amplitude was normalized with respect to the level of maximal voluntary contraction (MVC). In experiments where the inter-electrode distance was 18 mm over both groups of muscles, the reflex gain of the anterior temporal muscles was larger than that of the masseter muscles (P < 0.05). The threshold value did not differ significantly from zero for either group of muscles. Normalization of the reflex amplitude with respect to MVC can be carried out correctly only if the reflexly activated muscle fibres are distributed uniformly within the muscle. In order to gain an insight into this distribution, control experiments were performed with three subjects in which the inter-electrode distance was varied, thus influencing the depth in the muscle from which active muscle fibres were recorded. The reflex gain of the masseter muscle with an inter-electrode distance of 22 mm, which records from deeper layers of the muscle as well as superficial ones, was larger than with a distance of 11 mm (P < 0.01-0.10 in the various subjects). No such differences were found for the anterior temporal muscle. It was concluded that the afferents of the spindles in the jaw-elevator muscles do not project uniformly upon the motoneurons, but involve mainly fibres in the deeper layers of the muscle. The difference in gain found between the masseter and the anterior temporal muscles with the same inter-electrode distance of 18 mm is likely to be due to a larger distance of the reflexly activated muscle fibres in the masseter muscle with respect to the electrodes rather than to a difference in reflex sensitivity between the muscles.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Isometric muscle tension generated by masseter stimulation after prolonged alteration of the consistency of the diet fed to growing rats.

The forces developed by the masseter muscle and the diet-related changes were studied in situ. The active tetanic tension was measured indirectly by recording the forces applied to the mandible in four different predetermined interincisal distances. The highest tension developed in all the experimental groups was with an interincisal distance of 11 mm. The tetanic tension was significantly lower in rats fed a soft diet than in those fed a normal diet. This difference might be due to the smaller muscle fibres in rats with decreased functional demand. The changes in the masticatory muscles may influence the tension applied to the facial skeleton and cause the alteration in the craniofacial growth previously found in rats fed a soft diet.

Animals↗

Superficial and deep layer muscle fibre properties of the mouse masseter before and after weaning.

To clarify changes in the properties of the masseter muscle superficial and deep layer muscle fibres, which initiate masticatory movement, myosin heavy chain isoforms were evaluated based on immunohistochemistry at the transcription level in male mice both before and after weaning. In the results, MHC-2b isoforms, the isoforms with the fastest contraction speed, were observed in the superficial layer after weaning. However, MHC-2a isoforms with slower contraction speeds were not apparent. By contrast, in the deep layer, MHC-2a isoforms were present, as were MHC-2b isoforms, however, there were fewer MHC-2b isoforms present than in the superficial layer. The most rapid movement in the mouse mandible was observed anteroposteriorly during mastication. As the superficial layer of the masseter muscle runs parallel to the direction of mandibular movement, the presence of MHC-2b isoforms in it is consistent. The presence of MHC-2a isoforms in the deep layer, lying at right angles to the direction of mastication movement, is consistent with the positional adjustment of the mandible contributed by the deep layer muscle fibres during masticatory movement. We therefore conclude that complicated masticatory movement is achieved by the presence of various muscle bundles within the masseter, each carrying out different roles.

Animals↗

[A cephalometric, electromyographic and kinesiographic appraisal of a patient with mandibular prognathism and anterior openbite malocclusion before and after surgical orthodontic therapy: a case report].

A 19-year-old female patient with skeletal 3 and anterior openbite malocclusions was treated by a surgical orthodontic approach. A glossectomy was also performed. Cephalometric, electromyographic and kinesiographic records were taken before and after the treatment. The treatment results were as follows: 1. Esthetic improvement in facial profile and static alignment and intercuspation of teeth was obtained. 2. The dimension of the tongue with respect to that of the oral cavity proper measured on the lateral cephalograms revealed a value similar to that determined for the control data after the active treatment. 3. The proportion of reversed strokes with respect to the total chewing strokes increased at the completion of the active treatment both for the right- and the left-sided chewings, but it decreased during the retentive period. 4. At the initial stage, an earlier onset of the masseter muscle activity relative to the temporal muscle group was determined, while the temporalis muscles showed an earlier onset of activity in the postoperative phase. 5. The durations of chewing strokes became shortened in a postoperative phase both on the working and the balancing sides. This observation was particularly significant for the opening and the closing phases. In addition, the proportion of the duration of significant temporalis muscle activity with respect to that of the concomitant chewing stroke increased. 6. Anterior temporalis muscle and masseter muscle activity during clenching performance revealed a value similar to the control data. In summary, the current case suggests that the patients who receive surgical orthodontic treatment require sufficient time to obtain functional readaptation during the retentive period.

Adaptation, Physiological↗

Muscle and brain changes of calcitonin gene-related peptide in experimentally induced unilateral rat masseter myositis.

AIMS: To investigate changes in calcitonin gene-related peptide (CGRP)-like immunoreactivity (CGRP-LI) in the rat masseter muscle and brain after the unilateral experimental induction of masseter myositis. METHODS: Ipsilateral and contralateral changes of the CGRP were examined in rat masseter muscle after the induction of unilateral myositis on the right side with an intramuscular injection of 0.01 mL Freund's adjuvant. The left masseter, and left and right masseters of control rats, were injected with 0.01 mL saline (0.9%). After 21 days, tissue samples from the masseter muscles and the hypothalamic-pituitary-adrenal (HPA) axis were analyzed for the presence of CGRP by immunohistochemistry, radioactive immunoassay, and high performance liquid chromatography. Hematoxylin-eosin staining was used to confirm inflammation in the masseter muscles. RESULTS: Elevated CGRP-LI was detected bilaterally in the masseter muscles (P < .001) in the myositis group. CGRP-immunoreactive nerve fibers were mainly detected in close proximity to muscle cells and in the walls of the blood vessels. Compared to the control rats, a significant difference in scratching behavior was seen in the myositis group from day 9 until day 21. In the myositis group, CGRP-LI was increased in the pituitary gland concomitant with the increase in CGRP-LI in the masseter muscles but was decreased in the hypothalamus. A possible explanation for these changes could be that rats with chronic myositis develop an abnormal function of the HPA axis triggered by masseter muscle inflammation. CONCLUSION: The results of this study demonstrate that CGRP may play an important role both peripherally and centrally in masseter muscle myositis in association with presumed nociceptive behavior.

Animals↗

[Maximal isometric bite force and sports. Preliminary study].

INTRODUCTION: The evaluation of the bite forces coupled with EMG activity of masseter muscles allows to point out temporo-mandibular joint disorders. The intense practice of sports induces stress which may affect the mandibular statics, due to an hyperfunction of the elevator masticatory muscles, especially the masseter muscles. This concept has led us to compare the maximum isometric bite forces of sedentary and physically trained subjects. MATERIAL AND METHODS: The aim of this experimentation is to study the maximum isometric bite forces of the premolars, with a force transducer, for two groups of physically trained and sedentary volunteers (25 subjects), with distinction between male and female subjects. Subjects with normal denture and no temporo-mandibular joint disorder were retained. EMG and force recording were synchronized and recorded during 10 seconds of maximal contraction. RESULTS: The male subjects developed a maximal bite-force significantly higher (p < 0.05) compared to the female subjects. There is no significant difference between subjects practising a sport (at least 6 hours a week) and sedentary ones. The evolution of force during the contraction is different between sexes. EMG activity allowed to control that subjects developed a maximal force and an increase in muscular fatigability of physically active females compared to sedentary ones was noticed. DISCUSSION: The difference of maximal force between men and women is similar to the one found for the locomotor muscles. The analysis of the evolution of the force according to the contraction duration, might be linked to a different distribution of muscular fibers according to the sex. The practice of a sport might increase the fatigability of the masseter muscles and might be a factor inducing a muscular imbalance of the mandibular posture. But the relatively low number of subjects and the absence of well defined distinctions between different kinds of sport limit our conclusions.

Adult↗

Bite plates and stabilization splints in mandibular dysfunction. A clinical and electromyographic comparison.

Twenty patients with mandibular dysfunction, all women, aged 17-41 years, were randomized for treatment with either a bite plate with a frontal plateau or a full-coverage stabilization splint. The occlusal appliances were used at night for 6 weeks to compare clinical and electromyographic effects (EMGs). Integrated EMGs were recorded bilaterally from the anterior and posterior parts of the temporal muscle and the masseter muscle in the rest position and during gentle and maximal biting before and after treatment without the appliances in situ. Initially recorded EMG activity in the temporal muscle was correlated to signs of dysfunction in the rest position. Compared with previously investigated healthy subjects, the patients had lower EMG activity in the anterior part of the temporal muscle and in the masseter muscle during maximal biting. Use of occlusal appliances at night for 6 weeks did not change the EMG activity in the rest position or during maximal biting. The clinical signs improved, significantly in the splint group. The subjective symptoms improved in both groups, significantly more in the splint group.

Adolescent↗