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PubMed1994

The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder.

This study examined masseter and temporalis pain-pressure thresholds in 29 patients with chronic bilateral myogenous temporomandibular disorder and in 11 controls. Patients with evidence of temporomandibular joint pathosis were omitted. The influence of time, facial side, muscle site, and side of greatest spontaneous pain on pain-pressure thresholds was measured. No significant pain-pressure threshold differences were found between the more and less painful sides, as indicated by the patients, which lends support to theories of centrally mediated pain. Mean pain-pressure thresholds in patients differed over the four sessions, which is consistent with recent reports of fluctuating levels of pain in patients with temporomandibular disorders. Additional findings included significant pain-pressure threshold differences among muscle sites in patients and controls, and lower patient pain-pressure thresholds relative to controls. Within- and between-session reliability was adequate for patients (r = .85 and r = .75, respectively) and controls (r = .90 and r = .75, respectively).

Adult↗
PubMed1994

A system for analysis of sleep and nocturnal activity in craniomandibular muscles.

A system was developed for continuous, full-night, polysomnographic recording of sleep using manual sleep scoring and automatic electromyographic analysis of craniomandibular muscle activity. In the sleep laboratory, data are stored on tape with hard copy on paper followed by off-line, computer-controlled digital processing. Muscle activity is described by the Amplitude Probability Distribution Function and by parameters of time and intensity. Sleep and electromyographic data are available graphically on screen, and the results are presented in tables and graphics after statistical treatment. The system was developed to provide a differentiated, detailed analysis of sleep and nocturnal muscle activity in the craniomandibular system that is suitable for comparing groups of individuals, effects of treatments, and physical load of muscles. Applications of the system are demonstrated.

Adult↗
PubMed1994

Measurement of masseter and temporalis muscle thickness using ultrasonographic technique.

Ultrasonography was found to be a highly reliable and accurate method for imaging and measuring masticatory muscle thickness. No age and sex related variations were observed in this study on comparisons between the two groups. Similarly no changes were seen in the muscle thickness and different facial morphologies. Since no earlier studies on this type of investigation was done, it will be too premature to give a final verdict on the correlation between the masticatory muscle thickness and facial morphology for all the recorded cases. A long term follow up will provide a wealth of information for future clinical purposes. No age and sex related variations were observed in this study on comparisons between the two groups. Similarly no changes were seen in the muscle thickness and different facial morphologies.

Adolescent↗
PubMed1996

Electromyographic and ultrasonographic observations of masseter and anterior temporalis muscles in children.

Muscle thickness and activity of masseter and anterior temporalis muscles in children with Class I molar occlusion having normal anterior relation, anterior deep-bite and anterior open-bite were measured using ultrasonographic and electromyographic techniques. The results demonstrated an increased muscle thickness in the deep-bite followed by open-bite subjects. Muscle activity was high in the same groups. A significant correlation between thickness and activity was noted only in the anterior temporalis muscle of subjects with normal anterior relation. Activity index indicated that masseter contributed to the higher activity in the clenching effort.

Child↗
PubMed1997

[Neurophysiological studies of headaches].

INTRODUCTION AND OBJECTIVE: The diagnosis of headache is based on the clinical criteria suggested by the IHS in 1988. The neurophysiological examinations often used in the study of headache may support the clinical diagnosis and give information as to the prognosis. The objective of this paper is to review the neurophysiological examinations most often used in the clinical and pathological investigation of headache. DEVELOPMENT: As shown by recent studies, the EEG is of little value in the routine evaluation of a patient with headache. However, it may be useful as an exploratory test for underlying pathology in atypical headache or when intra-cranial pathology is suspected. Evoked potentials, when used to study migraine, show absence of Habituation (or Potentiation) in migraine patients. This finding may represent abnormality in the processing of information at a cortical level in these patients. There is a tendency to unify the theory of neurone hypoxia and the absence of Habituation in Migraine as a single hypothesis of pathogenesis. Negative Contingent Variation has proved to be clinically useful to optimize treatment in Migraine. The electromyogram and Muscle Reflexes have been used in the study of Tension Type Headaches, ES2 changes, showing brainstem antinociceptive reflexes support the participation of a central factor in the origin of chronic Tension Headache. CONCLUSION: Neurophysiological tests may be useful in investigation of the pathology of headache since they permit a functional study of many neurone paths and the action of drugs on the central nervous system.

Blinking↗
PubMed1995

Mean power frequency shift during fatigue and recovery in patients with craniomandibular disorders.

EMG spectral shifts of anterior temporal and medial masseter muscles were evaluated. Mean power frequency (MPF) shift during fatigue and recovery of 46 healthy subjects and 46 patients with craniomandibular disorder were recorded at the beginning and the end of fatiguing clenching, then 3, 8, 13 and 18 min following the fatiguing clenching. The reference clenching force was 80% of each subject's maximal voluntary contraction (MVC). Recording was stopped when subjects felt pain or discomfort. Significance was found between the healthy group (N) and the diseases group (CMD) in the three following points: (i) the mean of MPF values of the masseter muscles at the end of fatiguing clenching; (ii) the recovery pattern of the temporal muscles; and (iii) MPF shift induced by fatiguing clenching. Our results therefore suggest that MPF reflects several aspects of craniomandibular disorders. Thus, measuring fatigue and recovery MPF could be useful in the screening of CMD.

Adult↗
PubMedDate not supplied

Longitudinal electromyographic study of swallowing patterns in complete denture wearers.

A longitudinal electromyographic study of the swallowing activity of the anterior temporal and masseter muscles was performed on 21 subjects with complete dentures. In six patients, the lip activity was recorded. At the pretreatment stage, when the patients had a residual anterior dentition, the peak mean voltages of the elevators showed low values (range 18 to 30 microV), and after denture placement, the anterior temporal muscles showed a further decrease. After denture relining, slight increases in temporal activity were noted at the 1-year stage. During the second year, when no corrections of the dentures were made, the temporal activity decreased below the pretreatment level. The masseter activity showed no significant changes during the 2-year observation period. The mandibular lip showed significantly stronger swallowing activity than the maxillary lip. The mean durations of the swallows were markedly longer than values reported for subjects with a complete natural dentition.

Adult↗
PubMed1990

[A study on the relationships between imbalance of stomatognathic function and asymmetry of craniofacial morphology, and the center of gravity of the upright posture].

Mastication is one of the most important functions of the stomatognathic system and it can be performed either on the left side or right side. However, some people have each habitual chewing side, so imbalance of stomatognathic function between left and right is observed. This imbalance is supposed to reflect the relationship between the left and right elements of the stomatognathic system. Therefore, the analysis of this imbalance is very useful for assessing the stomatognathic system. The purpose of this study was to reveal the relationship between imbalance of stomatognathic function between left and right and asymmetry of craniofacial morphology, and the relationship between imbalance of stomatognathic function between left and right and center of gravity of upright posture. Eighty subjects without stomatognathic dysfunction were selected for this study. Electromyograms of the left and right masseter, anterior temporal, posterior temporal and anterior belly of digastric muscles during clenching were recorded, and mandibular movements during chewing were recorded. Analysis of imbalance between left and right was performed using functional parameters. Cephalograms (P-A) were taken for an analysis of craniofacial symmetry. The center of gravity of the upright posture was recorded using stabilograph. Analyses were performed to study the relationships between the parameters of stomatognathic function and craniofacial asymmetry, and the center of gravity of the upright posture. The results were as follows: 1. The analysis of functional parameters revealed some subjects showed imbalance between left and right sides. 2. On the side with wider craniofacial morphology as determined by some parameters, the activity of the masseter muscle during clenching showed tendency to be higher than that of the opposite, while the activity of the anterior temporal muscle showed tendency to be lower. On the side with longer craniofacial morphology, the activity of the anterior temporal muscle showed tendency to be higher than that of the opposite. 3. On the side where the center of gravity was shifted during clenching, the activities of the masseter, anterior temporal and posterior temporal muscles showed tendency to be higher than those of the opposite, and the durations of chewing cycle and opening phase showed tendency to be shorter. These results suggest that there are close relationships between imbalance of stomatognathic function and craniofacial asymmetry, and between imbalance of stomatognathic function and the center of gravity of the upright posture.

Cephalometry↗
PubMed2000

Masticatory muscle activity in children and adults with different facial types.

The purpose of this study was to examine the relationship between the duration of masticatory muscle activity during daytime and vertical craniofacial morphology in children and adults. Thirty children (12 boys and 18 girls) and 30 adults (20 men and 10 women) with normal anteroposterior skeletal relations, acceptable occlusions, and without any temporomandibular joint disorders, were selected as subjects. Activities of the masseter, temporal, and digastric muscles were recorded for 3 hours during daytime, excluding the periods for meals, sleep, and hard-exercise, using a portable electromyogram recording system. A lateral cephalogram was taken of each subject at the intercuspal position to divide the subjects into 3 different facial types, ie, low, average, and high angle groups. Masseter, temporal, and digastric muscle activities mainly consisted of low-amplitude bursts during daytime. Children exhibited longer duration of temporal muscle activity, whereas the masseter muscle presented longer duration of activity in adults. The activities of masseter and digastric muscles were significantly related with the vertical facial type in both children and adults, although temporal muscle activity presented no significant relationship with the craniofacial morphology. The duration of masticatory muscle activity during daytime showed a significant difference between children and adults, indicating a close association with vertical craniofacial morphology in children and adults.

Adult↗
PubMed1995

Functional masticatory evaluation in hemifacial microsomia.

The features of hemifacial microsomia with unilateral condylar hypoplasia in a 9-year-old female patient were analysed in a multidisciplinary fashion. Cephalometric roentgenograms revealed malformation of the mandible, with the right condylar process being smaller than the left. In addition, the right maxillary alveolar process was underdeveloped. Closed view radiography with oblique lateral transcranial projection (by modified Schüller's method) of the temporomandibular joint revealed an anterior dislocation of the condyle on the unaffected side. Computed tomography (CT) of the masticatory muscles demonstrated that the medial pterygoid muscle on the affected side, unlike the other muscles, was larger than that on the unaffected side. The surface electromyographic activities of the temporal and masseter muscles and reduction of the maximum bite force on the affected side during clenching corresponded with the CT findings. The hypertrophy of the medial pterygoid muscle on the affected side was considered likely to be a compensatory adjustment to keep the mandible centred. A three-dimensional study of the movement of the mandible revealed that the condyle on the affected side moved vertically and that the rotational centre was located antero-inferior to the condylar process during maximum jaw opening and closing movements. These findings suggested lack of articular guidance. Moreover, the unaffected condylar process showed considerable backward movement during retrusion and ipsilateral excursion of the mandible. The mandibular head on the unaffected side showed obvious protraction during all jaw movements, which might have induced the overgrowth of the condylar head on the unaffected side in this growing child.

Alveolar Process↗
PubMed1989

Influence of balanced occlusion and canine guidance on electromyographic activity of elevator muscles in complete denture wearers.

Electromyographic recordings were made from the anterior temporal and masseter muscles during maximal voluntary clenching with complete dentures in the intercuspal position and in the laterotrusive jaw position with balanced occlusion and canine guidance. The different pattern of activity of the two muscles in the laterotrusive occlusal schemes studied suggests that their motoneuron pools receive different inputs. The lower activity in both muscles with canine guidance suggests that canine guidance may be a significant factor for preventing parafunctional activity in edentulous patients.

Aged↗
PubMed2003

The fascial planes of the temple and face: an en-bloc anatomical study and a plea for consistency.

Many investigators have detailed the soft tissue anatomy of the face. Despite the broad reference base, confusion remains about the consistent nature of the fascial anatomy of the craniofacial soft tissue envelope in relation to the muscular, neurovascular and specialised structures. This confusion is compounded by the lack of consistent terminology. This study presents a coherent account of the fascial planes of the temple and midface. Ten fresh cadaveric facial halves were dissected, in a level-by-level approach, to display the fascial anatomy of the midface and temporal region. The contralateral 10 facial halves were coronally sectioned through the zygomatic arch at a consistent point anterior to the tragus. These sections were histologically prepared to demonstrate the fascial anatomy en-bloc with the skeletal and specialised soft tissues. Three generic subcutaneous fascial layers consistently characterise the face and temporal regions, and remain in continuity across the zygomatic arch. These three layers are the superficial musculo-aponeurotic system (SMAS), the innominate fascia, and the muscular fasciae. The many inconsistent names previously given to these layers reflect their regional specialisation in the temple, zygomatic area, and midface. Appreciation of the consistency of these layers, which are in continuity with the layers of the scalp, greatly facilitates an understanding of applied craniofacial soft tissue anatomy.

Dissection↗
PubMed1982

Changes in length and torque of the masticatory muscles produced by the activator appliance. A cephalometric study.

The purpose of this study was to measure cephalometrically the change in muscle length and torque of the masticatory muscles produced by an activator appliance. The study was based on 10 orthodontic cases with distoclusion. Muscle length and force arm (leverage) were measured on two lateral cephalometric roentgenograms of each subject, one with the teeth in centric occlusion and one with an activator between the teeth. The construction bite of the activator was taken with the mandible repositioned 2-3 mm below and 5-6 mm ahead of resting position. It was found that the temporal masseter and medial pterygoid muscles increased 5-15% in length whereas the lateral pterygoid decreased 25% in length with the activator in place. The effect on the force arm on the temporal muscle was small, a decrease of 3-6%, but that on the masseter was much more dramatic, a decrease of 21-22%. Thus, as far as the torque of the temporal muscle is concerned, the small decrease in force arm is well compensated for by the increased muscle tension due to the stretching by the activator. The clinical significance of the findings for obtaining the best construction bite of the activator is discussed.

Activator Appliances↗
PubMed1993

Fatigue and EMG changes in the masseter and temporalis muscles during sustained contractions.

Local muscle fatigue was investigated in the anterior temporal and masseter muscles during sustained isometric contractions. The volunteers' subjective perception of fatigue or pain was recorded at intervals during the sustained contractions, and this level was then compared to objective measures of fatigue. These objective measures included shift in median frequency of the power spectrum of the surface-detected EMG signal, and change in signal amplitude. The relationship was investigated while closing on a bite force meter placed between the second premolars and first molars unilaterally, and while simply clenching with the teeth together without the bite force meter. It was found that the subjective perception of fatigue, as measured on a visual analogue scale (VAS), had a nearly linear relationship with time, and that the relationship between the VAS score and median frequency shift was rather closer than the relationship with amplitude change.

Analysis of Variance↗