[Grafting intraoral defects after radical surgery for oral carcinomas. A standardized triple-flap concept].
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Carcinoma↗
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Biomechanical considerations in the surgical correction of mandibular deficiency.
A two-dimensional model is presented that allows calculation of mechanical advantage for the human masseter and temporalis muscles. Ten patients with high-angle mandibular deficiency and vertical maxillary excess had greatly reduced mechanical advantages with an anticipated elevated muscle activity. Superior repositioning of the maxilla with mandibular advancement, however, increased the overall mechanical efficiency of the masticatory system. When compared with mandibular advancement alone, the bimaxillary procedure resulted in a 13% increase in the mechanical advantage of the temporalis muscle and a 21% increase for the masseter muscle. This model suggests that various surgical procedures designed to correct facial disharmonies may have either desirable or undesirable effects on jaw biomechanics and long-term stability. Biomechanical influences are important considerations for the clinician in planning surgical procedures to correct dentofacial deformities.
Biomechanical Phenomena↗
[Reflexes in edentulous patients and subjects with a full set of teeth].
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Dentition↗
[Anomalies of the inclination of the occlusal plane: early treatment using indirect guide-planes--electromyographic response].
We discuss five cases of ANGLE's malocclusion Classes I, II or III that were rehabilitated basically by: restoration of masticatory function (previously pathological); the use of removable orthopaedic plates with indirect guideplanes. The patients (aged 6-15 years when treatment began) now have symmetrical balanced occlusion. Surface electromyography was used to study the function of the anterior temporal, surface masseter, deep masseter and anterior digastric muscles of 12 patients during rehabilitation of severe malocclusion. Electromyograms were obtained both with and without orthopaedic guideplanes installed. There were no significant differences as regards mean resting myoelectric activity. During maximum voluntary clenching in centric occlusion, the anterior temporal muscles were the most active, followed by the surface masseters. The activity of the anterior temporal muscles during clenching was significantly less (P < 0.01) with guideplanes than without. During lateral displacements, the non-working side anterior temporal muscle exhibited a significantly higher potential than the other muscles monitored, especially with guideplanes installed. The activity was lees with guideplanes during swallowing.
Adolescent↗
Masticatory muscle function in patients treated for condylar fractures of the mandible.
The activity of the temporal and masseter muscles and of the upper lip was examined by electromyography in five adults and in five children who had sustained uni- and bilateral fractures of the mandibular condyle. Electromyographic recordings were done in the postural position of the mandible, during maximal bite in the intercuspal and retruded mandibular positions, during chewing and swallowing of peanuts and during swallowing of water. In the children, who were examined on three occasions after the trauma, a reduced muscle activity was found shortly after the trauma, but it had normalized at follow-up examination 1 year after the injury. The adults, who were examined 4-6 years after the trauma, had, in general, normal muscle function. In subjects with a unilateral fracture, no difference in muscle activity was found between the two sides. An enlarged distance between the retruded and intercuspal positions of the mandible did not, in these subjects, seem to influence the muscle activity during the functions studied.
Adolescent↗
Denervation in murine fast-twitch muscle: short-term physiological changes and temporal expression profiling.
Denervation deeply affects muscle structure and function, the alterations being different in slow and fast muscles. Because the effects of denervation on fast muscles are still controversial, and high-throughput studies on gene expression in denervated muscles are lacking, we studied gene expression during atrophy progression following denervation in mouse tibialis anterior (TA). The sciatic nerve was cut close to trochanter in adult CD1 mice. One, three, seven, and fourteen days after denervation, animals were killed and TA muscles were dissected out and utilized for physiological experiments and gene expression studies. Target cDNAs from TA muscles were hybridized on a dedicated cDNA microarray of muscle genes. Seventy-one genes were found differentially expressed. Microarray results were validated, and the expression of relevant genes not probed on our array was monitored by real-time quantitative PCR (RQ-PCR). Nuclear- and mitochondrial-encoded genes implicated in energy metabolism were consistently downregulated. Among genes implicated in muscle contraction (myofibrillar and sarcoplasmic reticulum), genes typical of fast fibers were downregulated, whereas those typical of slow fibers were upregulated. Electrophoresis and Western blot showed less pronounced changes in myofibrillar protein expression, partially confirming changes in gene expression. Isometric tension of skinned fibers was little affected by denervation, whereas calcium sensitivity decreased. Functional studies in mouse extensor digitorum longus muscle showed prolongation in twitch time parameters and shift to the left in force-frequency curves after denervation. We conclude that, if studied at the mRNA level, fast muscles appear not less responsive than slow muscles to the interruption of neural stimulation.
Animals↗
Temporal summation of pain from skin, muscle and joint following nociceptive ultrasonic stimulation in humans.
This study investigated the phenomenon of temporal summation in response to repetitive focused ultrasound stimulation of skin, muscle and joint in human volunteers. Stimulation was carried out using a custom-designed, focused ultrasonic stimulator with a resonant frequency of 1.66 MHz. A series of stand-off attachments were used to ensure that the focal region of the ultrasound beam projected either cutaneously, within the distal interphalangeal joint of the index finger, or within the first dorsal interosseous muscle. Stimulation was carried out using single pulses and trains of five pulses of different pulse durations (25 ms, 50 ms, 75 ms, 100 ms), and using single pulses and trains of five pulses (50 ms duration) at different frequencies (0.5 Hz, 1 Hz, 2 Hz, 3 Hz, 4 Hz, 5 Hz). Tactile perception thresholds, pain thresholds and summation pain thresholds were recorded. Temporal summation of pain could be elicited by stimulation of both skin, joint and muscle, although the influence of temporal summation appeared to be more pronounced for muscle stimulation. Muscle stimulation also required greater ultrasound intensity compared with joint and skin stimulation. Temporal summation could not be elicited by tactile, low-intensity stimulation. Focused ultrasound is a potent, noninvasive technique with which to investigate temporal summation from somatic structures. A number of factors may account for the higher intensities required to elicit pain in muscle and the increased rate of temporal summation. It is clear, however, that if temporal summation is more pronounced in muscle than other tissues then this may be an important factor contributing to pain in musculoskeletal syndromes.
Adult↗
Reconstruction of the temporalis muscle.
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Craniotomy↗
Temporal profile of rat skeletal muscle capillary haemodynamics during recovery from contractions.
In skeletal muscle capillaries, red blood cell (RBC) flux (F(RBC)), velocity (V(RBC)) and haematocrit (Hct(CAP)) are key determinants of microvascular O2 exchange. However, the mechanisms leading to the changes in F(RBC), V(RBC) and Hct(CAP) during muscle contractions and recovery thereafter are not fully understood. To address this issue we used intravital microscopy to investigate the temporal profile of the rat spinotrapezius muscle (n = 5) capillary haemodynamics during recovery from 3 min of twitch muscle contractions (1 Hz, 4-6 V). Specifically, we hypothesized that (1) during early recovery F(RBC) and V(RBC) would decrease rapidly and F(RBC) would display a biphasic response (consistent with a muscle pump effect on capillary haemodynamics), and (2) there would be a dynamic relationship between changes (Delta) in V(RBC) and Hct(CAP). The values at rest (R) and end-recovery (ER) were significantly lower (P < 0.05) than at end-contraction (EC) for F(RBC) (in cells s(-1), R = 30.1 +/- 7.8, EC = 46.2 +/- 7.3 and ER = 26.0 +/- 6.1), V(RBC) (in microm s(-1), R = 368 +/- 83, EC = 497 +/- 62 and ER = 334 +/- 59) and Hct(CAP) (R = 0.193 +/- 0.016, EC = 0.214 +/- 0.023 and ER = 0.185 +/- 0.019). The first data point where a significant decrease in F(RBC), Hct(CAP) and V(RBC) occurred was at 5, 5 and 20 s post-contraction, respectively. The decrease in F(RBC) approximated a monoexponential response (half-time of approximately 26 s). The relationship between DeltaV(RBC) and DeltaHct(CAP) was not significant (P > 0.05). Based on the early decrease in F(RBC) (within 5 s), overall dynamic profile of F(RBC) and the approximately 20 s 'delay' to the decrease in V(RBC) we conclude that the muscle pump does not appear to contribute substantially to the steady-state capillary haemodynamics in the contracting rat spinotrapezius muscle. Moreover, our findings suggest that alterations in V(RBC) do not obligate proportional changes in Hct(CAP) within individual capillaries following muscle contractions.
Animals↗
Muscle impairment occurs rapidly and precedes inflammatory cell accumulation after mechanical loading.
Modified muscle use can result in muscle atrophy and impairment. We tested whether inflammatory cell concentrations correlate temporally with muscle impairment during modified loading periods. Rat hindlimbs were unloaded for 10 days followed by reloading. The density of neutrophils and ED1+ macrophages was significantly increased by 16.5- and 9.8-fold, respectively, after 1 day of reloading. ED2+ macrophage concentration was not significantly increased until 3 days of reloading. Maximal isometric tetanic tension (P(o); N/cm2) decreased during hindlimb suspension (HS), which was followed by a second drop in P(o) after 2 h of reloading. This latter loss in muscle force was uncoupled with the significant elevation in muscle inflammatory cell concentrations. Experiments where HS soleus muscles were incubated with caffeine revealed that at least 40% of the P(o) decrement at 2 h could be associated with a loss of efficiency of the excitation-contraction (E-C) coupling process. These data suggest that an important mechanism for the early loss in force is the inability to activate the contractile machinery likely caused by a failure in the E-C coupling process during the reloading period.
Animals↗
Marcus Gunn Jaw-Winking Phenomenon: management and results of treatment in 19 patients.
From 1980-1995, 19 patients displaying the Marcus Gunn Phenomenon (MGP) were treated in the Department of Maxillofacial Surgery of the Jagiellonian University in Kraków, Poland. Sixteen patients were operated on according to the Neuhaus method, in one case bilaterally. In three patients, the upper eyelid, after partial transsection of the levator muscle, was suspended from the frontal muscle on autogenous temporal fascia strips. At postoperative follow-up, the width and symmetry of the palpebral fissures were evaluated as well as persistent symptoms of synkinetic eyelid movement. In 13 (68.4%) patients, proper width and symmetry of the palpebral fissures were obtained, whereas in the remaining six (36.1%) marked improvement and decreased asymmetry of palpebral fissures were achieved. Pathological synkinesis disappeared totally in 16 (84.2%) of the patients on operated.
Adolescent↗
Abnormalities in the temporal patterning of lower extremity muscle activity in hemiparetic gait.
Following hemiparetic stroke, the timing of lower extremity muscle activity during gait often undergoes radical changes. In the present study, we compared the duration of activity in Biceps femoris (BF), Rectus femoris (RF), Tibialis anterior (TA) and Gastrocnemius medialis (GM) for four subphases of the gait cycle: the first double support phase (DS1), the single support phase (SS), the second double support phase (DS2) and the swing phase (SW) and compared these between 24 hemiparetic stroke patients and 14 healthy controls. In the upper leg, durations of BF and RF activity during SS were significantly longer on the paretic side (70% for BF, and 78% for RF) as well as on the nonparetic side (71% for BF, and 81% for RF), when compared to controls (45% and 53% for BF and RF, respectively). As a result, the duration of BF-RF coactivity during SS was longer in both legs of patients with stroke (61% in the paretic and 62% in the nonparetic leg) relative to control values (25%). In addition, during DS1 of the paretic leg, the total amount of BF-RF coactivity was abnormally long (82% versus 57% in controls). In the lower leg, longer total durations of GM activity were found during DS1 on the paretic side in people with stroke (51%) than in controls (38%). In the paretic TA, longer durations of activity were observed during SW (73% versus 60% in controls), whereas smaller total durations of activity were found during SS (28% versus 48% in controls). No statistically significant differences were found between the paretic and nonparetic leg within patients, except for the mean total duration of TA activity during DS1 (50% and 69% for the paretic and nonparetic leg, respectively). Overall, these results suggest that, despite large interindividual differences, some common disturbances can be observed in the temporal layout of muscle activity and coactivity associated with hemiparetic gait. Although these disturbances are more pronounced in the paretic leg, muscle activation patterns of the nonparetic leg also display some clear abnormalities.
Adult↗
The temporalis muscle flap: an evaluation and review of 38 cases.
This article analyzes the authors' experience with the temporal myofascial flap in orbital, maxillary, floor of the mouth, tongue, retromolar trigone, and buccal mucosa reconstruction after oncologic surgery. Thirty-eight patients were treated and evaluated after using this technique. Four of the patients received the flap to restore orbital defects; the other 34 flaps were used in oral reconstruction. The flap remained viable in all instances. Most of the patients experienced no perioperative complications. Ten patients (29.4%) with flaps transposed to the oral cavity showed partial wound dehiscence. Two patients experienced temporomandibular joint dysfunction, two severe reduction in the oral aperture, 22 had mild depression of the temporal fossa, and four had mild to severe alteration in the facial aesthetics secondary to bone resection. All flaps transposed to the oral cavity showed good epithelialization and adaptation to the recipient site.
Adolescent↗
The histochemistry of reactive masticatory muscle hypertrophy.
There are two types of hypertrophy of the muscles of mastication in man: reactive hypertrophy, the more common form; and nonreactive enlargements-myositic, genetic, myopathic, and idiopathic. Reactive hypertrophy develops when the masticatory muscle workload is increased by local bone and dental disorders; such triggers are not powerful but act over long periods, thus demanding increased endurance. Exercise for endurance has a greater effect on the muscles of mastication than it has on the large muscles of the limbs; these react solely by stimulating the oxidative metabolism of type 1 fibers, whereas masticatory muscle reacts structurally by hypertrophy and progressive type 1 fiber predominance. Eventually enzyme instability of type 1 fibers and end stage atrophy of type 2 fibers may appear. Unexpectedly, lesions have also been found in control masticatory muscle, in particular type 2 fiber specific atrophy like that seen in long-standing acquired autoimmune myasthenia gravis. It is suggested that the adverse lesions in hypertrophied and control masticatory muscle are the consequence of post-activation fatigue.
Adult↗
Maximal bite force and surface EMG in patients with myasthenia gravis.
Masticatory muscle strength was quantified in patients with bulbar myasthenia gravis and compared with that of patients with ocular myasthenia gravis, patients in clinical remission (whether or not pharmacological) who previously suffered from bulbar myasthenia gravis, and healthy subjects. Maximal bite force and maximal activity of the masseter and temporalis muscles and of the submental muscle complex were measured. Bite force was decreased in the patients with bulbar myasthenia gravis, but was normal in the patients in the clinical remission group and in the ocular group. These findings were consistent with the results of electromyographic data. Although subjective reports of masticatory muscle weakness provide valuable information, quantitative measurements provide more information about the degree of muscle weakness of individual muscles. This is especially important for longitudinal evaluation of therapy in individual patients and for pharmacotherapeutic research.
Adult↗
Internal architecture, origin-insertion site, and mass of jaw muscles in Old World hamsters.
The jaw muscle (i.e., masticatory, suprahyoid, and extrinsic tongue) anatomy and mass were examined in four genera of Old World hamsters (cricetine murids), Mesocricetus, Cricetulus, Tscherskia, and Phodopus. The masseter was the largest and most complicated of the muscles examined. In the superficial layer, a few ventral fibers form a small medially turned portion with an insertion site more similar to those of sciurids than of other murids. In Mesocricetus, the superficial layer has a discrete anteroventral portion that has not been reported for other murid rodents. Examination of the fiber attachment sites indicated that the deep layer contains four parts and the medial layer contains three parts. The deep layer originates from two aponeuroses that are firmly connected to each other at their anterior ends and lie along the zygomatic arch. The aponeurosis of insertion for the deep layer is situated along the masseteric ridge and the dorsal border of the angular process, but is absent in its middle part, consistent with reports in two relatives, sigmodontine and arvicoline murids. In cricetine murids, unlike in other rodents, fibers insert on the dorsal narrow strip of the posterior mandibular aponeurosis, not on its broad medial aspect. The relative mass of some masticatory and suprahyoid muscles is related to body mass. Small species (Cricetulus and Phodopus) have relatively larger masseter and mylohyoid muscles and smaller temporalis and geniohyoid muscles than large species (Mesocricetus and Tscherskia).
Animals↗
Exteroceptive reflexes in jaw-closing muscle EMG during rhythmic jaw closing and clenching in man.
Exteroceptive jaw reflexes might play a role in normal functions of the mouth such as mastication. Until now these reflexes have only been studied under isometric conditions. The aim of this study was to compare exteroceptive reflexes in jaw muscle EMG during the closing phase of rhythmic open-close movements and clenching, at the same jaw gape and with similar muscle EMG. Reflexes consisting of successive waves of decreased and increased muscle activity (the Q, R, S and T waves of the post-stimulus electromyographic complex (PSEC)), evoked by light noxious electrical stimulation of the vermillion border of the lower lip, were recorded from the jaw closing muscles of 17 subjects. Differences between the two tasks occurred in two phases of the PSEC: (1) in an early phase, around the R wave, there was significantly less EMG during jaw closing (mean EMG ratio between jaw-closing and clenching 0.71), and (2) in a late phase, around the transition between the S to the T wave, there was significantly more EMG during jaw closing (mean EMG ratio: 1.40). The decrease in EMG activity around the R wave during jaw closing may be due to a change in reflex sensitivity at an interneuron level. The increase in EMG activity around the transition between the S and T waves during jaw closing might, at least in part, be due to a proprioceptive stretch reflex. This reflex is mediated by muscles spindles that are activated by the deceleration of the jaw evoked by the lip stimulus. The finding of inhibitory reflex mechanisms that predominate more during rhythmic jaw movements than during clenching in an early phase of the PSEC might be related to protecting oral tissues from trauma when the jaw is closing with potentially a large muscle force. In contrast, when food is held between the teeth, a possible inhibitory influence of light noxious stimuli is diminished.
Adolescent↗