Unilateral hypertrophy of masseter muscle.
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The hypothesis was tested that increasing the resting length of the masseter and temporalis muscles by a bite-opening appliance with or without detachment and re-attachment of the masseter would not affect the contractile properties of these muscles. Appliances opened the bite of 10 adult female monkeys 20 mm. Five received the appliance alone (Group A); five received the appliance and in addition the masseter was detached and re-attached (Group ADR). Comparisons were made 48 weeks later. Small bundles of fibres were excised from the masseter and temporalis muscles of experimental animals and from 8 control animals. Isometric and isotonic contractile properties were measured in vitro and fibre classification and fibre areas were determined histochemically. No significant differences were observed within either masseter or temporalis muscles between animals in Groups A and ADR. In both groups, the bundles of fibres from the masseter had prolonged contraction and relaxation times compared to control masseter muscles but no difference was observed in the percentage of Type II fibres. As detachment and re-attachment had no significant effect on morphological or physiological characteristics, other than those due to lengthening, this procedure may be useful in decreasing the passive tension induced when orthognathic surgery increases muscle length. The significant prolongation of the contractile response of the masseter is similar to the adaptation induced by long-term stimulation at low frequency.
The duration of the masseteric EMG silent period as induced by tapping on the chin was measured at different levels of sustained bite force. Under both open bite and normal occlusion, the duration of the silent period was inversely related to the magnitude of the bite force. For bite force of the same magnitude, the value of the silent period remained relatively constant for the same subject in different trials (SEM congruent to 1 per cent), whereas the absolute values of the silent periods ranged far and wide for different individuals even under similar experimental conditions.
Reflex responses to standardized solenoid chin taps were studied on 21 subjects with electromyographic (EMG) recordings from two jaw muscle antagonists, the masseter and the digastric. Taps were delivered downward and upward as parallel as possible to the masseter fibre direction and also backwards at right angles to these directions. Taps were delivered during isometric masseter and digastric activity as well as during relaxed postural position. Reflex excitation of the digastric muscle with a latency of 25-35 ms was recorded during all three situations after taps in all three directions. When this response was superimposed on ongoing digastric isometric activity after downward and upward taps, it was followed by a period of inhibition (mean duration 31 ms) and directly followed by a second EMG burst (mean latencies 73 and 75 ms, respectively). Responses were significantly (p less than 0.001) more often obtained during digastric background activity than during postural position and clench. Upward and downward taps were equally efficient in evoking the responses, significantly (p less than 0.001) more so than backward taps. The concurrent recordings of the masseter EMG imply the possibility of a reciprocal interplay between the two antagonists. The results accord with reports of the capability of the digastric muscle to produce reflex responses despite lack of anatomically-defined muscle spindles.
The pathway and synaptic basis for the efferent discharge in the digastric nerve evoked by stimulation of the orbital cortex were studied in cats anesthetized with alpha-chloralose. Transection of the brain stem at the boundary between the pons and the medulla oblongata abolished discharge. Intracellular recording from anterior digastric motoneurones revealed that the orbital cortical stimulation evoked excitatory post-synaptic potentials with a latency that was longer by one synaptic delay than that of spike potentials evoked in medial bulbar reticular neurones making a direct excitatory projection to anterior digastric motoneurones. It was concluded that the excitatory effects was mediated by the medial bulbar reticular formation.
The masseter inhibitory period (silent period) and sensations evoked by tooth-pulp stimulation were examined in 12 healthy subjects and 12 patients with oral-facial pain and mandibular dysfunction (MPD). Trains of 30 pulses were applied to an upper incisor and the threshold intensities for detecting sensation, for detecting pain sensation and for the masseter inhibitory period were determined. Masseter activity was monitored during tooth stimulation by electromyographic recordings from surface electrodes. Electrical tooth stimulation elicited three different configurations of masseter inhibitory periods in both groups: single, double and merged. MPD patients exhibited a greater proportion of single inhibitory periods. The combined average total durations of the three types of configurations were less in MPD. The findings are consistent with the hypothesis that there is an increase in excitability of the central masseter motorneuron pool in MPD, resulting in a reduction in the effective duration of the masseter inhibitory period. The higher incidence of single inhibitory periods in MPD patients also could result from this increased central excitatory state. There was no difference between masseter inhibitory periods evoked in either painful or non-painful muscles, and no particular configuration associated with pain sensation. The findings do not support the hypothesis that nociceptive input contributes to the increase in duration of the silent period in MPD. Although there were no significant differences between masseter inhibitory period threshold, detection thresholds or pain threshold for both groups, MPD patients had detection thresholds higher than their masseter inhibitory thresholds. These effects may be related to differential central neural influences on sensory-discriminative and reflex pathways in the trigeminal system.
The electromyographic activity of the right masseter and digastric muscles was recorded in 10 subjects. A jaw-opening reflex was observed shortly after a mechanical stimulation in subjects performing clenching and active jaw-opening exercises. The latency of this reflex activity was about 28 ms, coinciding with the termination of the silent period of the masseter muscle. The experiments show that this opening reflex can occur without masseter spindle-unloading and may respond to low-threshold afferents.
This relationship between the function of the muscles of mastication and craniofacial form was investigated in young adult monkeys by increasing the functional length of the elevator muscles of the mandible non-invasively by a bite-opening splint cemented to the maxillary dentition. The major adaptations to increased vertical dimensional were (1) marked superior and some anterior displacement of the maxillary complex, (2) dental intrusion and (3) rotation of the mandible. These alterations produced a shortening of the lengthened masseter muscle, i.e. a reduction in the amount of muscle stretch brought about by the appliance. Migration of the masseteric insertion along the ramus did not contribute significantly to the pattern of adaptation. The role of the masseter muscle in craniofacial adaptations to altered vertical dimension was determined by detaching and re-attaching the insertion of the masseter muscle in one group of experimental animals. The myotomized monkeys experienced significantly less anterior displacement of the maxilla than the non-myotomized monkeys, indicating that the surgery may have lessened some of the anteriorly-directed distracting forces of the lengthened masseter. Masseter myotomy alone was not sufficient to eliminate the vertically-directed distracting forces of the remainder of the mandibular elevator muscles brought about by increasing the vertical dimension of the lower face.
An excitatory-masseteric reflex response was evoked by electrical gingival stimulation in five subjects; the reflex had an onset latency of 7.6 ms with a SD of 0.7 ms. The response occurred just prior to the silent or inhibitory period. There was consistent post-inhibitory synchronization of the EMG activity record in all subjects. Several methods were used to demonstrate this short-latency reflex. The first was to average non-rectified EMG activity. The second was to increase the number of receptors which are simultaneously activated by using multiple electrodes so that a greater area of gingiva could be stimulated. A third was to increase the level of excitability of the motoneurons in the masseteric pool by increasing voluntary bite force. Fourthly, the excitatory reflex was evoked during increased-excitatory drive to the pool, with the additional feature that the reflex appeared at a time when no ongoing EMG activity was present in the masseter muscle. Little doubt should now remain concerning the existence of a short latency excitatory reflex from intra-oral receptors to masseteric motoneurons in man.