Biomedical subjects

I J Klineberg

Publications and source records attributed to I J Klineberg.

At least 19 recordsLinked to original sources

PubMed2006

The influence of the leaf gauge and anterior jig on jaw muscle electromyography and condylar head displacement: a pilot study.

BACKGROUND: A leaf gauge and an anterior jig may be used to assist the recording of a reproducible jaw position for restorative and prosthodontic treatment. This study investigated possible condylar displacement using an opto-electronic jaw-tracking device and a leaf gauge or anterior jig. The effect of a leaf gauge and anterior jig on jaw muscle electromyography was also examined. METHODS: Five healthy adults without symptoms of temporomandibular disorders were selected. Condylar displacement during clenching were recorded simultaneously with electromyographic activity of superior and inferior heads of the lateral pterygoid, anterior and posterior temporalis, masseter, and suprahyoid muscles. Subjects were trained to bite at maximum and half-maximum bite-force using an anterior jig incorporating a force transducer. RESULTS: No consistent condylar displacement was observed in x, y and z axes between different bite-forces although there was a trend towards superior displacement. Comparison of maximum intercuspal clench and maximum clench on a leaf gauge and an anterior jig produced significant decrease in anterior temporalis activity (p < 0.05), whilst an anterior jig with maximum clench significantly decreased posterior temporalis muscle activity. CONCLUSION: Within the limits of this pilot study, no consistent change in condylar position was identified with these appliances.

Adult↗

PubMed2003

Functional heterogeneity in the superior head of the human lateral pterygoid.

The activity of the superior head of the human lateral pterygoid muscle (SHLP) is controversial. Given the non-parallel alignment of some SHLP fibers, the SHLP may be capable of differential activation. The aims were to clarify SHLP activity patterns in relation to location within SHLP. In 18 subjects, SHLP single motor units were intramuscularly recorded at computer-tomography-verified sites during horizontal (e.g., protrusion) and vertical (e.g., opening) jaw tasks (recorded by a jaw-tracking device) and at resting postural jaw position. None of 92 units was active at the resting postural position. Medially located units (21) showed activity during contralateral movement, protrusion, and opening; 5 were also active on jaw closing. There was a significant association between unit location and the number of units active during vertical tasks (i.e., jaw closing and clenching). Analysis of the data suggests differential activation within SHLP and raises the possibility of functional heterogeneity within SHLP.

Action Potentials↗

PubMed2001

Fear of pain in orofacial pain patients.

In the present study, we examined whether fear of pain, dental fear, general indices of psychological distress, and self-reported stress levels differed between 40 orofacial pain patients and 40 gender and age matched control general dental patients. We also explored how fear of pain, as measured by the Fear of Pain Questionnaire-III (J Behav Med 21 (1998) 389), relates to established measures of psychological problems in our sample of patients. Finally, we examined whether fear of pain uniquely and significantly predicts dental fear and psychological distress relative to other theoretically-relevant psychological factors. Our results indicate that fear of severe pain and anxiety-related distress, broadly defined, are particularly elevated in orofacial pain patients relative to matched controls. Additionally, fear of pain shares a significant relation with dental fear but not other general psychological symptomology, and uniquely and significantly predicts dental fear relative to other theoretically-relevant variables. Taken together, these data, in conjunction with other recent studies, suggest greater attention be placed on understanding the fear of pain in orofacial pain patients and its relation to dental fear and anxiety.

Adult↗

PubMed2000

Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part I. Occlusal interferences and occlusal adjustment.

This review, divided into two parts, evaluates the literature on the relationship between dental occlusion and temporomandibular disorders (TMD) and the need for occlusal therapy in the management of TMD. The first part of the review focuses on the aetiological importance of occlusal interferences and the place of occlusal adjustment in the management and prevention of signs and symptoms of TMD. This has long been a controversial issue, which has not yet been resolved. The literature does not give strong support for the role of occlusion in the aetiology of TMD. Experienced clinicians also repudiate the need for occlusal adjustment in the management of TMD, whereas (less experienced) general dentists adhere to a concept focusing on the occlusion in diagnosis and treatment of TMD. There is a consensus that generalized prophylactic occlusal adjustment is not justified. There is an obvious need for research with evidence-based methods, to be able to answer the many remaining questions in this field.

Dental Occlusion, Traumatic↗

PubMed2000

Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part II: Tooth loss and prosthodontic treatment.

The second part of this review, evaluating the literature on the relationship between dental occlusion and temporomandibular disorders (TMDs), focuses on the aetiological importance of tooth loss and the place of prosthodontic replacement in the treatment of TMD. Loss of teeth and lack of posterior occlusal support seem to have little influence on the development of TMD, which calls into question the use of prosthodontic restoration as prevention or treatment for TMD. In addition, there are practically no studies assessing the benefit of instrumental analysis in diagnosis or comparing the outcome of prosthodontic treatment with simple reversible methods in the management of TMD. There is a trend in the current literature to abandon any treatment, including positioning appliances and prosthodontic measures, to 'recapture the disk' in patients with disk displacements because of the favourable, long-term results achieved after using more simple methods. It is concluded that prosthetic therapy in TMD patients is not appropriate for initial TMD treatment and should only be carried out on prosthodontic indications after reversible treatment has alleviated pain and dysfunction.

Bruxism↗

PubMed1999

Electromyographic activity of the human lateral pterygoid muscle during contralateral and protrusive jaw movements.

Understanding of the normal function of the lateral pterygoid muscle is limited. The principal aim here was to determine whether there is a progressive increase in lateral pterygoid activity as the mandibular condyle moves downwards and forwards as would be expected if the muscle is concerned with the precise horizontal positioning of the mandible. In eight humans, recordings were made of the activity of the superior (SHLP) and inferior (IHLP) heads of the lateral pterygoid and the masseter, anterior temporal, posterior temporal and digastric muscles, together with the movement of the palpated lateral condylar pole (JAWS-3D tracking system) during trials of a contralateral and a protrusive jaw movement. Recording sites in SHLP and, in one participant, IHLP were verified by computed tomography. In each participant there was a progressive increase in the rectified and smoothed SHLP and IHLP activity in association with condylar movement during the contralateral and protrusive jaw movement. Further, irregularities in condylar movement, which reflected variations in the rate at which the jaw was moved, were correlated in time with prominent bursts of SHLP and IHLP activity. In all participants there was a consistently high correlation coefficient between the rectified and smoothed SHLP and IHLP activity and condylar displacement during the contralateral or protrusive jaw movements. For example, the mean (+/-SD) correlation between anterior condylar translation during contralateral excursion and SHLP activity was 0.91+/-0.09, and for IHLP 0.96+/-0.02. For the masseter, anterior temporal, posterior temporal and digastric muscles, mean r-values were, respectively, 0.10+/-0.77; -0.14+/-0.72; 0.24+/-0.78; 0.54+/-0.47. When treated as a group the correlation coefficients for SHLP and IHLP were statistically significantly different from the correlation coefficients for the other muscles treated as a group (ANOVA; p < 0.002 for correlation with anterior translation). These observations support the notion that the lateral pterygoid provides the principal driving force for moving the jaw forwards or laterally in protrusive or lateral excursive condylar movements. Further, the data suggest that the muscle plays a part in the fine control of jaw movements.

Adult↗

PubMed1999

Trajectories of condylar points during nonworking side and protrusive movements of the mandible.

STATEMENT OF PROBLEM: During lateral excursive and protrusive jaw movements, condylar points are distant from any instantaneous rotational center. Therefore, it is likely that different condylar points would follow similar trajectories during these movements. PURPOSE: This study evaluated the effect of changes in condylar point location on trajectories of condylar points on the nonworking side and during a protrusive jaw movement and compared these changes with the effects described for open-close and working-side condylar movements in the same group of subjects. METHODS: The movements of 5 clinically determined condylar points were recorded in 44 subjects during a contralateral excursion and during protrusion (7 radiographically determined condylar points in 2 subjects). RESULTS: During any single jaw movement, the trajectory of each condylar point was similar in form and dimension to the other condylar points within that subject. CONCLUSION: Changes in condylar point location had little effect on the trajectories of condylar points on the nonworking side and during protrusive jaw movement.

Adult↗

PubMed1999

Trajectories of condylar points during working-side excursive movements of the mandible.

STATEMENT OF PROBLEM: Trajectories of different condylar points provide different interpretations of condylar movement during open-close jaw movements. Movement of the working-side condyle is often assessed clinically by recording the trajectory of a single arbitrary condylar point. PURPOSE: This study examined the effect of the differences in condylar point location on condylar point movement trajectories during a working-side movement. METHODS: Different points exhibited different trajectories during a single working-side movement in each of 44 subjects. RESULTS: Up to 40% of a point's displacement could be attributed simply to the location of the point. CONCLUSIONS: Interpretation of condylar movement on the working side within a subject depends on the point chosen.

Adult↗

PubMed1999

Electromyographic evidence for functional heterogeneity in the inferior head of the human lateral pterygoid muscle: a preliminary multi-unit study.

OBJECTIVE: Functional heterogeneity, i.e. regional or selective activation of subpopulations of fibres within a muscle, has been described in some jaw and limb muscles. Each head of the lateral pterygoid muscle may also be functionally heterogeneous. The aims of this investigation were to develop a technique to test this hypothesis, and to use this technique to determine whether there is any multi-unit electromyographic (EMG) evidence for functional heterogeneity within the inferior head of the lateral pterygoid (IHLP). METHODS: In 3 human subjects without craniomandibular disorders, recordings were made of condylar movement and multi-unit EMG activity from two sites in the IHLP during repeated trials of a contralateral (n = 21) and a protrusive (n = 26) jaw movement. The recording sites within IHLP were approached extraorally (labelled IHLP-extra) and were verified by computer tomography (CT); the other (IHLP-intra) were from sites in IHLP approached intraorally. RESULTS: In each subject, the time of occurrence of the peak filtered signal from IHLP-extra was significantly different (P<0.05) from IHLP-intra for all protrusion trials but not for contralateral trials. CONCLUSIONS: The data suggest a task-dependent change in motor unit recruitment order within IHLP and that IHLP is functionally heterogeneous.

Adult↗

PubMed1998

An association of membrane-damaging toxins from coagulase-negative staphylococci and chronic orofacial muscle pain.

Forty-six patients presenting with chronic orofacial muscle pain and eight age- and sex-matched control subjects were investigated for the carriage prevalence of, and exotoxin production by, coagulase-negative staphylococci (CNS). The eight control subjects were selected from an initial group of 41 subjects on the basis of the absence of musculoskeletal symptoms. There was a significantly higher prevalence and multiple carriage of four or more strains of CNS in patients with chronic muscle pain than in control subjects (23 versus 9 isolates/10 subjects). Two of the 103 CNS isolates from patients with muscle pain and none from the control subjects produced toxic shock syndrome toxin 1 (TSST-1), suggesting that pyrogenic toxins do not significantly contribute to the aetiology of chronic muscle pain. There was a significantly higher prevalence of delta-haemolysin (41 of 114) and 'horse'-haemolysin (56 of 114) production by CNS isolates from patients with chronic muscle pain compared with those from control subjects. None of the control subjects was colonised with CNS that produced significant amount of either delta- or 'horse'-haemolysin, whereas 35 of 44 patients with chronic orofacial muscle pain were colonised with CNS that produced significant amounts of 'horse'-haemolysin, 37 that produced delta-haemolysin and 33 that produced both delta- and horse-haemolysin. This study suggests that membrane-damaging toxins, like delta- and 'horse'-haemolysin, may play a role in the aetiology of chronic orofacial muscle pain.

Adolescent↗

PubMed1998

A volumetric study of guided bone regeneration around titanium implants in the New Zealand white rabbit.

Previous studies have shown the ability for bone to grow under occlusive membranes. This study was undertaken to determine the time required for bone to form in the space created under the membrane and to determine the amount of bone that may be grown under the membrane. Thirty-two New Zealand white rabbits were divided into three groups. A Brånemark implant, having a diameter of 3.75 mm with a length of 7 mm, was placed in each tibia and Gore-Tex membrane was draped over the implant on the experimental side and tethered to the wound margin. Sixteen rabbits were sacrificed at six weeks, eight at twelve weeks, and eight at eighteen weeks. At six weeks the available space under the membrane was filled to 68 per cent, at twelve weeks it was 45 per cent, and at eighteen weeks 54 per cent. A comparison of bone height measurements on test and control sides showed a significant difference (p = 0.0001) at the three time intervals. A comparison of grown bone volumes (test vs control) was also statistically significant (p = 0.0001). The ability to grow bone under an occlusive membrane was confirmed but the long-term survival rate and ability to support load needs to be investigated.

Analysis of Variance↗

PubMed1997

The variability of condylar point pathways in open-close jaw movements.

STATEMENT OF PROBLEM: Clinical assessments of condylar movement often rely on the movement of a single clinically determined or average value condylar point. PURPOSE: The aim of this investigation was to study the effect of differences in condylar point location on recorded movement trajectories with an open-close jaw movement. METHODS: Recordings were made of the movements of various condylar points in 44 subjects. The points were identified clinically (average value points) and radiographically. RESULTS: The trajectory of each condylar point, whether average value or radiographically determined, was different in form and dimension from any other condylar point within a subject for the same open-close jaw movement. CONCLUSIONS: Depending on the point chosen in the vicinity of the condyle, quite different interpretations of condylar movement within a subject could be made. The data underscore the caution that must be exercised when interpreting condylar movement from the movement of a single condylar point.

Adult↗

PubMed1997

The effect of posterior tooth guidance on non-working side arbitrary condylar point movement.

Occlusal form is frequently modified in clinical practice and yet we do not have detailed knowledge of the possible effects of these changes on condylar movement. The aim of this study was to quantify the effects of an alteration in the occlusion on condylar movement during a lateral excursive jaw movement. Posterior tooth guidances (i.e. metal overlays) were attached to both maxillary first molars. The movement of arbitrary condylar points on the non-working side was recorded in seven subjects during lateral excursion under natural tooth guidance (control) and was compared with that after placement of the overlays (guidance). The guidance resulted in statistically significant changes to the displacement of the arbitrary condylar points on the non-working side. For example, at a standardized (3 mm) displacement along the mid-incisor point trajectory during the lateral excursion for both control and guidance in all subjects, the corresponding displacements of the condylar points were statistically significantly decreased under the guidance situation in comparison with the control situation. These data suggest that, for the same magnitude of mandibular displacement during lateral excursion, the introduction of a posterior tooth guidance limits condylar displacement on the non-working side.

Adult↗

PubMed1996

Preliminary determination of a molecular basis of chronic fatigue syndrome.

Chronic fatigue syndrome (CFS/ME) is a debilitating fatigue illness that has an unknown etiology. We studied 20 chronic fatigue syndrome (CFS) patients, who complied with the Oxford and American CDC definitions, and 45 non-CFS subjects. Participants completed questionnaires, were clinically examined, and had first morning urine specimens collected, which were screened by gas chromatography-mass spectrometry for changes in metabolite excretion. Multivariate analysis of the urinary metabolite profiles differed significantly in the CFS patients compared to the non-CFS patients (P < 0.004). The CFS patients had increases in aminohydroxy-N-methylpyrrolidine (P < 0.00003, referred to as chronic fatigue symptom urinary marker 1, or CFSUM1), tyrosine (P < 0.02), beta-alanine (P < 0.02), aconitic acid (P < 0.05), and succinic acid (P < 0.05) and reductions in an unidentified urinary metabolite, CFSUM2 (P < 0.0007), alanine (P < 0.005), and glutamic acid (P < 0.02). CFSUM1, beta-alanine, and CFSUM2 were found by discriminant function analysis to be the first, second, and third most important metabolites, respectively for discriminating between CFS and non-CFS subjects. The abundances of CFSUM1 and beta-alanine were positively correlated with symptom incidence (P < 0.01 and P < 0.001, respectively), symptom severity, core CFS symptoms, and SCL-90-R somatization (P < 0.00001), suggesting a molecular basis for CFS.

Aconitic Acid↗

PubMed1996

Preliminary determination of the association between symptom expression and urinary metabolites in subjects with chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) patients have a urinary metabolite labeled CFSUM1 with increased incidence (P < 0.004) and relative abundance (P < 0.00003). The relative abundances of urinary CFSUM1 and beta-alanine were associated with alterations in metabolite excretion and symptom incidence. In 20 CFS patients and 45 non-CFS subjects, symptom/metabolite associations were investigated by assessing symptom sensitivity and specificity, and symptom indices of total symptom incidence, CFS core symptoms, cognitive, neurological, musculoskeletal, gastrointestinal, infection-related and genitourinary symptom indices, as well as a visual analogue pain scale of average pain intensity. Thirty-three symptoms had significant (P < 0.005) sensitivity and specificity in the CFS patients compared to that in the non-CFS controls. Severe fatigue was the only symptom with 100% sensitivity and specificity and CFSUM1 excretion was the primary metabolite for expression of this symptom. All nine symptom indices had elevated responses in the CFS patients (all P < 0.0000001). Multiple regression analyses indicated that all the symptom indices had significant correlations (R) with changes in the urinary excretion of metabolites (P < 0.0001). CFSUM1 and beta-alanine were the first and second metabolites correlated with the CFS core symptom index and CFSUM1 was primarily associated with infection-related and musculoskeletal indices whereas beta-alanine was primarily associated with gastrointestinal and genitourinary indices. The strong associations of CFSUM1 and beta-alanine with CFS symptom expression provide a molecular basis for developing an objective test for CFS.

Adolescent↗

PubMed1996

Placement and verification of recording electrodes in the superior head of the human lateral pterygoid muscle.

Previous studies in man have relied only on electromyographic (EMG) activity patterns and anatomical landmarks to confirm electrode placement in the superior head of the lateral pterygoid. Computed tomography (CT) was used here to determine whether indwelling fine wires could be visualized in that muscle head in man and thus provide evidence for correct placement before EMG. Two imaging sessions were conducted in six individuals. First, a series of contiguous axial CT slices was obtained to calculate the trajectory of insertion of fine wire electrodes into the superior head. For each individual, the trajectories for the location of the fine wires in the approximate mediolateral and anteroposterior centre of the superior head were different. Further axial CT slices were taken after electrode insertion; in each case, these slices clearly showed the wire ends located within the muscle. It was concluded that fine wires in the lateral pterygoid can be imaged by CT. Furthermore, imaging is necessary to accommodate interindividual anatomical variations and to confirm the position of the electrodes within the muscle.

Adult↗

PubMed1996

Assessment of pain (distribution and onset), Symptoms, SCL-90-R Inventory responses, and the association with infectious events in patients with chronic orofacial pain.

A visual analog pain scale and scalar responses to 13 pain/symptom indicator Symptom Checklist-90-Revised (SCL-90-R) questions were used to assess symptom prevalence and pain severity in 43 chronic orofacial muscle pain patients and 40 control subjects. The orofacial muscle pain group reported pain in an axial skeletal distribution; neurocognitive, gastrogenitourinary, and musculoskeletal symptoms; infectious events at or preceding onset; similar symptoms in sexual partners; and low prevalence of trauma. Sudden onset was reported by 30.2% of pain patients. Strong associations were found between chronic orofacial muscle pain and (1) onset-related infectious-like events (67.4%); (2) a higher prevalence of history of respiratory and gastrogenitourinary infectious events; and (3) high prevalences of similar pain symptoms in long-term sexual partners. The SCL-90-R somatization scores (> 62) had a higher prevalence in the chronic pain group. No prevalence differences or associations with pain/symptom indicators were found for depression or anxiety dimension scores. These data suggest that patients with recurrent systemic infectious events have a higher prevalence of reporting of chronic orofacial muscle pain compared with control subjects, and these infectious events are associated with the onset of chronic orofacial muscle pain in 67% of patients.

Adolescent↗

PubMed1994

A new approach for accurate pre-planned occlusal adjustment.

Occlusal adjustment is important in prosthodontic pre-treatment procedures and in the management of some cases of craniomandibular disorders. This may involve tooth surface reduction and tooth surface addition with an appropriate restorative material. Occlusal adjustment must be distinguished from occlusal equilibration and selective grinding with clear indications and aims. A systematic pre-clinical and clinical protocol has clear advantages and the use of a thermoplastic vacuum-formed template greatly increases the clinical accuracy of a pre-planned adjustment.

Dental Occlusion, Balanced↗