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PubMed1986

Effect of gum hardness on chewing pattern.

Chewing rhythms are set by a putative central pattern generator whose output is influenced by sensory feedback. In this study we assessed how an altered feedback imposed by changing the hardness of a gum bolus modifies the timing of chewing, the maximal gape, and the activity in the masseter muscle on the chewing side. Ten adult subjects with no orofacial dysfunction chewed a standard piece of soft or hard gum for at least 3 min in random order. Vertical jaw movements were recorded with a kinesiograph and activity of the masseter muscle was recorded and integrated from surface EMG electrodes. The subjects sat in a dental chair and viewed a video lecture to distract their attention from chewing; they were instructed to chew on the right molars. Cycle-by-cycle analysis showed that 9 of the 10 subjects chewed the hard gum more slowly than the soft with no significant change in gape. The increases in cycle duration were due to changes in the duration of the opening and occlusal phases. The duration of closing was not significantly changed even though the duration and level of masseter activity were both significantly increased. We conclude that gum hardness by altering proprioceptive feedback modifies the output of the masticatory central pattern generator in such a way that the temporal aspects of chewing and the output of the masseteric motor pool are affected.

Adult↗
PubMed1992

Preliminary observations on oral blood flow.

Using laser Doppler flowmetry (LDF), the blood microcirculation of the masseter muscle was studied in one healthy male subject performing clenching and grinding of the teeth. LDF suggested that blood flow was increased during clenching, and that it did not change appreciably during grinding. In one female patient (acute pain from myofibrostic lesion in masseter muscle), LDF suggested that flow within the lesion was increased during rest (postural position). In three healthy adults, subjected to simulated traumatic occlusion of the incisors, LDF suggested an absence of consistent changes in pulpal blood flow.

Adult↗
PubMed1987

The influence of dental occlusion on electromyographic silent periods.

Electromyographic silent periods (EMG SP) and occlusal contact intensity were studied in 31 young patients (9-18 years of age) having different types of malocclusion. EMG SP was induced from bilateral temporalis and masseter muscles by chin tapping during isometric contraction. The simple silent period (SSP), depressed activity (DP) and double silent period (2SP or 3SP) were classified according to the character of silence. The occlusal contact intensity was obtained by using a polymer wafer for clenching and was analysed with a photocclusion analyser. It was found that the average amplitude of temporalis and masseter muscles during clenching was about 400 microV. The mean SSP was around 34 msec. The total SP was around 40 msec in temporalis and 44 msec in masseter. All of the subjects demonstrated one or more DP in ten taps while 18 of them had 2SP or 3SP. The difference in contact intensity between right and left had a strong correlation with the EMG SSP+DP, SSP+2SP3SP and total SP. Anterior-posterior difference was not as strongly related to SP parameters. Less significant correlation was found between SSP and occlusal intensity. It is concluded that the influence of occlusion on EMG SP is basically related to the uneven occlusal contact between the two sides rather than the total occlusal contact intensity or the difference in intensity anterior-posteriorly.

Adolescent↗
PubMed2002

A transparotid transcutaneous approach for internal rigid fixation in condylar fractures.

Closed versus open reduction in condyle fractures is a dilemma that may torment the plastic surgeon. Although at present it is accepted that there are fractures that must be open reduced as when the middle cranial fossa or temporal fossa are involucrated, foreign body are in the joint capsule, lateral extracapsular deviation of condylar deviation, and open fractures. Risdon or retromandibular approaches are used for the treatment of fractures in the condyle neck and superior third of the lower ramus.When both approaches are used the correct placement of screws is very difficult for the following reasons: 1. Both drill and screwdrivers must be placed in an oblique direction to the bone surface; as a result, screws do not press the plate toward the bone and therefore a deficient stabilization results; 2. A distraction of too much soft tissue entrapped between the skin and mandibular bone is necessary for a good visual to surgical field and 3. The parotid tissue, the masseter muscle, and the facial nerve must be strongly distracted facilitating the nerve injury.A transcutaneous transparotid approach is the most appropriate for screws placement. By means of transbuccal set it is possible to reach the mandibular bone going through both the parotid tissue and the masseter muscle avoiding the injury the branches of the facial nerve.A case report illustrates the practical application of the above technique and it shows that as the lesion of branches of the facial nerve can be avoided.

Aged↗
PubMed1997

Expression of an alpha-cardiac like myosin heavy chain in diaphragm, chronically stimulated, and denervated fast-twitch muscles of rabbit.

An additional slow fibre type, type I alpha, is detected in diaphragm and appears in fast-twitch hindlimb muscles of rabbit under the influence of altered neuromuscular activity. Type I alpha fibres were delineated from fibres expressing myosin heavy chain I beta (type I beta) by immunohistochemistry with a monoclonal antibody raised against the alpha-cardiac MHCI alpha. When stained for mATPase after acid and alkaline preincubations, some type I alpha fibres resembled type I beta and type IIA fibres, respectively. Some type I alpha fibres displayed dissimilar mATPase staining, indicating heterogeneity of this fibre population. The appearance of numerous type I alpha fibres in stimulated muscles, which in addition contain type IIA and type I beta fibres, suggested that they may be interspaced between types IIA and I beta. Electrophoresis under nondenaturing conditions disclosed an additional isomyosin both in normal diaphragm and stimulated muscles. This band displayed the same mobility as the slowest isomyosin in rabbit masseter muscle. It was recognized by the same monoclonal (anti-alpha-cardiac MHC) antibody used for immunohistochemistry. Therefore, this isomyosin appeared to be very similar, but perhaps not identical to the alpha-cardiac MHC-based isomyosin, probably resulting from discrete differences in the MHC complement. This assumption agrees with additional findings suggesting an even greater heterogeneity of the MHCs than generally assumed. In support of this, we show in atrium and masseter muscles the existence of an additional, electrophoretically distinct MHC isoform which migrates in close vicinity to MHCI alpha.

Animals↗
PubMed2005

Contrasting phenotypes of putative proprioceptive and nociceptive trigeminal neurons innervating jaw muscle in rat.

BACKGROUND: Despite the clinical significance of muscle pain, and the extensive investigation of the properties of muscle afferent fibers, there has been little study of the ion channels on sensory neurons that innervate muscle. In this study, we have fluorescently tagged sensory neurons that innervate the masseter muscle, which is unique because cell bodies for its muscle spindles are in a brainstem nucleus (mesencephalic nucleus of the 5th cranial nerve, MeV) while all its other sensory afferents are in the trigeminal ganglion (TG). We examine the hypothesis that certain molecules proposed to be used selectively by nociceptors fail to express on muscle spindles afferents but appear on other afferents from the same muscle. RESULTS: MeV muscle afferents perfectly fit expectations of cells with a non-nociceptive sensory modality: Opiates failed to inhibit calcium channel currents (I(Ca)) in 90% of MeV neurons, although ICa were inhibited by GABA(B) receptor activation. All MeV afferents had brief (1 msec) action potentials driven solely by tetrodotoxin (TTX)-sensitive Na channels and no MeV afferent expressed either of three ion channels (TRPV1, P2X3, and ASIC3) thought to be transducers for nociceptive stimuli, although they did express other ATP and acid-sensing channels. Trigeminal masseter afferents were much more diverse. Virtually all of them expressed at least one, and often several, of the three putative nociceptive transducer channels, but the mix varied from cell to cell. Calcium currents in 80% of the neurons were measurably inhibited by mu-opioids, but the extent of inhibition varied greatly. Almost all TG masseter afferents expressed some TTX-insensitive sodium currents, but the amount compared to TTX sensitive sodium current varied, as did the duration of action potentials. CONCLUSION: Most masseter muscle afferents that are not muscle spindle afferents express molecules that are considered characteristic of nociceptors, but these putative muscle nociceptors are molecularly diverse. This heterogeneity may reflect the mixture of metabosensitive afferents which can also signal noxious stimuli and purely nociceptive afferents characteristic of muscle.

Action Potentials↗
PubMed2001

The relationship between selective sleep deprivation, nocturnal jaw-muscle activity and pain in healthy men.

The relationship between nocturnal jaw-muscle activity and temporomandibular disorders (TMD) is still controversial. The aim of this study was to investigate the effect of selective slow wave sleep (SWS = non-rapid-eye-movement (NREM) stage 3 + 4) deprivation on jaw-muscle activity using a new automatic system. Ten healthy men without signs of symptoms of TMD participated. The subjects slept in the laboratory for six continuous nights including one adjustment night, one baseline night, three nights with experimental sleep deprivation and one recovery night. Polysomnographic recordings of electroencephalography (EEG) and electromyography (EMG) were obtained for recognition of sleep stages and masseter muscle activity. During the three experimental nights, computer-controlled sound stimulation (60--90 dB(A), 1000 Hz) were given as long as the subjects were in SWS. Maximum voluntary occlusal force (MVOF), pain pressure threshold (PPT) and visual analogue scales (VAS) were used to assess the state of the masseter muscles every morning and evening during the study period. The results showed that the time spent in SWS was significantly decreased during the first sleep deprivation night, but there were no significant effects on nocturnal EMG activity (i.e. the numbers of bruxism episodes per hour of sleep, bruxism bursts per episodes bruxism bursts per hour of sleep), MVOF, VAS or PPT. Furthermore, the automatic system only deprived the SWS in five subjects for the following two nights although the sound stimulation was given at the maximum intensity. These results suggest that deprivation of SWS may not interact immediately with nocturnal jaw-muscle activity and jaw-muscle pain.

Adult↗
PubMedDate not supplied

Comparison between intramuscular and perimuscular injections of botulinum toxin type A.

BACKGROUND: Botulinum toxin type A (BTX-A) must be injected in the intramuscular area to exert its paralytic effect. The durability of the BTX-A effect varies in different patients, and this fact can result from different locations of the drug injection, for example, the muscle peripheral area (perimuscular). This study aimed to evaluate whether a difference exists in the effect duration of the muscle paralysis between intramuscular and perimuscular injections of BTX-A. METHODS: This study used 18 male New Zealand rabbits divided into two groups (A and B) based on the location of the BTX-A injection. The group A animals received 10 units of BTX-A diluted with 0.1 ml of normal saline injected perimuscularly. The group B animals received the same dosage injected in the intramuscular area of the left masseter muscle. An electroneurophysiologic study was performed 1 week before the experiment for all the animals, then repeated 1, 4, and 8 weeks after the toxin injection. RESULTS: The amplitude values recorded in the masseter muscle were significantly lower in both groups throughout the study than the physiologic amplitude. The comparison between groups A and B did not show any statistically significant amplitude variations throughout the 8 weeks. CONCLUSION: No significant difference in the neuromuscular blockade induced by botulinum toxin type A was observed between injections into the muscle peripheral area and intramuscular injections.

Animals↗
PubMed1992

Occlusal control of mandibular elevator muscles.

Occlusal stability and mandibular elevator muscle function was studied in 25 women (20-30 yr of age). They had 27-32 fully erupted teeth with few treated occlusal surfaces, and craniomandibular function including mandibular mobility was normal. The aim was to analyze the influence of natural patterns of occlusal contact on electromyographic activity, unaffected by pain and functional disorders. Occlusal stability was assessed in the intercuspal and in lateral contact positions as the number of teeth with physical contact and the number of opposing pairs of teeth in contact. Electromyographic activity was recorded by surface electrodes over anterior and posterior temporalis and masseter muscles. In general, positive correlations were found between occlusal stability in intercuspal position and moderate to strong static and dynamic contractions, most significant in masseter muscles, indicating that forceful contraction of these muscles implies stable occlusion. Systematically, the duration of activity during chewing was negatively correlated with occlusal stability in the intercuspal position, most pronounced in working-side muscles. This pointed to shorter contractions with stable occlusion and is interpreted as the result of less need for stabilizing activity. It is concluded, that the correlations between occlusal stability and elevator muscle function are probably based on feedback mechanisms from periodontal pressoreceptors.

Adult↗
PubMed1997

[Masticatory muscles. Part IV. The masticatory muscles do not work homogeneously].

The temporalis and masseter muscles have a complex architectural design with large attachment areas. As a consequence, each of these muscles is capable of producing a large number of mechanical effects. In addition, within each muscle the muscle fibres and sarcomeres undergo different excursions during jaw movements. This leads to intramuscular differences in the possible excursion range and the capacity to produce force. Depending on the desired motor task, the nervous system is able to vary both the magnitude and direction of muscle force by selective activation of specific muscle portions. The anterior temporalis and the superficial and deep masseter are capable of generating large forces, e.g. during biting and chewing. The posterior temporalis and the anterior and posterior deep masseter are suited to establish a precise adjustment of forces and movements during laterotrusion and protrusion/retrusion.

Biomechanical Phenomena↗
PubMed1994

Statistics of differential Lissajous EMG for normal occlusion and Class II malocclusion.

Differential Lissajous electromyography (DL-EMG), a method of representing the simultaneous EMG values of two paired muscles as a single, continuous figure, was used in chewing tests with a sample of Japanese women having normal occlusion compared with a like group of Japanese female adolescents, having Class II, Division 1 malocclusion. For the normal sample, the DL-EMG figures described by the coordinated activity of the bilateral temporal and masseter muscles during chewing gum mastication typically appeared as repetitions of loops. Statistical data were gathered on the total EMG voltages, and on the location, rotational direction, and orientations of the DL-EMG loops when graphed onto Cartesian coordinates. These data were compared with those taken from the Class II sample. Significant differences were observed in the latter group for the EMG voltage levels of the balancing-side masseter muscles. The DL-EMG figures of the Class II group also showed irregularities in the shapes, locations, rotational directions, and orientations of the loops, indicative of irregular masticatory patterns. These data suggest that with sufficient control of factors such as age and sex, electromyography and especially DL-EMG techniques can be useful for characterizing masticatory differences between various occlusal groups.

Adolescent↗
PubMed1991

Influence of pressure rates on the reliability of a pressure threshold meter.

The relationship between the rate of pressure applied over the masseter muscle and the pressure pain threshold was studied with the aid of an algometer (pressure threshold meter, PTM) connected to a stopwatch. Twenty consecutive patients with various degrees of craniomandibular dysfunction were included in the study. In 10 of the patients, the belly of the right superficial masseter muscle was recorded with the algometer 10 times using different pressure rates arbitrarily and unsystematically ranging from low to high values. The correlation between pressure rate and the PTM value was high. An increased pressure rate increased the PTM value (mean regression coefficient b = 0.70). A PTM value range of 0.5 kg/cm2 was found to correspond to a pressure rate range of 0.50 kg/cm2/s. In the remaining 10 patients, repeated recordings of the same site with a constant pressure rate did not influence the PTM value significantly.

Adult↗
PubMed2001

Sex-related suppression of reflex jaw muscle activity by peripheral morphine but not GABA.

The present study examined the effect of peripherally applied morphine and GABA on jaw muscle electromyographic activity reflexly evoked by co-injection of glutamate into the temporomandibular joint (TMJ) of lightly anesthetized Sprague-Dawley rats of both sexes. In male but not female rats, morphine significantly suppressed glutamate-evoked jaw muscle activity in a dose-dependent and naloxone-reversible manner. The median suppressive dose (+/- s.e.) for male rats was 12.7 +/- 3.1 microg (digastric muscle) and 12.6 +/- 1.3 microg (masseter muscle). GABA (5 micromol) significantly reduced glutamate-evoked muscle activity in both sexes. These data suggest that female rats are considerably less sensitive than male rats to the suppressive effects of peripherally applied morphine, but both sexes are equally affected by peripherally applied GABA.

Analgesics, Opioid↗
PubMed1998

Trigeminal responses evoked by painful electrical stimulation.

Trigeminal sensory and motor responses to high-intensity electrical stimuli were studied in 10 healthy male subjects. During contraction at 10% of maximal bite force, late exteroceptive suppression periods assessed by EMG and bite force from masseter muscles were recorded together with evoked vertex potentials. Electrical stimuli were either delivered as 1 ms single pulses or as 21 ms (5 x 1 ms, 200 Hz) train pulses at two different intensities above the pain threshold. Three different perioral regions were stimulated in random order. The duration of the masseter suppression period was significantly longer and its latency significantly shorter at higher stimulus intensities whereas the amplitude of the evoked vertex potentials remained unchanged. Both the evoked potentials and the exteroceptive suppression period in the masseter muscle differed significantly between stimulation at the three perioral regions. The present results from combined measurements of sensory and motor responses in the trigeminal system may be explained by the function of trigeminal polysynaptic reflex circuits and the central cerebral processing of afferent inputs.

Adult↗
PubMed1986

The use of bilateral EMG equalization training in the treatment of temporomandibular joint dysfunction--a case report.

This paper describes a single-subject experiment testing two methods of using EMG biofeedback in the treatment of TMJ dysfunction. Following a baseline period, electrodes were placed on the left and right masseter muscles, and the subject was taught general relaxation of this area using visual biofeedback. Although data supported the conclusion that the subject had indeed learned to relax, this was not associated with any change in the report of pain or dysfunction. Equalization training, the goal being to equalize the levels of EMG in the right and left masseter muscles, was then begun. Once the patient had learned to maintain equal levels of EMG, relaxation was then re-introduced. This produced substantial decreases in her reported pain, both within the session and averaged across days for the time between sessions. These treatment gains were maintained at 2-month follow-up.

Adult↗
PubMed2004

Reproducibility of visual analog scale (VAS) pain scores to mechanical pressure.

This study tested the reproducibility of visual analog scale (VAS) pain scores to measure changes in masseter muscle pain evoked by maximally tolerable mechanical stimulation over a short time period in healthy subjects. This study also evaluated gender differences in reproducibility of VAS scores to mechanical stimulation. Ten healthy female and eight healthy male individuals participated in this study. The recordings of VAS pain scores to an identical mechanical pressure on the masseter muscle were performed at three different sessions (T1, T2, and T3). The subjects rated their pain on a VAS to a maximally tolerable stimulus that was recorded on an algometer at the first session. The algometer pressure reading was recorded for each subject and then used to duplicate the same identical mechanical stimulus at each of the three sessions. This identical pressure was repeated in the same marked spot at six minutes and after 30 minutes. The subjects rated the pain on a VAS to this identical stimulus at each session. There was no significant difference in VAS pain scores of all subjects at T1, T2, and T3. There was no significant difference in reproducibility of VAS pain scores in females compared to males. Intraclass correlation coefficients were 0.811 on the right masseter and 0.844 on the left masseter. VAS pain scores to mechanical stimulation were reproducible over a short time period. Gender did not affect the reproducibility. This previously unreported method of measuring pain to repeated identical mechanical stimulation appears to have potential for both clinical and research application.

Adult↗
PubMed2006

[Pure trigeminal motor neuropathy presenting with temporo-mandibular joint dysfunction in a patient with HIV and HCV infections].

Pure trigeminal motor neuropathy (PTMN) is a rarely described condition. We report the case of a 41-year-old woman infected with the human immunodeficiency virus (HIV1) and hepatitis C virus who presented with weakness of left temporalis and masseter muscles and painful left temporomandibular joint dysfunction (TMD) a few months after cerebral toxoplasmosis revealing acquired immunodeficiency syndrome (AIDS). Magnetic resonance imaging revealed severe wasting and fat replacement of the left temporalis, pterygoid and masseter muscles and showed neither abnormalities in the left motor nucleus of the trigeminal nerve nor compression of the left trigeminal nerve. Electromyographic examination gave evidence of denervation in the left temporalis, masseter and pterygoid muscles and blink reflex studies were normal, confirming the diagnosis of PTMN which was probably secondary to HIV and HCV co-infection.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Effects of experimental muscle pain on electromyographic activity of masticatory muscles in the rat.

The aim of the present study was to investigate the effects of noxious chemical stimulation of a jaw muscle on postural electromyographic (EMG) activity from several masticatory muscles in lightly anesthetized rats. Unilateral injection of a substance known to induce acute muscle pain (5% NaCl) or longer duration of pain with inflammation (mustard oil) was made into the masseter muscle. The changes in EMG activity following the injection were recorded from the injected and contralateral masseter muscles and the ipsilateral digastric muscle. The algesic chemicals produced a significant but transient increase in EMG activity in all three muscles. The data from the present study and similar observations from clinical and experimental human studies suggest that increased activity from muscle nociceptors is not sufficient to produce a prolonged increase in postural EMG activity. Therefore, the development and maintenance of chronic jaw muscle pain does not appear to result from a feedback cycle mechanism.

Action Potentials↗