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Biomedical subjects

Esther Gazit

Publications and source records attributed to Esther Gazit.

5 recordsLinked to original sources
PubMed2006

Effect of controlled masticatory exercise on pain and muscle performance in myofascial pain patients: A pilot study.

The aim of this study was to test the hypothesis that strengthening masticatory muscles using a controlled chewing exercise protocol improves muscle function, as evaluated quantitatively by electromyogram, and reduces pain at rest and during function. The study included 20 patients diagnosed with myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders with low masseter volume increase during maximal clench. The exercise group (ten patients) was subjected to a controlled gum chewing exercise protocol for eight weeks: the control group (ten patients) received only support and encouragement. Patients were examined at the beginning and at the end of the experiment which included an electromyogram (EMG) to assess muscle performance, masticatory muscle tenderness to palpation, mouth opening range, subjective anamnestic indices to evaluate pain perception and pain relief, and chewing tests. The EMG showed that the masticatory muscle exercise did produce objective physiologic results. In the exercise group, a significant increase was found in the electric muscle activity of the masseters during maximal voluntary clench (p=0.007). The exercise group showed significant reduction in pain during rest, pain during the chewing test, and a disability score. At the end of the study, a difference between the two groups was shown in the Pain Relief Scale: significantly greater pain relief was found in the exercise group as compared to the control group (p=0.019). For all other clinical parameters, there was no difference between the two groups or interaction between time and treatment. The results of this study seem to be equivocal. Additional experiments on larger population groups with extended chewing protocols are necessary before a more substantial conclusion can be reached.

Adult↗
PubMed2003

Quantitative evaluation of lip symmetry in functional asymmetry.

The objectives of this study were to quantitate lip symmetry/asymmetry from clinical photographs; to demonstrate that asymmetry due to functional side shifts (functional asymmetry) leading to unilateral crossbites including the canines, results from measurable thinning of the upper lip and thickening of the lower lip on the side of the crossbite when viewed in the intercuspal contact position; and to show that orthodontic treatment aimed at eliminating the functional shift and crossbite would achieve lip symmetry, both visually and quantitatively. The study consisted of 26 patients, who were divided into two groups: a study group of 13 patients (eight females, five males, aged 8-17 years) with a functional asymmetry, and a control group of 13 age- and gender-matched subjects with other forms of malocclusion without functional asymmetry. All patients in the study group exhibited unilateral crossbites including the canines in intercuspal contact position. Digitized images of frontal facial photographs were analysed for upper and lower lip symmetry pre- and post-orthodontic treatment. The upper and lower lips were subdivided into four quadrants and the surface area and length of each quadrant were measured and expressed as a percentage of the total surface area/length of the relevant lip. The degree of asymmetry was obtained by calculating the difference in percentage area or length between the two quadrants of each lip. In the study group, the lower lip quadrant on the shift side was enlarged while the contralateral side was reduced (mean area ratio 59.9 to 40.1 per cent, mean length ratio 53.0 to 47.0 per cent). The upper lip demonstrated differences that were smaller and inverse. The controls showed a small difference between the right and left sides (less than 1 per cent). After treatment, both groups displayed visual and quantitative lower and upper lip symmetry, i.e. an area or length of approximately 50 per cent of each quadrant. In absolute values, the control patients had up to 3 per cent asymmetry in area regardless of treatment. The patients in the study group exhibited mean absolute asymmetry of 9.2 per cent in the upper lip and 19.8 per cent in the lower lip. Asymmetry values in the study group were reduced to approximately 3 per cent post-treatment. The absolute values of asymmetry in length of all patients were up to 2 per cent in the control group regardless of treatment. The subjects in the study group exhibited mean absolute asymmetry of 6.3 per cent in the upper lip and 8.6 per cent in the lower lip. Asymmetry values in the study group were reduced post-treatment to approximately 2 per cent. Although asymmetry in the study group could be quantitated using both parameters (lip surface area and lip length), the surface area parameter proved to be a more sensitive tool for measuring lip asymmetry.

Adolescent↗
PubMed2002

Experimental chewing in myofascial pain patients.

AIMS: To evaluate the potential capacity of a chewing exercise to differentiate chronic myofascial pain (MFP) patients from healthy controls and to test whether there are distinct pain response differences among MFP patients. METHODS: Eighty-nine subjects participated in the study; 49 were diagnosed as belonging to the MFP subgroup of temporomandibular disorders (TMD) and had suffered from MFP for at least 6 months, and 40 healthy age- and gender-matched subjects comprised the control group. After completion of a clinical examination, all subjects performed a chewing exercise. Subjects chewed on half a leaf of green casting wax for 9 minutes and then held their jaw at rest for another 9 minutes. They indicated the intensity of the pain experience on a visual analog scale (VAS) every 3 minutes from the beginning (P0) to the end (P18) of the chewing exercise. Only changes in pain report of more than 5 mm on the VAS were considered. Analysis of covariance with repeated measures was used to analyze fluctuations in pain levels during the test, with the pain level at baseline (P0) as a covariant. RESULTS: Statistical analysis revealed a significant main effect for group (MFP versus control); a significant main effect for activity (chewing versus rest); an interaction between activity and time; and an interaction between activity, time, and group. The latter revealed the significant effect of the chewing activity on pain levels in both groups along the axis of time and its recovery at rest. In the MFP patients, pain had increased by 32 mm at P9 in 84% of the patients and recovered to almost the initial pain levels by P18; 6% reported a decrease in pain sensation and 10% reported no change in pain. In the controls, pain had increased 4.9 mm by P9, a value within the recording error range of the scale. CONCLUSION: (1) A strenuous chewing exercise is a potentially beneficial tool in the diagnostic process of myofascial pain patients and, if validated, could be incorporated into clinical examinations. (2) The increase in pain intensity following the chewing exercise is typical of most of the MFP group. (3) The phenomenon of pain decrease in a small percentage of MFP patients should be further investigated.

Adolescent↗