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Biomechanical changes in the rabbit masticatory system during postnatal development.

Using dissection, biometry, and two three-dimensional mechanical models, the postnatal changes of the rabbit masticatory muscles were studied by analyzing their three-dimensional orientation, their strength and fiber lengths, and certain functional consequences of these changes. The first mechanical model uses length-tension relationships of the muscles and predicts the maximum bite force as a function of mandibular position. It shows that young rabbits are able to generate large bite forces at a wider gape than adult animals and that the forces are directed more vertically. In spite of the postnatal changes the mechanical advantage of the system remains about equal. However, the muscles are reoriented so that they exert a larger degree of parallel action, suggesting a larger bite force magnitude but a smaller range of bite force directions. The second model-predicts this range. It shows that during postnatal development a relative gain occurs in the possibilities for the system to exert forces directed rostrodorsally. In all other directions the capability to exert force decreases. The results suggest that during development the possibility of the system to generate large bite forces is increased at the cost of a restriction in the range of jaw excursion and that a restriction takes place in the range of possible force directions that can be exerted at the molars.

Animals↗

Harmonic imaging of the brain parenchyma using a perfluorobutane-containing ultrasound contrast agent.

We evaluated the signal-enhancing effect of the novel perfluorobutane-based ultrasound contrast agent BR 14 (Bracco Research, Switzerland) in grey-scale harmonic imaging of the brain parenchyma. Six sedated male beagle dogs were investigated with transcranial grey-scale harmonic imaging (SONOS 5500, 1.8/3.6 MHz). After bolus injection of two different doses of BR 14, acoustic densitometry was performed to quantify changes in regional contrast intensity. In the dogs' brain parenchyma, the mean relative peak increase in acoustic intensity was +61% after administration of 0.05 ml/kg BW of BR 14 and +24% after 0.2 ml/kg BW. In the masticatory muscle, application of the higher dose resulted in a stronger increase in contrast intensity compared to the lower dose. Evaluation of the contralateral base of the skull showed a dose-dependent decrease in acoustic intensity. Bolus injection of BR 14 produces an increase in acoustic intensity, which can be used for the visualization of contrast agent in the brain parenchyma. Using high dosages, a strong signal-enhancing effect in the regions near the ultrasound probe leads to a consecutive attenuation of signals from structures being located beyond ("shadowing-effect"). This is the explanation for the paradoxical result that the higher dose leads to a lower peak signal increase in the brain parenchyma.

Animals↗

Development of chewing in children from 12 to 48 months: longitudinal study of EMG patterns.

Developmental changes in the coordinative organization of masticatory muscles were examined longitudinally in four children over 49 experimental sessions spanning the age range of 12-48 mo. Electromyographic (EMG) records were obtained for right and left masseter muscles, right and left temporalis muscles, and the anterior belly of the digastric. Two independent analytic processes were employed, one that relied on identification of onset and offset of muscle activation and a second that used pairwise cross-correlational techniques. The results of these two analyses, which were found to be consistent with each other, demonstrated that the basic chewing pattern of reciprocally activated antagonistic muscle groups is established by 12 mo of age. Nevertheless, chewing efficiency appears to be improved through a variety of changes in the chewing pattern throughout early development. Coupling of activity among the jaw elevator muscles was shown to strengthen with maturation, and the synchrony of onset and offset of these muscles also increased. Coactivation of antagonistic muscles decreased significantly with development. This decrease in antagonistic coactivation and increase in synchrony among jaw elevators, and a parallel decrease in EMG burst duration, were taken as evidence of increased chewing efficiency. No significant differences in the frequency of chewing were found across the ages studied. Additional considerations include the appropriateness of this coordinative infrastructure for other developing oromotor skills, such as speech production. It is suggested that the relatively fixed coordinative framework for chewing exhibited by these children would not be suitable for adaptation to speech movements, which have been shown to rely on a much more variable and adjustable coordinative organization.

Child Development↗

Creation of a three-dimensional model of the mandible and the TMJ in vivo by means of the finite element method.

The aim of this study was to develop a three-dimensional finite element model of the mandible, including its TMJ. The model consisted of 7942 nodes and 41,010 elements, which were obtained from a convergence test, done to minimize the result error. It included cancellous and cortical bone, periodontal ligament, masticatory muscles (masseters, temporalis, lateral and internal pterygoids), teeth and the articular disk. All characteristics such as dental, mandibular, and muscle geometry were obtained from a computerized tomography (CT) of a living person. CT sections were scanned and digitized with a CAD software program. After images were adequately assembled, a vertical tracing was done which allowed the definition of a three-dimensional mesh. Modeling of teeth was carried out independently and the periodontal ligament was later included, limiting the alveolar area. Muscles were modeled based on flat-scale photographs and total muscle force was distributed in multiple vectors. The articular disk was generated having 2 mm of thickness with the combination of spring-type (axial stiffness) and gap-type (contact) elements. The model was then analyzed with finite element method (FEM) software where a mesh was generated and values for Poisson's ratio, elasticity, and shear modulus were assigned. These were orthotropic for cancellous and cortical bone, and isotropic for dentin, periodontal ligament, articular disk, and temporal bone. The boundary conditions were defined restricting the nodes on the periphery of the temporal bone. It was therefore possible to generate a three-dimensional finite element model based on information obtained in vivo.

Adult↗

Frequency analyses of EMG power spectra of anterior temporal and masseter muscles in children and adults.

To study the functional change of masticatory muscles during growth and development, frequency analyses of surface electromyogram (EMG) power spectra were carried out. The subjects were six children (five males and one female), aged 4.5 +/- 0.2 years, having full deciduous dentition (Hellman's dental age IIA) and six adults (four males and two females), aged 27.7 +/- 3.8 years, having full permanent dentition. EMG signals were recorded bilaterally by using bipolar silver-surface electrodes from the anterior temporal and masseter muscles while the subjects were chewing gum and while performing maximum clenching in the intercuspal position. A fast Fourier transform algorithm was used to obtain the power-spectral density function and the power spectra of the EMG signals. Since the total power value from 62.5 to 1000 Hz was 100 percent, the frequencies at 25, 50, 75, and 90 percent of the cumulative power were calculated. The results showed that the frequencies at every percent of the cumulative power were age-dependent and that the EMG power spectra patterns in adult muscles were shifted to significantly lower frequencies than those in child muscles. The shift was probably caused by differences in the proportion of fiber type and fiber size between muscles of children and adults.

Adult↗

Comparative functional morphology of mandibular forward movement during mastication of two murid rodents, Apodemus speciosus (Murinae) and Clethrionomys rufocanus (Arvicolinae).

The anatomy of the masticatory apparatus, the direction in which masticatory muscles act during mastication, and jaw muscle forces as estimated by muscle dry weight are compared between two murid rodents, the Japanese field mouse (Apodemus speciosus, subfamily Murinae) and the gray red-backed vole (Clethrionomys rufocanus; subfamily Arvicolinae). The occlusal forces exerted by the deep masseter and the anterior temporalis are large in C. rufocanus. Furthermore, in this species, the angle between the sagittal plane and the occlusal plane of the cheek teeth is larger than in A. speciosus. Therefore, a relatively large occlusal force can be generated in C. rufocanus. The estimated line of action of the anterior temporalis differs markedly between these two species. The functional significance of this difference is discussed relative to the adaptive dental characteristics for food processing, the forces required to masticate different types of food, and the forces that control mandibular forward movement.

Animals↗

Changes in mandibular morphology from the Jomon to modern periods in eastern Japan.

Metric characteristics of the mandibles of modern and various historical populations from the Kanto region (east-central Japan) were compared with those of their possible ancestral populations, i.e., the Jomon population from Kanto and the Yayoi population from northern Kyushu and Yamaguchi (western Japan). The Jomon people were aboriginal Holocene inhabitants of Japan, while the Yoyoi skeletal series are considered to largely represent immigrants from the Asian continent. Compared to the presumed ancestral morphology, the mandibles of the modern and pre-modern peoples of Kanto showed a marked narrowing, as well as reduction in the regions of major masticatory muscle attachments. The main cause of this underdevelopment is likely to be a diminished chewing stress, resulting in insufficient stimulation for proper growth of the jaw bone. In contrast, symphyseal height increased compared to the earlier Kanto populations. This may be a reflection of the existence of significant Yayoi genetic contribution in the formation of the modern and pre-modern Kanto populations. On the other hand, the mandibles of the protohistoric to medieval populations of the Kanto region are morphologically closer to Jomon. Therefore, they seem to have been genealogically continuous from the native Jomon people with some degree of gene flow stemming from the immigrants.

Adult↗

Studies of biologic parameters for denture design. Part III: Effects of occlusal adjustment, base retention, and fit on masseter muscle activity and masticatory performance.

EMG recordings of ipsilateral and contralateral masseter muscles and standardized masticatory performance tests were made in 20 denture wearers before and after modifications were made to their clinically unsatisfactory dentures. The improvement of retention and stability by correction of gross occlusal prematurities and by the use of a denture adhesive or base reline with a soft tissue-conditioning material did not significantly alter the chewing performance or muscle activity during mastication in denture wearers. The results support our previous findings that the influence of denture factors on chewing ability of denture wearers is limited. To avoid variations in EMG activity caused by changes in electrode positions, all tests for a given subject were made at the same sitting. Thus the study design did not provide time to denture wearers for their neuromuscular mechanism to adapt to the modifications prior to testing masticatory function. A replication of this study that permits sufficient adaptation time after each modification is suggested to validate the findings.

Adhesives↗

Psychophysiological definitions of clenching.

This study tested the hypothesis that individuals show considerable variability in EMG activity produced by the masticatory muscles when they are instructed to clench than when they are instructed to make minimal or maximal contact. Twenty individuals without temporomandibular disorder (TMD) pain participated in a biofeedback-training task to establish a relaxed baseline. They were instructed to clench their teeth according to their personal definition of the term, while EMG data were collected. This process was repeated two more times, followed by similar instructions to make minimal and maximal contact between the teeth. Results showed that individual subjects were very consistent in their behavioral definition of clenching and that the subjects taken as a whole showed markedly greater variability. The precise behavioral meaning of clenching varies across individuals. The failure to account for these individual differences may explain in part reported discrepancies on the role of parafunctions in TMD.

Adolescent↗

Interleukin-6 in synovial fluid and HLA-DR expression in synovium from patients with temporomandibular disorders.

Interleukin-6-dependent mouse hybridoma cell line KD83 was used to test the biologic activity of interleukin-6 in synovial fluid from 37 patients with temporomandibular disorders. The results showed that the interleukin-6 level was greater than 100 U/mL in 13 of 18 patients with degenerative joint disease and in five of 12 patients with temporomandibular disc displacement. However, the interleukin-6 level was less than 100 U/mL (range, 20 to 75 U/mL) in all patients with masticatory muscle disorder. It has been found that degenerative joint disease tends to have acute and chronic stages, and interleukin-6 activity was probably related to the acute stage in the patients. Histologic studies of the synovium from seven patients with degenerative joint disease showed a variable degree of hyperplasia of the synovial lining cells and chronic inflammation in five of eight specimens. Immunostaining studies clearly showed the presence of significantly more HLA-DR-expressing cells (human leukocyte antigen-D-related) in synovium. Although it is unlikely that immune responses play an important primary role in initiating synovial inflammation and cartilage destruction, immune reactions may be one important factor in the maintenance and severity of some patients with temporomandibular disorders.

Adolescent↗

A comparison of the muscular relaxation effect of TENS and EMG-biofeedback in patients with bruxism.

This study investigated effects of electromyographic (EMG) biofeedback (BFB) and transcutaneous electrical neuromuscular stimulation (TENS) on the EMG activity of the masticatory muscles and skin conductance level (SCL) of patients, suffering from myofacial pain syndrome. In the course of the investigation, EMG activity as well as the SCL was measured after a 20 min BFB or, respectively, after a myomonitor session in 20 patients and pre- and post-treatment values were compared. Results showed tendencies of decreased mean-EMG levels for both groups after the treatment sessions, with higher EMG values for the myomonitor group. There was no indication of a significant decrease in mean EMG levels over the sessions. Furthermore, an increase of the SCL during the period of treatment was observed for both groups in session I and II, while session III produced nearly stable values. No existing correlations for changes in SCL and EMG-activity could be established.

Adult↗

Occlusal and TMJ loads in subjects with experimentally shortened dental arches.

To determine whether shortened dental arches (SDAs) cause functional overloading of the teeth and the temporomandibular joints, which has been implicated in periodontal diseases and temporomandibular disorders, we investigated the influences of SDA on occlusal and joint loads. Bite force and masticatory muscle electromyograms were recorded in five dentate subjects who clenched maximally on intra-oral appliances, creating symmetrical SDAs experimentally. Muscular forces estimated from the recorded electromyograms were fed into a finite element jaw model for calculating bite forces and joint loads. Comparison between the measured and the calculated bite forces ensured that the joint loads were representative. The bite force on each tooth increased with missing molar occlusions, while joint loads decreased. The bite force per root surface area was always greatest on the most posterior tooth, and these values were most constant. The findings provide no evidence that SDA causes overloading of the joints and the teeth, which suggests that neuromuscular regulatory systems are controlling maximum clenching strength under various occlusal conditions.

Adaptation, Physiological↗

Evaluation of body posture in individuals with internal temporomandibular joint derangement.

Temporomandibular dysfunctions (TMD) comprise a great number of disruptions that may affect the temporomandibular joint (TMJ), the masticatory muscles, or both. TMJ internal derangement is a specific type of TMD, of which the etiology and physiopathology are broadly unknown, but have been suggested to be linked to head, neck, and body posture factors. This study aimed at verifying possible relationships between body posture and TMJ internal derangements (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Subjects' clinical evaluations included anamnesis, stomatognatic system evaluation, and plotting analysis on body posture photographs. No statistically significant differences were found between the groups. Results do not support the assertion that body posture plays a role in causing or enhancing TMD; however, these results should be cautiously considered because of the small number of subjects evaluated and the many posture variables submitted to statistical procedures that lead to high standard deviations.

Adolescent↗

The clinical usefulness of surface electromyography in the diagnosis and treatment of temporomandibular disorders.

BACKGROUND: This article presents a comprehensive review of the recent literature regarding the scientific support for the use of surface electromyography (SEMG) in diagnosing and treating temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED: The authors conducted a Medline search involving human studies using the key words "surface electromyography or electromyography" and "masticatory muscles or temporomandibular disorders or craniomandibular disorders." They also reviewed relevant articles regarding the clinical usefulness of SEMG based on reliability, validity, sensitivity and specificity, as well as additional references included in some of the articles. RESULTS: The clinical use of SEMG in the diagnosis and treatment of TMD is of limited value when one considers reliability, validity, sensitivity and specificity as measurement standards. SEMG does not appear to contribute any additional information beyond what can be obtained from the patient history, clinical examination and, if needed, appropriate imaging. CONCLUSIONS: Clinically, the determination of the presence or absence of TMD does not appear to be enhanced by the use of SEMG. However, the modality may be useful in a meticulously controlled research setting. CLINICAL IMPLICATIONS: SEMG has limited value in the detection or management of TMD and in some instances may lead to unnecessary dental therapy as a solution for those disorders.

Craniomandibular Disorders↗

Can temporomandibular dysfunction signs be predicted by early morphological or functional variables?

The aim of the present study was to establish whether the early signs of various orofacial dysfunctions, malocclusions, or occlusal interferences can predict the development of temporomandibular dysfunction (TMD) in young adults. Forty-eight subjects referred for speech therapy and 49 controls participated in all four stages of this longitudinal study. The subjects were examined at the ages of 7, 10, 15, and 19 years. The phoniatrician diagnosed errors in place of articulation and problems in the movement and co-ordination of the speech articulators. Occlusion, TMD signs (palpatory tenderness of the masticatory muscles, and of temporomandibular joints (TMJ), jaw deviation on opening, and clicking), mandibular movement capacity and occlusal interferences were registered by the orthodontist. Multiple logistic regression models were applied in order to evaluate whether single signs of TMD at the age of 19 years were related to previous/present malocclusions or interferences, to misarticulations of speech, problems in oral motor skills, or other signs of TMD. The effect of gender was also considered. The results showed that excessive overjet was the only variable which seemed to consistently increase the risk of TMD. In addition, girls seemed to be more prone to the development of TMD than boys. Although, during growth, there were both local and central factors associated occasionally with TMD development, the predictive value of those variables in the estimation of the individual risk of TMD was rather small.

Adolescent↗

Two-dimensional jaw tracking and EMG recording system implanted in the freely moving rabbit.

A system for simultaneously recording mandibular position in the sagittal plane together with masticatory muscle activity was designed and tested in rabbits. Two small magnetic sensors were implanted in the maxillary bone and a powerful magnet made of a rare earth metal attached to the mandibular central incisors. The magnetic sensors detected the mandibular movements in the sagittal plane by movement of the magnet. Masseter EMG was recorded by fine wire electrodes and amplified by a specially designed amplifier. The necessary preamplifiers were assembled as an integrated circuit (IC) chip in a small housing. The signals from the preamplifier were then passed through a signal processing unit and taped on an instrumentation tape. The system was applied to the freely moving rabbit supplied with food and water during the night. It worked without any trouble for more than 24 h. Since the implanted magnetic sensors were stable for more than 4 months, long-term recording could be done by merely reimplanting the magnet, the cables and the EMG electrodes, which was simple.

Animals↗

Functional influence on sutural bone apposition in the growing rat.

INTRODUCTION: The aim of this study was to quantify the influence of reduced masticatory muscle function on sutural bone apposition in the growing rat. METHODS: Twenty-six growing male albino rats were randomly divided into 2 equal groups; 1 (hard-diet group) received the ordinary diet of hard pellets, and the other (soft-diet group) received the powdered form of the ordinary diet mixed with water. The experimental period started when the rats were 4 weeks old and lasted 42 days. At days 0, 14, and 28, calcein was injected into all animals. At the end of the experiment, the animals were killed, and the heads were taken for preparation of undecalcified frontal sections, 120 microm thick. Three representative homologous sections for each animal in both groups were selected and studied under a fluorescence microscope. The level of bone apposition at the time of calcein injection was marked with separate fluorescing lines. Because the lines from the first injection could not be seen in all areas, bone apposition in the internasal, naso-premaxillary, and inter-premaxillary sutures was quantified from day 14 to the end of the experimental period, by using an image analysis software. RESULTS: In both groups, greater bone apposition was found between days 14 and 28 than between days 28 and 42 of the experimental period. Less bone apposition was found in the soft-diet group than in the hard-diet group in all sutures studied. CONCLUSIONS: The findings suggest that bone apposition in the studied facial sutures in the anterior facial skeleton of the growing rat is significantly affected by reduced masticatory function.

Analysis of Variance↗

Interobserver variability in assessment of signs of TMD.

PURPOSE: The aim of this report was to study the ability of examiners to measure reliably the clinical signs of temporomandibular disorders (TMD). Four examiners participated in this study of 11 TMD patients and 25 nonpatients. MATERIALS AND METHODS: Vertical and lateral excursions of the jaw were measured using a millimeter ruler. Joint sounds during vertical jaw movements were assessed using digital palpation. The reliability of delivering appropriate degrees of digital pressure to assess masticatory muscle pain was assessed using a manometer after training examiners to exert specified pressures. RESULTS: Intraclass correlation coefficients for the measurement of vertical and protrusive jaw movements were > or = 0.87, which was considered excellent. The intraclass correlation coefficient for measurements of left and right lateral jaw excursions varied between 0.73 and 0.85, which was considered acceptable. The interobserver agreement for detecting the joint sounds showed overall agreement across examiners of 78%. Kappa for every possible pair of examiners varied between .52 and .86 (median .75, interquartile range .18). Reliability for diagnostic categories from the Helkimo index and Research Diagnostic Criteria for Temporomandibular Disorders involving joint noises showed modest reliability. CONCLUSION: Point estimates and measures of spread for reliability measures of single clinical TMD signs as well as combinations of signs into diagnostic categories from the Helkimo index and Research Diagnostic Criteria for Temporomandibular Disorders involving joint noises were sufficient in a group of four examiners.

Adolescent↗