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Isolation and culture of rat sensory neurons having distinct sensory modalities.

We have recently published papers in which sensory neurons that innervate either the tooth pulp or masseter muscle spindles were labelled in vivo and later identified and studied in primary tissue culture (Taddese et al., 1995; Cook et al., 1997). Here, we provide detailed descriptions of cell labelling and tissue culture methods that we used. The purpose of the preparations is to compare nociceptive and non-nociceptive sensory neurons in vitro. The spindles in mastication muscles are the only muscle afferents whose cell bodies reside in the mesencephalic nucleus (MeN5) of the fifth nerve (Corbin and Harrison, J Neurophysiol, 1940; Cody et al., J Physiol, 1972). Thus, labelling neurons projecting to the masseter muscle and dissecting the MeN5 isolates muscle spindle afferents. Pain is the only conscious sensation elicited by physiological stimulus of tooth pulp (Anderson and Matthews, 1967; Edwall and Olgart, 1977; Ahlquist et al., 1984; Narhi et al., 1994); there may be unconscious sensations that arise from the pulp, but these have never been demonstrated. Thus, tooth pulp afferents represent at least a highly enriched, and possibly a pure, population of nociceptors. In broad outline, the methods of labelling and tissue culture are standard, but we have honed many details in order to obtain practical yields.

Affinity Labels↗

Quantitation of blood flow in the rat mandible after vertical osteotomy.

Vertical osteotomies were performed in the mandibles of rats and combined with elevations of the buccal or bilateral mucoperiosteal pedicles. Isotope fractionation and particle distribution were used to measure blood flow in the distal and proximal segments of the mandible, the masseter muscle and the submandibular gland. Average decrease in blood flow ranged from 9-39% in the distal segment and from 8-24% in the proximal segment. Decrease in blood flow was most pronounced when bilateral mucoperiosteal pedicles were performed. Blood flow in the masseter muscle increased by 16-26% after osteotomy with mucoperiosteal elevations.

Animals↗

Short-term effect of the stabilization appliance on masticatory muscle activity in myogenous craniomandibular disorder patients.

The short-term effect (4 to 6 weeks) of a stabilization appliance on masticatory muscle activity was investigated in 26 myogenous craniomandibular disorder patients. The patients were instructed to clench at 10% and 50% of their maximum clenching effort in the intercuspal position and on the appliance. Recordings were made before and immediately after appliance delivery, and 2 and 4 weeks after delivery. The average EMG activity of the masseter muscles remained the same during the period of appliance use, whereas the anterior temporal muscles showed an immediate and long-lasting reduction in activity. The appliance also resulted in an improvement in the balance of left and right masseter muscle activity. There was a minor improvement in temporal muscle symmetry at the 50% clenching level and after 4 weeks of appliance use.

Adolescent↗

Effects of local and remote muscle pain on human jaw reflexes evoked by fast stretches at different clenching levels.

Muscle pain imposes significant changes on natural motor tasks, but the consequences for stretch reflexes are still disputed. The present study examined the jaw reflexes to fast (10 ms) stretches of the mandible in an experimental model with local pain in the masseter muscle and remote pain in the tibialis anterior muscle. The stretch reflexes were elicited in healthy volunteers (n=13) before, during, and after periods with constant levels of experimental pain and while the subjects clenched at 0%, 15%, 30%, and 45% of the maximal voluntary contraction (MVC) levels. Surface electromyography (EMG) was used to record the reflex responses. Pain in the masseter muscle (mean +/- SEM, 3.8+/-0.4 on a 10-cm visual analogue scale), but not in the tibialis anterior muscle (3.4+/-0.3; paired t-test, P=0.318) was associated with significant changes in both prestimulus EMG activity (ANOVA, P=0.002) and in peak-to-peak amplitudes of the stretch reflex (ANOVA, P=0.022). However, when the changes in prestimulus EMG activity were taken into consideration a significant increase in the stretch reflex persisted in the painful muscle at 15% and 30% MVC. Local circuits at the trigeminal level involving the fusimotor system are proposed to mediate a significant part of this modulatory effect.

Adult↗

A physiotherapeutic approach to craniomandibular disorders: a case report.

This is a case report of a 19-year-old female who presented with a unilateral weakness of the right masseter muscle evidenced by electromyographic examination. The presence of a mandibular deviation to the right during opening because of this weakness was treated with neuromuscular electrical stimulation (NMES). After the physiotherapeutic treatment, the electrical activity of the right masseter muscle increased during function and the mandibular deviation disappeared. Electromyography (EMG) can have a useful role in the determination of the muscular profile, and for evaluating therapeutics.

Adult↗

Distribution of electrical myotonia in myotonic muscular dystrophy.

Twenty-five successive patients with myotonic dystrophy were examined to determine the anatomical distribution of electrical myotonia. Proximal and distal limb muscles and orbicularis oris and masseter muscles were examined. Electrical myotonia was present in all muscles examined in only 3 patients. Moreover, of the 15 muscles examined, none showed myotonic discharges in every patient, the highest individual muscle involvement being 96%.

Adolescent↗

Masseteric electromyographic silent period duration in patients with temporomandibular joint dysfunction.

1. The present study compared the duration of the electromyographic silent period (SP) of the masseter muscles elicited by chin-tapping in normal asymptomatic adults (N = 39) and in a group with symptoms of temporomandibular joint dysfunction (TMJD) (N = 31). 2. EMG activity was recorded from right (RM) and left (LM) masseter muscles using bipolar surface electrodes coupled to a DISA 1500 EMG-System. During maximal clenching, ten taps were applied downwards to the chin with a reflex hammer. 3. The mean SP durations obtained for the normal group were 25.45 +/- 4.20 ms (RM) and 25.33 +/- 4.18 ms (LM), whereas the TMJD group presented significantly greater values (P less than 0.01, Student t-test) of 41.89 +/- 12.94 ms (RM) and 42.40 +/- 12.99 ms (LM). The upper limits of normality calculated for RM and LM were 32.36 ms and 31.21 ms, respectively. Eighty-four percent of patients with TMJD showed SP durations above these limits. 4. The results indicate that the measurement of masseteric SP duration may be used as an objective diagnostic method of TMJ disorders, provided that borderline values are interpreted with caution along with clinical impressions.

Adolescent↗

The use of botulinum toxin type A in aesthetic mandibular contouring.

The lower third of Asian faces is wider than that of Caucasians and it is determined by the size and width of the mandibular bone and the thickness of muscles and subcutaneous fat tissues surrounding it. Efforts to create an aesthetically slim and smooth facial contour line in nonobese people have led the authors to focus on two approaches: surgical resection of the masseteric muscle and modeling ostectomy of the square-angled mandibular bone. Because these procedures present some problems, the authors adopted a nonsurgical concept that chemically denervates muscles and reduces the bulk of the muscle. The authors have conducted a total of 1021 clinical cases from March of 2001 through September of 2002, in which patients were treated with botulinum toxin type A (Dysport; Ipsen Ltd, Slough, United Kingdom) for remodeling the lower facial contour line; 383 of those cases were followed up for at least 3 months after the initial injection. A database was made by measuring the change in the thickness of the injected muscle with an ultrasonogram. Eleven patients underwent resection of the mandibular angle before injection. The preinjection ostectomy group was involved in the study as a result of their dissatisfaction with the surgical results; they had a rather thick masseter muscle and not a bone problem. Some had both bone problems and a thick masseter muscle. Three months after the botulinum toxin injection, the thickness of the muscle was reduced by 31 percent on average. The atrophic effect of injection was observed after 2 to 4 weeks for most patients. Seventy percent of the 383 patients tracked were greatly satisfied with the result, with another 23 percent generally satisfied. No long-term side effects were reported. Masseteric hypertrophy is frequent in Asians because of racial characteristics and dietary habits. Botulinum toxin type A has made a new epoch in facial contouring for Asians. Considering that Asians have a prominent malar and a prominent mandible angle, the reduction in the thickness of the masseter can provoke relative prominence of the malar and mandible angle. Therefore, precise indication and anatomy of the facial muscle should be thoroughly understood, which will decrease the incidence of side effects and problems. Botulinum toxin type A (Dysport) injection is simple in technique, has few side effects, and promises a rapid return to daily life. The authors conclude that the injection of botulinum toxin type A can replace surgical masseter resection.

Adult↗

Diagnosis and surgical treatment of periapical infection of the third mandibular molar in five horses.

Diagnosis and treatment of periapical infection of the third mandibular molar in 5 horses was assessed. In 4 of 5 horses, there was a recent history of dental work performed. Diagnosis required multiple imaging techniques. Radiography revealed evidence of periapical bone lysis or tooth root lysis of the third mandibular molar in 3 of 5 horses. Sonographic examination was effective in identifying abscesses within the masseter muscle and defects of the lateral cortex of the mandible in 4 of 5 horses. Nuclear scintigraphy was diagnostic in 1 of 2 horses examined. All horses were treated by repulsion of the affected tooth. The surgical approach involved elevating the masseter muscle from the caudal portion of the mandible. This approach provided excellent access to the affected tooth with minimal postoperative complications. All incisions healed with good cosmetic results.

Animals↗

Sensory and motor responses of trigeminal and reticular neurons during ingestive behavior in rats.

Activities of 53 neurons in the brain stem were recorded with chronically implanted fine wires in freely eating and drinking rats. Twenty units were isolated from the trigeminal mesencephalic nucleus; 18 were spindle afferents and 2 periodontal afferents. The spindle units were classified into 4 types: 5 units showed rhythmical activity related only to the jaw opening phase during both licking and chewing, 8 units discharged at jaw opening phase during licking, but both at jaw opening and jaw closing phases during eating, 2 units increased phasic activity at jaw opening phase during licking, but increased tonically independent of jaw movements during eating, and the remaining 3 units responded only at jaw closing phase both in licking and eating behavior. Nine units were assumed to be alpha motoneurons isolated from the trigeminal motor nucleus; 2 innervating the temporalis muscle, 3 the masseter muscle, 2 the digastric muscle, and the remaining 2 presumably the pterygoid muscles. These units, with a mean tonic spontaneous rate of about 10 impulses/s, showed phase-related rhythmical burst activities during licking and eating. Four units were isolated from the trigeminal main sensory nucleus. Sixteen units were isolated from the medullary reticular formation and 1 from the pontine reticular formation. Of these 16 units, 3 from the parvocellular part of the medullary reticular formation were presumably premotor interneurons, and 3 units in the "intertrigeminal region", 2 units in the "juxtatrigeminal region", and 8 units in the "supratrigeminal region" were responsive to multiple sensory modalities. These results demonstrate that almost all the units sampled showed characteristic rhythmic activities associated with the position of the tongue or mandible during rhythmical jaw movements.

Action Potentials↗

[Influence of the Esmarch splint on chewing and tongue muscle activity during sleep].

To clarify the functional mechanism of the Esmarch device in the treatment of sleep apnea, its effect on muscle activity during sleep was studied electromyographically with and without the appliance at the inferior head of the lateral pterygoid muscle, the genioglossal muscle, and the masseter muscle in 15 patients with sleep apnea syndrome. During the obstructive apnea the muscles showed significantly lower amplitudes than before the apnea. No significant decrease in the amplitude was observed during the central apnea, but, after the obstructive and central apnea, significantly higher amplitudes were seen than beforehand. The amplitudes rose after the placement of the appliance, and the amplitudes of the genioglossal and lateral pterygoid muscles during obstructive apnea increased significantly after the insertion of the appliance. The results suggest that the device can activate the masticatory and tongue muscle activity and indicate that the muscles activated with the appliance can prevent obstruction in the oropharynx. The Esmarch device not only helps avoid obstruction by mandibular protraction, but also affects function by activating the muscles.

Child↗

An electromyographic study of masticatory and lip muscle function in patients with complete dentures.

The activity of the anterior and posterior portions of the temporal muscle, of the masseter muscle, and of the upper and lower lips was studied with electromyography in 10 individuals with complete dentures. Recordings were made when the patients had old, ill-fitting dentures and 6 months after these were replaced with new dentures. The muscle activity was studied in the postural position of the mandible, during chewing and swallowing of three test foods, and during maximal biting. The maximal tooth tapping rate was also recorded. The postural muscle activity was the same with old and new dentures and comparable with that in patients with natural teeth. The muscle activity during maximal biting was markedly lower than in patients with natural teeth and lower with new than with old dentures. There was no difference in muscle activity between chewing with old and new dentures, but the activity was lower than in patients with natural teeth. This was not compensated for by a longer duration of chewing. The lips were not especially active during chewing in the complete denture wearers.

Aged↗

The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders.

The aim of this study was to assess the electromyographic characteristics of the masticatory muscles (masseter and temporalis) of patients with either "temporomandibular joint disorder" or "neck pain". Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 38 patients aged 21-67 years who had either (a) temporomandibular joint disorder (24 patients); (b) "neck pain" (13 patients). Ninety-five control, healthy subjects were also examined. During clenching, standardized total muscle activities (electromyographic potentials over time) were significantly different in the three groups: 75 microV/microVs% in the temporomandibular joint disorder patients, 124 microV/microVs% in the neck pain patients, and 95 microV/microVs% in the control subjects (analysis of variance, P<0.001). The temporomandibular joint disorder patients also had significantly (P<0.001) more asymmetric muscle potentials (78%) than either neck pain patients (87%) or control subjects (92%). A linear discriminant function analysis allowed a significant separation between the two patient groups, with a single patient error of 18.2%. Surface electromyographic analysis during clenching allowed to differentiate between patients with a temporomandibular joint disorder and patients with a neck pain problem.

Adult↗

Masticatory muscle responses associated with unloading of biting force during food crushing.

The aim of this study was to evaluate masticatory muscle responses during food crushing. Electromyograms were recorded simultaneously with mandibular movement and the sound of food fracture in eight healthy adult males at the superior and inferior heads of the lateral pterygoid muscles, the anterior belly of the digastric muscle, the temporal muscle, and the masseter muscle. After fracture of the food, silent periods of the elevator muscles and excitatory responses of the depressor muscles were observed. The latency and duration of the silent periods increased significantly with increasing incisal velocity after fracture. The mean latency of the excitatory responses of the depressor muscle was stable. After the application of anaesthetic into the temporomandibular joint capsule, the excitatory response disappeared, whereas the silent period was partly maintained. These findings suggest that the excitatory response of the depressor muscle occurs via a polysynaptic reflex arc, and that several reflex arcs are involved in the development of the silent period during food crushing. An important role for the temporomandibular joint receptors is implied.

Adult↗

Methionine flux and tissue protein synthesis in lactating and dry goats.

Whole-body methionine flux (rate of irreversible loss from plasma) and tissue protein synthesis were estimated in dry and early lactating goats (10-14 d postpartum) by intravenous infusion of L-[35S]methionine. Tissue protein mass was significantly (p less than 0.05) higher for mammary gland and liver but lower for carcass in lactating animals. The plasma methionine flux was higher during lactation (8.5 vs. 5.1 g/d). The fractional synthesis rates of tissue proteins (Ksp: %/d) were lower during lactation for some muscles, especially the masseter muscle (1.46 vs. 2.15), and for skin (0.59 vs. 1.22) and the pooled head plus feet fraction (1.64 vs. 2.31), but the rates were greatly increased in mammary gland (42 vs. 3). The non-mammary methionine flux (plasma flux minus the flux corresponding to milk methionine output and methionine utilization for mammary protein synthesis) was significantly (p less than 0.05) lower for the lactating goats than for the dry group (93 vs. 131 mg.d-1.kg empty body weight-1). This is in agreement with the lower rates of protein synthesis in carcass (542 vs. 948 mg.d-1.kg empty body weight-1) and skin (93 vs. 189) for lactating compared to dry goats. It can be inferred from these data that in early lactation, when nutrient requirements of animals are not adequately met, an adaptative mechanism occurs that allows amino acids to be available for the mammary gland by a decrease of their utilization in some extramammary tissues.

Animals↗

Melkersson-Rosenthal syndrome: distal facial nerve branch palsies, masseter myopathy and corticosteroid treatment.

We described a case of Melkersson-Rosenthal syndrome in whom facial nerve branch palsies and an isolated masseter muscle atrophy were found in association with indolent multifocal facial soft tissue swellings. Non-caseating granuloma was found by the biopsy of swollen upper lip. Facial nerve conduction studies showed extremely low amplitude of compound muscle action potentials with slightly elevated distal latencies. Electromyogram of the atrophic masseter muscle indicated myogenic process. The persistent swellings responded dramatically to a 3 day-course of intravenous methylprednisolone (1,000 mg/day) followed by maintenance oral prednisolone but the facial nerve branch palsies responded rather slowly. Granulomatous involvements of the distal facial nerve branches and consequent wallerian degeneration appear responsible for this type of facial paralysis in Melkersson-Rosenthal syndrome and thus corticosteroid be used for a prolonged period in order to ensure the functional improvement.

Adrenal Cortex Hormones↗

Reflex responses induced by tooth unloading.

The reflex response of the masseter muscle to the rapid unloading of a single maxillary incisor tooth was studied. Unloading of a static force of 2 N in the horizontal direction resulted in a short-latency excitation, inhibition, and long-latency excitation of masseter muscle activity occurring at latencies of approximately 13, 20, and 40 ms, respectively, with a corresponding change in bite force occurring slightly later in each case. Following the blocking of periodontal input by the injection of local anesthetic around the stimulated tooth, inhibitory responses were abolished. Therefore, it is concluded that the observed masseteric inhibition was caused by the unloading of periodontal mechanoreceptors and thus that these receptors may contribute to the jaw unloading reflex.

Adult↗

Masseter thickness, endurance and exercise-induced pain in subjects with different vertical craniofacial morphology.

The aim of the study was to compare neuromuscular features of the masseter muscle in subjects with different vertical craniofacial morphology. Fifteen short-faced (mandibular plane-Frankfurt plane angle < 15 degrees) and 15 normal- to long-faced (mandibular plane-Frankfurt plane angle > or = 23 degrees) male students participated. The thickness of the masseter was assessed by ultrasonography. Onset and endurance of exercise pain were recorded during sustained biting at a level of 15% of maximum voluntary contraction and 30 micro V electromyographic activity. Pain and fatigue was measured on visual analog scales before and after the biting, as well as before and after 10 min chewing. Statistical comparison showed that the masseter muscle was significantly thicker (+15%) in the short-faced than the normal- to long-faced subjects. The pain onset time and endurance time were also consistently shorter in short-faced subjects, whereas the intensity of pain and fatigue did not differ significantly between the two groups. Multiple stepwise regression showed positive influence from the mandibular plane inclination and the masseter thickness on the pain onset time and endurance time. The present findings support the concept that subjects with different craniofacial morphology show neuromuscular differences.

Adult↗