Bite force, endurance and masseter muscle fatigue in healthy edentulous subjects and those with TMD

It is well known that bite force and EMG activity are considerably reduced in edentulous patients, but the susceptibility of their jaw-closing muscles to localized fatigue is less certain. This information is even less clear for edentulous subjects who have TMD. Eleven healthy edentulous subjects and 10 edentulous subjects with TMD participated in this study. Maximum bite force was measured first, with the transducer placed on the canine-first premolar region bilaterally, and then two rapid relaxations were made from a brief voluntary clench to 50% of maximum. A sustained voluntary clench of 50% of maximum was then maintained and endurance time was noted. EMG was recorded from both masseter muscles and the median frequency of the power spectrum of the EMG from 2 s at the beginning of the sustained clench and 2 s at the end was subsequently calculated. Two more rapid relaxations from brief clenches were performed immediately after the sustained clench. The mean maximum bite force in the healthy group was 115 N (SD +/-41) and in the TMD group was 75 N (SD +/-22), this difference being significant (P = 0.0013). The mean endurance time in the healthy group was 86 s (SD +/-51) and in the TMD group was 63 s (SD +/-20). The percentage change in the median frequency in the healthy group as a result of the sustained contraction was 6% (left) and 8.6% (right) and in the TMD group was 13.9% (left) and 12.8% (right). The percentage change in the mean relaxation half time for the healthy group was 28.5% and for the TMD group was 72%, a significant difference (P = 0.0046). It was apparent that the maximum bite force was low in edentulous subjects and was further reduced in edentulous TMD subjects; endurance time was reduced in TMD subjects; fatigue resistance of the masseter muscles was reduced in TMD subjects.