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[A study of the relationship between electromyographic activity of the masticatory muscles and the variations of the occlusal vertical dimension for edentulous subjects]

The study was performed in fifteen edentulous subjects with the EMG activity were recorded at the varying occlusal vertical dimension maintaining constant bite force value of 4kg.The results showed that maintaining constant bite force the amplitudes of EMG activity of the anterior temporal and masseter muscles are decreased with increasing the occlusal vertical dimension and correlation relation between them,that there is a stable region about 1.0mm for the anterior temporal muscle and about 1.5mm for the masseter muscle during the changes in electrical activity.It is represent that there is a physiological region of the occlusal vertical dimension for edentulous patient.

Journal Article↗

Congenital fistula from ectopic accessory parotid gland: diagnosis with CT sialography and CT fistulography.

We report a case of congenital fistula from ectopic accessory parotid gland to the cheek demonstrated by CT sialography and CT fistulography. The right parotid gland was abnormally located lateral to masseter muscle. The fistula was arising from an ectopic accessory parotid gland with ectopic duct positioned anterior to masseter muscle. CT sialography and CT fistulography were very helpful in the diagnosis and surgical planning.

Cheek↗

[Role of muscle spindle afferents in the control of jaw-closing muscle activity].

In order to understand how muscle spindle afferents contribute to the control of jaw-closing muscle activity, the following two experiments were performed in the urethane anesthetized rabbits; 1) EMG activities of the masseter muscle during chewing a test strip were compared before and after the trigeminal mesencephalic tract (Mes V) lesion. The Mes V, where the ganglion cells of jaw-closing muscle spindle afferents are located, was lesioned by thermal cauterization. Since the cells lying around the Mes V may also be damaged, it is possible that the effects of lesioning may partly be ascribed to the destruction of these cells. In order to circumvent this problem, kainic acid was injected into the Mes V one week before the lesioning. 2) Unit discharges were recorded from the Mes V during passive jaw-opening and during chewing a test strip. The response of these units to suxamethonium (SCh) administration was also examined. The results were as follows; 1) In the animals with the Mes V lesion, the facilitatory response of the masseter muscle during chewing the test strip was significantly reduced on the side ipsilateral to the Mes V lesion, while the contralateral masseteric activities were not affected. 2) The Mes V units were classified as the primary and secondary spindle afferents depending on the responses to SCh administration. During chewing, the Mes V units showed discharges locked to a certain phase of a single masticatory cycle. They were classified into 4 types, depending on the time relation between unit discharges and the jaw movement; 1) those fired predominantly on the jaw-opening phase, 2) those fired on the jaw-closing phase, 3) those excited at the beginning of both-jaw opening and power phases and 4) those fired within the period of the masseteric burst. The firing frequency of the third type units increased during the jaw-closing muscle burst induced by application of the test strip between the opposing molars. They were sensitive to SCh administration and supposed to be the primary spindle afferents. It is concluded that the muscle spindles of jaw-closing muscles (presumably primary endings) contribute to the enhancement of jaw-closing muscle activities during chewing.

Animals↗

Muscle attachment to the lateral aspect of the articular disk of the human temporomandibular joint.

OBJECTIVE: To investigate the anatomic attachments to the lateral aspect of the anterior band of the human temporomandibular joint articular disk. MATERIAL AND METHODS: Sixteen human cadaver half-heads were dissected and examined macroscopically. RESULTS: No direct attachment was observed between the deep masseter muscle and the temporomandibular joint articular disk. In one specimen, a small band of the anterior temporalis muscle was directly attached to the lateral aspect of the temporomandibular joint disk; whereas, on the same specimen, the attachment of the superior belly of the lateral pterygoid muscle was a comparatively large band. In another specimen, the lateral pterygoid muscle passed in an anterolateral direction. CONCLUSIONS: The masseter muscle has no functional significance in the biomechanics of temporomandibular joint disk displacement. The anterior temporalis muscle may have functional significance when it is accompanied by an anterolaterally divergent lateral pterygoid muscle.

Aged↗

Modulation of trigeminal laser evoked potentials and laser silent periods by homotopical experimental pain.

Cutaneous laser stimulation activates predominantly the A-delta and C mechano-heat nociceptors. Applied to the perioral region, low intensity CO(2)-laser pulses evoke reproducible trigeminal cortical evoked potentials (LEPs). High intensity CO(2)-laser stimuli induce a reflex response in the contracted jaw-closing muscle, the so-called laser silent period (LSP). Both LEPs and LSP provide a useful tool to study the physiology of the trigeminal nociceptive system. In ten healthy subjects we recorded the subjective ratings of the perioral laser stimulation and the trigeminal LEPs and LSP before, during and after homotopic experimental tonic muscle (infusion of hypertonic saline into the masseter muscle) and tonic skin pain (topical application of capsaicin to the cheek). LEPs were recorded from the vertex at two stimulus intensities: low (1.1 x pain threshold, PTh) and high (1.5 x PTh). LSP from masseter and temporalis muscles were recorded bilaterally through surface electromyographic (EMG) electrodes. CO(2)-laser pulses were applied to the perioral region (V2/V3) on the painful and non-painful side. The amplitude of LEPs increased with higher stimulus intensities (P<0.0001), but were suppressed by 42.3+/-5.3% during experimental muscle pain (P<0.0001) and by 41.6+/-3.2% during skin pain (P<0.0001). No pain-related effects were observed for the N and P latency of the LEPs (P> 0.20). The LSP in the masseter and temporalis muscles had similar onset-latency (80+/-5 ms), offset-latency (111+/-5 ms) and duration (31+/-4 ms). Experimental pain had no effect on the onset- and offset-latency (P>0.05). Experimental pain, whether from muscle or from skin, reduced the degree of suppression (P<0.01) and the area under the EMG curve (P< 0.005) of the LSP. The LSP was still suppressed during the post-pain recordings when the skin pain had disappeared (P<0.05). In all experiments experimental tonic pain decreased the subjective ratings of the perioral laser stimulation (P< 0.001). Experimental tonic pain, either from muscle or from skin, induced bilateral inhibitory effects on the trigeminal laser evoked potentials and brainstem reflex responses and on the subjective ratings of the laser pulses. These effects could be mediated through the activation of segmental and suprasegmental inhibitory systems that may function interdependently.

Administration, Topical↗

Modulation of human soleus H reflex in association with voluntary clenching of the teeth.

1. To determine the effects of motor activity in the jaw on more general motor behavior, we examined the modulation of the soleus H reflex in association with voluntary clenching of the teeth in healthy adult volunteers. 2. The amplitude of the H reflex increased remarkably during teeth clenching. The increase during maximal teeth clenching was greater than that induced either by maximal voluntary isometric contraction of the wrist extensors or by maximal voluntary clenching of the fists. 3. The increase in amplitude of the soleus H reflex showed a positive correlation with the strength of teeth clenching, as monitored by recording electromyographic (EMG) activity from the masseter muscle. 4. The increase in amplitude of the H reflex associated with teeth clenching started before the onset of the EMG activity of the masseter muscle, reached a peak shortly after the onset, and then declined to a plateau that continued in parallel with the masseter EMG until the end of teeth clenching. 5. The increase in amplitude of the H reflex in association with teeth clenching was partially decreased during the inhibitory masseteric reflex evoked by innocuous electrical stimulation of the lip. 6. It is concluded that the soleus H reflex is facilitated in association with voluntary teeth clenching, and that descending influences from the cerebral cortex, as well as peripheral afferent impulses from the oral-facial region, are involved in this facilitation. It is proposed that oral motor activity can exert strong influences on the motor activity of the other parts of the body.

Adult↗

Modulation of exteroceptive suppression periods in human jaw-closing muscles by local and remote experimental muscle pain.

The exteroceptive suppression periods (ES) in human jaw-closing muscles can be conditioned by a wide range of somatosensory stimuli and cognitive states. The aim of this study was to examine the effects of tonic experimental jaw-muscle pain versus remote muscle pain on the short-latency (ES1) and long-latency (ES2) reflex in the jaw-closing muscles. Twelve healthy subjects participated in the first experiment with jaw-muscle pain. In random order 5% hypertonic or 0.9% isotonic saline was infused into the left masseter muscle for 15 min. The pain intensity was scored continuously by the subjects on a 10-cm visual analogue scale (VAS). Electromyographic (EMG) activity was recorded bilaterally from the masseter and temporalis muscles during the pre-infusion, early phase of infusion (from 120 to 480 s), late phase of infusion (from 540 to 900 s) and post-infusion. An electrical stimulus was delivered to the skin above the left mental nerve (ipsilateral to the painful muscle) to evoke the ES in the contracting jaw-closing muscles. Ten healthy subjects participated in experiment 2 which was as identical to experiment 1 except that the electrical stimulus was delivered to the right mental nerve (contralateral to the painful muscle). Nine healthy subjects participated experiment 3 where remote muscle pain was induced in the left tibialis anterior muscle. In experiment 1 painful infusion of hypertonic saline caused a significantly later onset latency of ES2 in the left masseter muscle during the late phase of infusion compared to pre-infusion values (P < 0.05). The duration of ES2 in the same muscle was significantly shorter during the late infusion phase compared to pre- and post-infusion values (P < 0.05) and the degree of suppression was significantly reduced during the early infusion compared to the pre-infusion values (P < 0.05). Isotonic saline did not influence the ES1 or ES2. In experiment 2, similar significant inhibitory changes were found in the ES2 on the painful side. In experiment 3, no significant effects on ES1 and ES2 were observed during painful infusion of hypertonic saline into the leg muscle. These results indicate that the effects of tonic jaw-muscle pain on ES2 can be distinguished from a generalized effect of muscle pain. Furthermore, there seems to be a differential and lateralized effect of jaw-muscle pain on the brain stem reflex circuits involved in the generation of ES1 and ES2 probably through a presynaptic mechanism.

Adult↗

Influence of sex on reflex jaw muscle activity evoked from the rat temporomandibular joint.

Injection of glutamate into the rat temporomandibular joint (TMJ) evoked a concentration-dependent increase in jaw muscle activity. We investigated whether there are sex-related differences in glutamate-evoked jaw muscle activity that are mediated by sex hormones and whether prior injection of glutamate into the TMJ alters the magnitude of jaw muscle activity evoked by a subsequent injection of the algesic and inflammatory compound mustard oil (MO) into the TMJ. The magnitude of glutamate-evoked digastric and masseter muscle activity was significantly greater in female than male rats when 1000 mM glutamate was injected into the TMJ. Gonadectomy significantly reduced the magnitude of glutamate-evoked digastric muscle activity in female rats. Treatment of gonadectomized female rats with estrogen (20 microg/day) increased the magnitude of glutamate-evoked digastric muscle activity. Glutamate-evoked jaw muscle activity in gonadectomized and estrogen-treated gonadectomized males was not significantly different from intact males. Prior injection of glutamate over a concentration range of 10-1000 mM significantly increased digastric muscle activity evoked by MO injection into the TMJ 30 min later. In contrast, MO-evoked masseter muscle activity was significantly increased by prior injection of 250 mM glutamate only. There were, however, no sex-related differences in the enhancement of MO-evoked jaw muscle activity by prior injection of glutamate. These findings indicate that there are sex-related differences in glutamate-evoked jaw muscle activity that are dependent on female sex hormones, and increased glutamate concentrations sensitize the TMJ to noxious chemical stimuli.

Animals↗

Skeletal muscle perfusion during prolonged 2.03% end-tidal isoflurane-O2 anesthesia in isocapnic ponies.

Effects of 1.55 minimum alveolar concentration isoflurane O2 anesthesia (2.03% end-tidal isoflurane) on blood flow in the up-(nondependent) and down-(dependent) positioned skeletal muscles were studied at 60, 120, and 180 minutes in 6 healthy isocapnic ponies in right lateral recumbency on a nonpadded hardwood floor. Measurements were made, using 15-micron diameter radionuclide-labeled microspheres injected into the left ventricle, and comparisons were made with data obtained from ponies in the conscious state. Isoflurane administration caused a sharp reduction in cardiac output and systemic pressure (P less than 0.01), but total peripheral resistance did not change significantly. In the triceps brachii, gluteus medius, biceps femoris, and vastus lateralis of both sides, blood flow decreased significantly during 1.55 minimum alveolar concentration isoflurane anesthesia (P less than 0.01), and fluctuations did not occur with increasing duration of anesthesia. In masseter muscles, perfusion values during the 3 hours of anesthesia were not significantly different from values in awake ponies. Despite the fact that 4 ponies developed marked edema of the dependent masseter muscle, 1 pony without masseter edema developed postanesthetic forelimb lameness and 2 of the 4 ponies with masseter edema had generalized hind limb weakness after anesthesia; significant differences in blood flow between up- and down-positioned muscles were not observed. During isoflurane-O2 anesthesia in ponies, a sharp significant decrease in skeletal muscle blood flow was observed (P less than 0.01). Decreased equine skeletal muscle perfusion during isoflurane anesthesia also may be accompanied by accentuated O2 loss from the arterial blood via the countercurrent O2 exchange between large arterioles and venules.

Adrenal Glands↗

Histochemical analysis of the masseter and temporalis muscles in macaca mulatta after mandibular advancement using rigid or nonrigid fixation.

This study compared the histochemical characteristics of the temporalis and masseter muscles in monkeys who underwent mandibular advancement with and without immobilization of the mandible. The results showed, when compared with controls, that the animals who underwent maxillomandibular fixation (MMF) following advancement of the mandible had significant atrophy in both temporalis and masseter muscles. In contrast, much less myoatrophy was noted in the animals who underwent rigid internal fixation and no MMF following advancement of the mandible.

Analysis of Variance↗

Botulinum toxin for the treatment of temporomandibular joint disk disfigurement: clinical experience.

Type A botulinum toxin was used for the treatment of symptoms of 26 patients (40 joints) with temporomandibular joint disk disfigurement. In all patients, 0.5 ml (12.5 U) was injected into the lateral pterygoid muscle. The temporalis, medial pterygoid, and masseter muscles were injected if severe tenderness was noted. The data were compared using the Wilcoxon signed rank test and the McNemar test. With the exception of clicking of the right joint, all mean outcome measures showed a significant difference between the preinjection and postinjection assessments. There was a significant difference between the preinjection and postinjection pain scores of the right joint (P=0.0019) and the left joint (P=0.000). Postinjection values of the mouth opening (P=0.002), subjective functional dysfunction (P=0.065), and clicking of the left joint (P=0.001) also showed a statistically significant difference from the preinjection values. In addition, the severity and frequency of headache were reduced after botulinum toxin-A injection into the lateral pterygoid muscle.

Adult↗

The relationship between the temporomandibular joint capsule, articular disc and jaw muscles.

The anatomy of the temporomandibular joint capsule and its possible relationships to other structures near the joint are not fully understood. A 3-dimensional analysis based on sagittal, frontal and horizontal serial sections through the human temporomandibular joint region was therefore undertaken. Capsular elements which directly connect the temporal bone with the mandible were seen only on the lateral side of the joint. In the posterior, anterior and medial regions of the joint the upper and lower laminae of the articular disc are attached separately either to the temporal bone or to the mandibular condyle. The shaping of the articular cavities and the texture of the joint capsule permit movements of the articular disc predominantly in the anteromedial direction. On the entire medial side of the joint the articular disc and its capsular attachments are in close contact with the fascia of the lateral pterygoid muscle whereby a small portion of the upper head of this muscle inserts directly into the anteromedial part of the articular disc. Thus both the upper and the lower heads of the lateral pterygoid muscle are likely to influence the position of the articular disc directly during temporomandibular joint movements. Laterally, the articular disc is attached to the fascia of the masseter muscle, and part of the lateral ligament inserts into the temporalis fascia. Since these attachments are relatively weak, neither the temporalis nor the masseter muscles are considered to act directly on the articular disc; instead, via afferents from muscle spindles, they may take part in signalling the position of the temporomandibular joint components, including that of the articular disc.

Adult↗

Neglected conditions producing preauricular and referred pain.

Various theories regarding temporomandibular joint symptoms are reviewed. Two hundred and forty six patients suffering from head, neck, or facial pain, or masticatory dysfunction were studied. In 108 of these patients, the diagnosis of temporomandibular joint synovitis, lateral pterygoid muscle dysfunction, or tenomyositis of the masseter muscle was made. Examination procedures, diagnosis, frequency of occurrence, and initial treatment of these conditions are described.

Adolescent↗

Electrophysiological study on jaw-opening reflex recorded from digastric muscle in Parkinson's disease and primary cranial dystonias.

We investigated digastric reflex excitability in normals and in patients with extrapyramidal disorders such as primary cranial dystonias and Parkinson's disease. Relationships between exteroceptive suppression of masseter muscle and digastric reflex were also investigated in some cases. Digastric reflex hyperexcitability was observed in dystonic patients when compared to normals and parkinsonian patients. Furthermore, some patients with cranial dystonia presented absence of exteroceptive suppression reflex in masseter muscle with enlarged digastric response. These results indicate hyperexcitability of the digastric reflex and abnormal agonist-antagonist muscle co-contraction in chewing reflexes of patients with cranial dystonias. This shows that digastric reflex is an important electrophysiological investigation to explore the physiopathological mechanisms of primary cranial dystonias.

Aged↗

Effects of experimental muscle pain on mechanical properties of single motor units in human masseter.

OBJECTIVE: Muscle pain is known to influence muscle activity but the details of its effects on the mechanical properties of single motor units (SMU) have not been described. We have recently reported a decreased firing rate of SMU in the human masseter muscle during painful contractions with a constant force output. Force output can be modulated by the SMU discharge rate in relation to the contractile properties of SMU. Therefore, the objective of the present study was to measure the mechanical properties of SMU in the masseter to clarify the mechanism which underlies the decrease in SMU firing rate during jaw-muscle pain. METHODS: A spike-triggered averaging (STA) technique was used to determine the mechanical properties of low-threshold SMU in the masseter muscle recorded with fine wire electrodes during a voluntary isometric contraction. The twitch amplitude, contraction time, and half-relaxation time were determined from the averaged force records before and during experimental jaw-muscle pain induced by injection of 0.2 ml (100 microg/ml) capsaicin in 8 healthy subjects. Injections of 0.2 ml isotonic saline served as a non-painful control in 11 healthy subjects. RESULTS: The twitch amplitude was significantly increased during capsaicin-evoked muscle pain (P<0.001) without significant changes of half-relaxation time and contraction time. No significant changes in SMU twitch properties were observed during the control injections. CONCLUSIONS: Potentiation of twitch force could be a possible compensatory mechanism to maintain a constant force output during painful isometric contractions when SMU firing decreases. This finding therefore provides new information on the adaptation of motor function by muscle pain.

Adult↗

Computed tomographic features of bilateral coronoid process hyperplasia with special emphasis on patients without interference between the process and the zygomatic bone.

OBJECTIVE: To reveal computed tomography (CT) features of patients with coronoid process hyperplasia without interference between the process and the zygomatic bone. STUDY DESIGN: A case-control study was designed. Thirteen cases without interference (2 male and 11 female, 28-56 years old) and 65 controls were sampled from a patient database. Differences in CT features were analyzed between the 2 groups regarding the following 7 points of 5 regions: configuration of the coronoid process, vertical level of the coronoid process, the distance between the bilateral zygomatic arches, thickness of the temporal muscle, anteroposterior width of the temporal muscle, thickness of the temporal muscle tendon, and thickness of the masseter muscle. Cluster analysis was applied to differentiate between individuals. RESULTS: All cases had bilateral hyperplastic change of the coronoid process. Differences were found between the cases and controls in 6 of 7 CT features with the exception of temporal muscle thickness. All incidences of significant difference showed larger values in the cases. All cases were clustered into the same group and were differentiated from the controls. CONCLUSION: CT features appeared to be effective for diagnosis of this condition, and these patients should be put into the same category under the diagnosis of coronoid process hyperplasia.

Adult↗

Stimulation of the locus coeruleus suppresses trigeminal sensorimotor function in the rat.

The nucleus locus coeruleus (LC) has been implicated in the modulation of the spinal sensorimotor function. The aim of the present study was to examine the effect of electrical stimulation of the LC on sensorimotor function in the trigeminal system. The following two cases of sensorimotor behaviors mediated by the trigeminal brainstem sensory nuclear complex were examined: (1) the activity of the masseter muscle evoked by pressure on the region of the temporomandibular joint (TMJ); and (2) the activity of the digastric muscle evoked by electrical stimulation of the tooth pulp, resulting in the jaw-opening reflex. In the first case, LC stimulation at 10, 30 and 50 microA resulted in a 70%, 68% and 55% reduction in the magnitude of electromyogram (EMG) activity of the masseter muscle compared with the control (without LC stimulation), respectively. The threshold intensity for the onset of masseter EMG activity increaced to 106%, 111% and 121% of the control with 10, 30 and 50 microA LC stimulation, respectively. In the second case, EMG magnitude in response to the digastric muscle decreased to 42% of the control when 30 microA of LC stimulation was delivered. These results suggest that descending influences from the LC can act in suppression of the trigeminal sensorimotor function.

Animals↗