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Differential activation of neuromuscular compartments in the rabbit masseter muscle during different oral behaviors.

The rabbit masseter muscle is composed of multiple anatomical partitions that produce different mechanical actions. The purpose of this study was to test the hypothesis that these compartments are differentially activated during the performance of different oral behaviors. Rhythmic activation of the masticatory muscles was elicited by stimulating the cortical masticatory area (CMA) while recording forces generated at the incisors in three dimensions with the mandible immobilized. Torques about the right temporomandibular joint (TMJ) were calculated using these forces recorded during isometric function. A set of 1-15 unique rhythmic behaviors was identified for each rabbit using torque phase plot patterns. Electromyographic recordings were made at nine different compartments in the right masseter, two compartments in the left masseter, two regions in the right digastric, and single locations in the left digastric and right and left medial pterygoid muscles. In activation cycles producing similar mechanical actions, activity patterns at the 16 recording sites were clustered into three to six groups using principal component analysis (PCA). To test for similarities in the activation of masseter compartments, pair-wise comparisons of the PCA assignment for the nine masseter compartments were conducted and frequencies of common assignment were compiled for each unique rhythmic behavior for each rabbit. Masseter muscle compartments were found to vary significantly in their PCA from the expected distribution of 100% common principal component (PC) assignment (i.e., similar activation pattern). This finding is consistent with the independent activation of masseter compartments.

Animals↗

Relationships among nocturnal jaw muscle activities, decreased esophageal pH, and sleep positions.

The purpose of this study was to examine the relationships among nocturnal jaw muscle activities, decreased esophageal pH, and sleep positions. Twelve adult volunteers, including 4 bruxism patients, participated in this study. Portable pH monitoring, electromyography of the temporal muscle, and audio-video recordings were conducted during the night in the subjects' homes. Rhythmic masticatory muscle activity (RMMA) episodes were observed most frequently, with single short-burst episodes the second most frequent. The frequencies of RMMA, single short-burst, and clenching episodes were significantly higher during decreased esophageal pH episodes than those during other times. Both the electromyography and the decreased esophageal pH episodes were most frequently observed in the supine position. These results suggest that most jaw muscle activities, ie, RMMA, single short-burst, and clenching episodes, occur in relation to gastroesophageal reflux mainly in the supine position.

Adult↗

A syndrome of progressive muscle spasm, alopecia, and diarrhea.

A syndrome of progressive muscle spasm, alopecia, and diarrhea was seen in 15 patients. The syndrome was characterized by painful intermittent muscle spasm, alopecia, amenorrhea, and malabsorption, and was sometimes associated with epiphyseal destruction and retarded growth. Symptoms began at age 10 and were more common in women than men. Muscle cramps affected the limbs first and then, several years after onset, the neck, trunk, and masticatory muscles. The course was progressive and led to malnutrition. Four patients died from 5 to 18 years after onset. Autopsy revealed polypoid changes throughout the gastrointestinal tract.

Adolescent↗

Measurement of muscle hardness using a hardness meter: application to the masseter and temporal muscles and reproducibility of measurement.

This study was designed to evaluate the intra-examiner and inter-examiner reliability of measurements of masticatory muscle hardness and to confirm that the muscle hardness increases with contraction using a commercially available muscle meter. Twenty healthy asymptomatic female subjects participated in this study. Hardness was expressed as numerical relative values (0-100). First, muscle hardness was measured at a standardized point located in the masseter muscle and temporal muscle in a randomized order by two examiners, and again by one of the same examiners after ten minutes for the reproducibility study. Then the muscle hardness was measured at each point for 0 kgf, 3 kgf, 6 kgf, and 9 kgf levels of bite force. As a result, intraclass correlation coefficient (ICC) analysis revealed good intra-examiner reliability in the masseter muscle (ICC = 0.711), good intra-examiner reliability in the temporal muscle (ICC = 0.643), good inter-examiner reliability in the masseter muscle (ICC = 0.631), and unacceptable inter-examiner reliability in the temporal muscle (ICC = 0.008). Also, our results showed that muscle hardness increased with contraction, and relationships with a slope of 1.229, a y-intercept of 62.513, and a correlation coefficient of 0.448 were observed in the masseter muscle. However, no correlation was found between muscle hardness and bite force in the temporal muscle. The findings indicate that measurement of hardness provides reliable physiological information about the masseter muscle in this setting.

Adolescent↗

Short term pain reduction with acupuncture treatment for chronic orofacial pain patients.

BACKGROUND: Acupuncture has been used for treatment of many pain conditions. National Institutes of Health (NIH), in its consensus statement on acupuncture of November of 1997, states that promising results have been shown for postoperative dental pain. NIH states that in other situations such as myofascial pain, acupuncture may be useful as an adjunct treatment or an acceptable alternative treatment. The vast majority of chronic orofacial pain conditions are temporomandibular disorders (TMD). Myofascial pain is one of the most common TMD's. TMD's are a set of musculoskeletal disorders affecting the temporomandibularjoint, masticatory muscles or both. TMD's are comprised of diverse diagnoses with similar signs and symptoms affecting the masticatory system that can be acute, recurrent or chronic conditions. TMD's are rarely life threatening, but can impact heavily on a person's quality of life. Few studies have been done on outcomes of acupuncture treatment for chronic orofacial pain. MATERIAL/METHODS: A chart review of 29 patients (twenty two females and seven males), age 22 to 60, who had acupuncture treatment for chronic orofacial pain was completed. Patients had rated their pain before and after acupuncture treatment on a numerical analog scale. RESULTS: The mean value of pain sores before treatment was 5.28 and after treatment was 2.26. There was a significant difference of pain scores between before treatment and after treatment (Wilcoxon signed rank test, P < 0.0001). CONCLUSIONS: Acupuncture provided a significant short-term pain reduction in patients with chronic Orofacial pain.

Acupuncture Analgesia↗

[A case of progressive myopathy with tubular aggregates].

Tubular aggregates (TA) are unusual intramuscular structures stained basophilic on hematoxilin and eosin (HE) staining and red on modified Gomori trichrome (GT) staining. The structures are said to be originated from sarcoplasmic reticulum and are collections of tubules with double membranes on electron microscopic studies. The TA are usually seen in biopsy muscles from patients with muscle pain and cramps but without muscle weakness, periodic paralysis or alcoholic myopathy. In addition, there are five reports on families with progressive myopathy and tubular aggregates in the literature. We presented here a 48-year-old postman without any family history, who had had progressive muscle weakness for 17 years. He had never noticed pain or cramps in his muscles, not taken any particular medicine, and not had regular alcoholic beverages. There was no ptosis, facial weakness, masticatory muscle weakness or dysphagia. Muscle wasting, started from the proximal part of four extremities had progressed to the distal part of them. He could not walk on heels or toes and walked with waddling gait. He stood up with Gowers' maneuver. Serum GOT, GPT and CK were elevated. EMG showed myogenic pattern and MCV was normal. The muscle biopsies were performed; the first one taken from quadriceps femoris muscle at 42 years old showed myopathic changes including marked variation in fiber sizes, with scattered necrotic fiber splitting and TA in type 2B fibers. The second biopsy from biceps brachii muscle at the age of 48 years, showed densely proliferated fibrous tissues, marked variation fiber sizes and scattered split fibers. The TA were rarely seen and type 2B fibers were decreased in number.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗

Relationship between mandibular position and the coordination of masseter muscle activity during sleep in humans.

Although bruxism has been regarded as having a possibly important role in the aetiology of craniomandibular disorders, the activity of masticatory muscles relative to mandibular position during sleep grinding as recorded by electromyography (EMG) has not yet been clarified. Surface EMGs of the bilateral superficial masseter muscles were recorded simultaneously with mandibular position during sleep from 12 volunteers for three consecutive nights. The incidence of two mandibular positions were recorded with magnetic sensors for both left- and right-sided mandibular grinding. One of the mandibular positions was the canine edge-to-edge position, and the other was the midpoint between the intercuspal position and the canine edge-to-edge position. The mode of the working/ balancing activity ratio ranged from 1/10 to 2/10, showing the marked predominance of balancing side masseter muscle activity during sleep grinding. During sleep grinding, EMG bursts of masseter muscle were observed mainly with mediotrusive mandibular movement from the canine edge-to-edge position. From the results of the present study, it is suggested that muscular dynamics during sleep are unique compared to that during voluntary clenching, and exert a greater mechanical load to the balancing side temporomandibular joint.

Adult↗

Masseter muscle activity during the whole day in children and young adults.

Changes in size and shape of the craniofacial skeleton during growth may be related to the masticatory muscle function in daily life. The purpose of this study was to measure the masseter muscle activity during the whole day in children and to investigate the differences between children and young adults. Fifteen children (7.8-13.0 years of age) and 30 young adults (20.3-34.7 years of age), who had acceptable occlusions without any remarkable skeletal discrepancy or temporomandibular disorder, were used as the subjects. In both children and young adults, most high-amplitude bursts of masseter muscle appeared mainly during mealtime, whereas a substantially larger number of low-amplitude ones were widely distributed throughout the whole day. The number and total duration of bursts of masseter muscle activity during the whole day was greater in children than in young adults, although significant differences were not found between the sexes. During daytime and sleep, both the number and total duration of bursts were greater in children. During mealtime, no significant differences in the number of bursts were found between children and young adults, however, the duration of bursts tended to be longer in children. It is concluded that the masseter muscle activity during the whole day is greater in children than in young adults.

Adolescent↗

A morphometric investigation of myotube formation in rabbit embryo medial pterygoid muscle.

To determine the times of the appearance of myoblasts, early myotubes, late myotubes, and myofibers, we studied a region between two aponeuroses of the medial pterygoid masticatory muscle in embryos of two strains of rabbits, without disturbing the normal innervation. The objectives of this study were to define the quantitative relations among these cells and to determine their kinetics statistically. We used Fauve de Bourgogne and New Zealand rabbit embryos on day 17, day 17 plus 12 hours, day 18, day 18 plus 12 hours, and days 20, 22, and 28 of gestation. Cell proliferation was studied with a light microscope, by means of counting methods. Similar development was observed in the two strains of rabbits. The numbers of myoblasts decreased as follows: (i) a marked decrease; (ii) a sudden cessation of the decrease, marked by a rebound at 18 days, and lasting less than 24 hours; and (iii) a plateau between embryonic days 22 and 28. The onset of reduction in the number of early myotubes coincided with the rebound of myoblasts. The number of late myotubes increased at the time of maximal early myotube density and during rebound of the myoblasts. Myofiber densities were similar to late myotube densities on day 22. We suggest that early myotubes are formed very gradually by fusion of myoblasts, and that the significant increase in the numbers of myoblasts corresponds to the second generation of myoblasts necessary for differentiation of late myotubes.

Analysis of Variance↗

Histomorphometric evaluation of short-term changes in masseter muscle after lengthening the rabbit mandible by distraction osteogenesis.

PURPOSE: Structural changes in muscles may affect the process during and after distraction osteogenesis (DO) of the mandible. However, the response of the masticatory muscles is still not well defined after gradual lengthening of the mandible. In this experimental study, short-term structural changes in masseter muscles of the rabbits are evaluated after mandibular DO. MATERIALS AND METHODS: Left mandibles of 10 New Zealand rabbits were lengthened by DO for 7 days in the rate of 1 mm/day. Mandibles of all animals were removed at the end of the consolidation period. Muscle biopsy samples of distracted and contralateral sides were histopathologically investigated, and histomorphometric results were statistically analyzed. RESULTS: Atrophy, hypertrophy, regeneration, and concomitant mild interstitial edema and fibrosis were found more evident in experimental side biopsy samples 30 days after distraction. Histomorphometric analysis revealed a statistically significant decrease in the mean regions of masseter muscle fibers of the distracted sides compared with the control sides (P <.05). CONCLUSION: This experimental study showed that the structure of masseter muscle is influenced during and shortly after mandibular distraction osteogenesis. Atrophic changes of the ipsilateral masseter muscles may be regarded as regenerative response that occurs during and shortly after distraction period.

Animals↗

Attrition: possible mechanisms of compensation.

Attrition, or wear of the occlusal surfaces of the teeth, may not only be physiologically normal, but necessary for function. Since occlusal wear must lead to reduction in tooth length, significant dimensional changes in facial morphology are inevitable unless mechanisms exist to compensate for attrition. Secondary dentine formation, alveolar growth, and adaptive changes in the masticatory muscles can provide this compensation, and may be part of a complex system by which an effective level of masticatory function is maintained even when attrition is extreme.

Adult↗

[Localization of C. ovis in experimentally infected lambs].

Studied were the distribution of Cysticercus ovis in cadavers of lambs experimentally infected with various amounts of Taenia ovis ova, the ratio between superficially localized cysticerci and those found deep in the individual groups of muscles and organs, and the ratio between alive and dead cysticerci. The tests were carried out with thirteen lambs treated as follows: 2 animals were infected with 1000 T. ovis ova each; 3 were infected with 4000 ova each; 4--with 7000 ova each; and 4--with 30 000 ova each. No strictly defined predilection for the localization of Cysticercus ovis was established in the body of the experimentally infected lambs. In compliance with the parasite burden in the individual organs and muscle groups per unit of mass these ranked in the following descending order: heart, diaphragm, fore and hind limbs, masticatory muscles, neck and back muscles, tongue, and abdominal and intercostal muscles. Experimentally, highest was the percent of viable cysticerci in the muscles of the fore and hind limbs and in the muscles of the neck.

Animals↗

The influence of the dentition on the shape of the mandible.

In the course of life the mandible undergoes substantial morphological and dimensional changes. The changes concerning mandibular angle, relation between the length of the mandibular corpus and ramus as well as roughness in the place of insertion of masseteric and pterygoid muscles do not depend upon age or sex but (apodictical) exclusively upon the dentition. In the complete dentition all masticatory muscles take part in chewing and grinding. The function of the temporal and masseter muscle is (reduced) weakened in partial or complete loss of teeth. The most evident morphological change of the lower jaw consists of an apparent elongation of its corpus resulting in a characteristic senile appearance. Measurements have been performed on 114 macerated mandibles of individuals ranging from 4 months to 68 years of age. The following measures have been taken: number of teeth in the lower jaw, angle between the corpus and ramus of mandible, length of the mandibular corpus, height of the mandibular ramus and angle of the mandibular incisure. The angle between the mandibular corpus and ramus is significantly lower in mandibles with 11 and more teeth (p < 0.001). The length of the mandible is significantly larger (p < 0.02) in mandibles with less than 11 teeth. The mandibular ramus is significantly higher in mandibles with more teeth (p < 0.01). There were no significant differences in the angle of the mandibular incisure within the groups (p > 0.05). The discriminant analysis reveals that 62.3% of the variability of mandibles is dependent upon the number of teeth. The rest of proportional variability of 37.7% is probably due to new circumstances and adjustment of the mandible in the period from tooth extraction.

Adolescent↗

Masseter muscle activity during the whole day in young adults.

This study was conducted to evaluate the biting function during the entire day in young adults by measuring the masseter muscle activity with a 24-hour electromyography (EMG) system. With this system, the masseter muscle activity for 24 hours was recorded in 20 male and 10 female young adult subjects with acceptable occlusion. For the male subjects, means of the number and total duration of bursts over level 2, which is one-fourth of the maximum discharge voltage during maximum clenching, were 1938 times and 357 seconds. For the female subjects, the values were 2356 times and 419 seconds. A large percentage of such high amplitude bursts as level 3 or 4 was observed during meals in both groups. These results indicated that most of the strong bursts of the masseter muscle appeared only during meals and a number of low amplitude bursts were observed during the entire day, although masseter muscle activity during the entire day in young adults was less than expected. It is anticipated that the nature of masticatory muscle activity revealed in this study might provide valuable information about the association between the biting function and the craniofacial structure or malocclusion.

Activity Cycles↗

A trigeminal neuralgia-like paroxysmal pain condition presumably due to buccal nerve compression in the temporalis muscle.

We encountered three patients with trigeminal neuralgia-like paroxysmal pain in the buccal nerve region. In all cases, paroxysmal pain was felt spreading to the receptive field of the ipsilateral buccal nerve, and clear tenderness was observed during intraoral palpation at the inner side of the mandibular ramus where the temporalis muscle runs and attaches. It was assumed that the paroxysmal pain might be caused by nerve compression related to temporalis muscle hyperactivity. To lend support to this hypothesis, we also studied the anatomical relationship between the buccal nerve and the masticatory muscles. In this autopsy study, the buccal nerve pierced the temporalis muscle in six (12%) of 52 specimens from 26 cadavers. These findings support the hypothesis that peripheral buccal nerve compression could be an etiology of paroxysmal neuropathic pain in the unilateral orofacial region.

Aged↗

[Anatomical study with MRI of a small muscle: the masseter].

Magnetic resonance imaging (MRI) provides functional information in an anatomic presentation allowing to distinguish soft tissues with high sensitivity. The goal of this study was to investigate the normal anatomy of the major masticatory muscle, the masseter, both at rest or during contraction by using three dimensional (3D) MRI. Eighteen subjects aged from 19 to 28 years, all in good health, were studied. Several experiments were first realized on phantoms to test the 3D-MRI technique. After reconstruction and segmentation processing, 3D acquisition, enabled obtaining data on the masseter anatomy. The normal anatomical position of the masseter was reported to the skin plan as the mean internal distance (7.9 +/- 0.42 mm) and external distance (15.2 +/- 0.41 mm). While there was no difference between internal distance, for sex or side, the external distance was significantly (p = 0.02) shorter in male (7.7 +/- 0.5 mm) than in female (8.8 +/- 0.4 mm) for both sides. The mean volume for all subjects and both sides (20.3 +/- 1.1 cm3) did not change significantly between rest and exercise. The masseter volume was significantly (p < 0.00001) greater in male (24.2 +/- 2.0 cm3) than in female (16.4 +/- 3.6 cm3) groups. These physiological references may be useful for further MRI investigations of masticatory system pathologies.

Adult↗

Botulinum toxin type A in the management of masseter muscle hypertrophy.

PURPOSE: We sought to evaluate the response of 6 patients with masseter muscle hypertrophy to botulinum toxin type A therapy. PATIENTS AND METHODS: Six patients with unilateral or bilateral masseter muscle hypertrophy received intramuscular injection of the botulinum toxin type A. The functional and cosmetic results were evaluated as well as recurrence. RESULTS: In all patients, satisfactory regression of the masseter muscle hypertrophy occurred and mild muscular pain was relieved. Recurrence was observed in 2 cases. CONCLUSIONS: The use of botulinum toxin type A in masseter muscle hypertrophy therapy was shown to be a successful and safe treatment method. This procedure to control parafunctional activities involving the masticatory muscles of patients appears to be useful.

Adolescent↗