Effects of myogenous facial pain on muscle activity of head and neck

This study evaluated the effects of visual input on surface electromyography (sEMG) of some stomathognatic and neck muscles (anterior temporalis, masseter, anterior digastric and sternocleidomastoid muscles) in patients experiencing myogenous facial pain compared with healthy volunteers. All subjects kept the mandible at rest with teeth apart and underwent a 15-s sEMG recording of anterior temporalis, masseter, digastric and sternocleidomastoid muscles. Each recording was carried out with closed and then open eyes. The sEMG activity of each muscle was compared between the two groups. In the study group, anterior temporalis, masseter and sternocleidomastoid sEMG with closed eyes showed higher values compared with controls (p < 0.05). In the study group, left and right anterior temporalis (p < 0.003) and right digastric (p < 0.03) sEMG with open eyes showed higher values than sEMG with closed eyes. In the control group no significant differences were observed between closed and open eyes. In patients with myogenous facial pain, visual input appears to be associated with a significant increase in the sEMG activity of some head and neck muscles.     

Relation between cervical posture on lateral skull radiographs and electromyographic activity of masticatory muscles in caucasian adult women: a cross-sectional study

The aim of this study was to evaluate the association between cervical posture on lateral skull radiographs and surface electromyographic recordings (sEMG) of head and neck muscles. The sample comprised 40 Caucasian adult females, average age 26.8 (20-48); lateral skull radiographs were obtained in natural head position (mirror position). sEMG activity was bilaterally investigated for the following muscles: masseter, anterior temporalis, digastric, posterior cervical, sternocleidomastoid and upper and lower trapezius. All muscles were monitored at rest and during maximal voluntary clenching (MVC). A Pearson's correlation coefficient revealed significant correlations (P < 0.01) between cranio-cervical angulations and sEMG activity of masseter, digastric, lower trapezius, during MVC and anterior temporalis at rest. Significant correlations (P < 0.01) were also found between cervical lordosis angle and sEMG activity of masseter (during MVC) and lower trapezius (at rest). In view of transversal method, no conclusion was possible about the mechanism concerning these results. Future longitudinal studies should be directed to understand the extent of environmental and genotype influences by masticatory muscle activity on cervical posture.     

Comparison of electromyographic activity of jaw-closing muscles between mixing ability test and masticatory performance test

PurposeThe purpose of this study was to compare the muscle activity of jaw-closing muscles during chewing of a wax cube used for mixing ability test with that of peanuts used for masticatory performance test.MethodsTwenty subjects with complete dentitions (mean age 24.1 years) were directed to perform a mixing ability test and a masticatory performance test. Surface electromyograms (EMGs) were recorded from the masseter and temporalis muscles on right and left sides. Muscle work, maximal voltage and duration were measured on the integrated EMG signal in each muscle. In addition, muscle work was normalized with EMG activity during maximum voluntary clenching at centric occlusion. The mean of the 2nd to 5th cycle in each parameter was employed for statistical analysis.ResultsRepeated measures one-way multiple analysis of variance found a significant effect of chewing test on muscle work, normalized muscle work and maximal voltage (P < 0.002), but no significant effect on duration (P = 0.07). Muscle work, normalized muscle work and maximal voltage for the mixing ability test were significantly less than for the masticatory performance test in all muscles (paired t-test, P < 0.006).ConclusionThe results of this study suggest that muscle activity of jaw-closing muscles in the mixing ability test is less than that in the masticatory performance test using peanuts as test food.     

Effects of the antigravitary modification of the myotension of asset (MAGMA) therapy on myogenic cranio-cervical-mandibular dysfunction: a longitudinal surface electromyography analysis

This study was aimed at evaluating the effects of a novel physiotherapy machine called MAGMA (AntiGravitary Modification of the Myotensions of Asset) on postural and masticatory muscles of subjects with myogenic cranio-cervical-mandibular dysfunction (CMD), by using surface electromyography (sEMG). Fifteen subjects, nine males and six females (mean age 27.6 years), with CMD were included in the study. The bilaterally monitored muscles were: masseter, anterior and posterior temporalis, digastric, posterior cervical, sternocleidomastoid, and upper and lower trapezius. All muscles were monitored at rest, with a second record of maximal voluntary clenching (MVC) for both the masseter and anterior temporalis. Patients were subjected to MAGMA therapy for one session/week of 30 min over ten weeks. The surface EMG activity was recorded twice, at the baseline and at the end of the therapy. After MAGMA therapy, the sEMG activity at rest of the monitored muscles was significantly better when compared to the baseline; the only exception was the anterior and posterior temporalis muscles which did not improve. On the contrary, with the MVC, all the monitored muscles (masseter and anterior temporalis) significantly improved their sEMG activity. Although more investigations are needed, these results indicate that the use of such antigravitary therapy can provide a tool for resolving myogenic CMD.     

Effects of the Antigravitary Modification of the Myotension of Asset (MAGMA) Therapy on Myogenic Cranio-Cervical-Mandibular Dysfunction: A Longitudinal Surface Electromyography Analysis

This study was aimed at evaluating the effects of a novel physiotherapy machine called MAGMA (AntiGravitary Modification of the Myotensions of Asset) on postural and masticatory muscles of subjects with myogenic cranio-cervical-mandibular dysfunction (CMD), by using surface electromyography (sEMG). Fifteen subjects, nine males and six females (mean age 27.6 years), with CMD were included in the study. The bilaterally monitored muscles were: masseter, anterior and posterior temporalis, digastric, posterior cervical, sternocleidomastoid, and upper and lower trapezius. All muscles were monitored at rest, with a second record of maximal voluntary clenching (MVC) for both the masseter and anterior temporalis. Patients were subjected to MAGMA therapy for one session/week of 30 min over ten weeks. The surface EMG activity was recorded twice, at the baseline and at the end of the therapy. After MAGMA therapy, the sEMG activity at rest of the monitored muscles was significantly better when compared to the baseline; the only exception was the anterior and posterior temporalis muscles which did not improve. On the contrary, with the MVC, all the monitored muscles (masseter and anterior temporalis) significantly improved their sEMG activity. Although more investigations are needed, these results indicate that the use of such antigravitary therapy can provide a tool for resolving myogenic CMD.     

Effects of anterior cruciate ligament (ACL) injury on muscle activity of head, neck and trunk muscles: a cross-sectional evaluation

This study evaluated the that effects a pathology of the knee, due to an anterior cruciate ligament (ACL) injury, has on muscular activity of neck, head, and trunk muscles. Twenty-five (25) subjects (mean age 28+/-9 years) with ACL injury of the left knee were compared with a control no-pathology group. Surface electromyography (sEMG) at mandibular rest position and maximal voluntary clenching (MVC) wasused to evaluate muscular activity of the areas: masseter, anterior temporalis, posterior cervicals, sternocleidomastoid (SCM), and upper and lower trapezius. The sEMG activity of each muscle, as well as the asymmetry index between the right and the left sides, were compared between the two groups. Subjects in the study group showed a significant increase in the asymmetry index of the sEMG activity of the anterior temporalis at mandibular rest position (p<0.05). At rest, the areas of anterior temporalis and masseter in the control group showed a significantly lower sEMG activity compared with subjects in the study group, both in the right and the left sides (p<0.05). The same was found for the sEMG activity of the areas of SCM and lower trapezius. At MVC, the right areas of anterior temporalis and masseter in the study subjects showed a significantly lower sEMG activity compared with the control group. The same was observed for the lower trapezius area, both in the right and the left sides. In general, ACL injury appears to provide a change in the sEMG activity of head, neck and trunk muscles.     

Surface electromyographic evaluation of jaw muscles in children with unilateral crossbite and lateral shift in the early mixed dentition. Sexual dimorphism

Objectives: To examine the activity of jaw muscles at rest and during maximal voluntary clenching (MVC) in children with unilateral posterior crossbite (UPXB) and functional lateral shift in the early mixed dentition and to evaluate sex differences. Material and Methods: The sample included 30 children (15 males, 15 females) aged 6 to 10 years old, with UPXB and functional mandibular lateral shift (≥1.5 mm) in the early mixed dentition. sEMG activity coming from the muscle areas (anterior temporalis [AT], posterior temporalis [PT], masseter [MA] and suprahyoid [SH]) were obtained from both the crossbite (XB) and noncrossbite (NONXB) sides at mandibular rest position. sEMG acti-vity of the bilateral AT and MA muscles sides was obtained during MVC. Asymmetry and activity indexes were calculated for each muscle area at rest and during MVC; the MA/TA ratio during MVC was also determined. Results: At rest, no differences were found between sexes for any muscle areas or asymmetry and activity indexes. No differences were found between XB and NONXB sides. During MVC, however, significant sex differences were found in AT and MA activity, with higher sEMG values in males than in females, on both XB and NONXB sides. Asymmetry indexes, activity indexes and MA/AT ratios did not show significant differences between the sexes. Activity was symmetric both in males and in females. Conclusions: At rest, no sex differences were found, but during MVC males showed higher activity than did females in both XB and NONXB AT and MA muscle areas. Muscular activity was symmetrical at rest and during MVC in both sexes. Sexual dimorphism should be considered in the diagnosis and treatment of UPXB and lateral shift in the early mixed dentition. Key words:Unilateral crossbite, mandibular shift, jaw muscles, sEMG, early mixed dentition.     

An index for the evaluation of 3D masticatory cycles stability

ObjectivesTo introduce an index (Masticatory Stability Index, MSI) to analyze the stability of chewing cycles in standardized conditions and test it in a group of patients with subclinical mild temporomandibular disorder (TMD).Design23 subjects with mild subacute TMD and 21 healthy subjects were involved; they all responded to a questionnaire about signs and symptoms of TMD (ProTMDmulti) and underwent a myofunctional orofacial evaluation with scores, using the protocol of orofacial myofunctional evaluation with scores (OMES). Their mandibular kinematics was assessed with a 3D motion capture system during deliberate unilateral gum chewing. The MSI was computed synthesizing the information contained in nine kinematics parameters into a single global figure. Patients’ and controls’ MSI were compared considering the preferred and non-preferred chewing side using a 2-way ANOVA (factors: group, side).ResultsTogether with a lower total score of myofunctional orofacial status, the TMD group showed a reduced stability based on MSI (p < 0.05).ConclusionsThe MSI is an efficient method to measure the stability of the masticatory cycles. These preliminary results encourage validating the index on a larger sample. The variability in the motor behavior of chewing can impair the objectivity of its evaluations in several types of patients, including those with TMD. The MSI could be useful to complement clinical assessments, providing data for planning the rehabilitation of masticatory function in these patients.     

Interferential effect of the over-erupted third molar on chewing movement

ObjectiveTo clarify whether over-eruption of the mandibular third molar can disturb chewing movement.MethodsEighteen patients with a unilateral mandibular over-erupted third molar confirmed by both study cast observation and T-scan occlusal detection were selected from a sample of patients with complaints of temporomandibular disorder (TMD) symptoms. A unilateral gum-chewing trace was recorded separately for left and right side chewing by an electrognathography system. The average chewing pattern (ACP) was created based on segments from the recorded chewing trace to represent the chewing movement characteristics of each individual. Two factors, the TMD symptomatic side and the over-eruption side, were analysed for their effects on values of difference in the parameters (Δvalue) regarding the ACP between chewing with right and left side. Three-dimensional amplitudes of ACP and the cross point value of ACP with the vertical axis (termed the cross zero point value) which described the turning point of the chewing cycle from the balancing side to the working side, were compared between sides.ResultsThe over-eruption side had an effect on the Δvalue of the medial amplitude, the lateral amplitude, and the cross zero point (P < 0.05), but the symptomatic side didn’t (P > 0.05). When chewing on the over-eruption side, the medial amplitude was shorter, the lateral amplitude was larger, and the cross zero point value was smaller than those when chewing on the other side (P < 0.05).ConclusionThe present data indicate an effect of the over-erupted mandibular third molar on the chewing pattern while that from the symptom(s) is limited.     

Effects of therapy on masseter activity and chewing kinematics in patients with unilateral posterior crossbite

ObjectiveTo describe the effects of therapy on masseter activity and chewing kinematic in patients with unilateral posterior crossbite (UPC).DesignFifty children (age: mean ± SD: 9.1 ± 2.3 years) with UPC (34 on the right side, 16 on the left side) and twenty children (age: 9.5 ± 2.6 years) with normal occlusion were selected for the study. The mandibular motion and the muscular activity during chewing soft and hard boli were simultaneously recorded, before and after correction with function generating bite, after a mean treatment time of 7.3 ± 2.4 months plus the retention time of 5–6 months. The percentage of reverse cycles and the percent difference between ipsilateral and contralateral peaks of the masseter electromyography envelopes were computed.ResultsBefore therapy, the percentage of reverse cycles during chewing on the crossbite side was greater in patients than in controls (P < 0.001) and significantly reduced after therapy (P < 0.001) towards the reference normal value (soft bolus; pre: 57 ± 30%, post:12 ± 17%; hard bolus; pre: 65 ± 34%, post: 12 ± 13%; reference value: soft bolus 4 ± 2%, hard bolus 5 ± 3%). Before therapy the percent difference between electromyography envelope peaks in patients was lower than in controls (P < 0.01) and significantly increased after therapy (P < 0.05) becoming similar to the reference normal value.ConclusionsThe correction induced a normal-like coordination of masseter muscles activity together with a significant reduction of the reverse chewing patterns. The previous altered muscular activation corresponded to the altered kinematics of reverse chewing cycles that might be considered a useful indicator of the severity of the masticatory function involvement.     

Does the habitual mastication side impact jaw muscle activity?

ObjectiveTo compare electrical activity in the anterior temporal and masseter muscles on the habitual (HMS) and non-habitual mastication side (NHMS), during mastication and in the mandibular postural position. In addition, the increase in electrical activity during mastication was assessed for the HMS and NHMS, analysing both working (WSM) and non-working side during mastication (NWSM).MethodsA total of 28 healthy women (18–32 years) participated in the study. They were submitted to Kazazoglu’s test to identify the HMS. Bioresearch ‘Bio EMG’ software and bipolar surface electrodes were used in the exams. The exams were conducted in the postural position and during the unilateral mastication of raisins, on both the HMS and NHMS. The working and non-working side on HMS and NHMS were assessed separately. The obtained data were then statistically analysed with SPSS 20.0, using the Paired Samples Test at a significance level of 95%.ResultsThe differences in the average EMG values between HMS and NHMS were not statistically significant in the postural position (Temporal p = 0.2; Masseter p = 0.4) or during mastication (Temporal WSM p = 0.8; Temporal NWSM p = 0.8; Masseter WSM p = 0.6; Masseter NWSM p = 0.2). Differences in the increase in electrical activity between the masseter and temporal muscles occurred on the working side, on the HMS and NHMS (p = 0.0), but not on the non-working side: HMS (p = 0.9) and NHMS (p = 0.3). The increase in electrical activity was about 35% higher in the masseter than in the temporal muscle.ConclusionsMastication side preference does not significantly impact electrical activity of the anterior temporal and masseter muscles during mastication or in postural position.     

Relations between the results of complex clinical and neurophysiological examinations in patients with temporomandibular disorders symptoms

Objective: Reinvestigation of clinical importance of surface electromyography recordings (sEMG) from the masticatory, neck and shoulder girdle muscles in patients with various clinically detected temporomandibular disorders (TMDs).

Methods: Fifty women with myalgia diagnosis of Axis I DC/TMD and the same number of healthy female volunteers were studied clinically and neurophysiologically by means of sEMG.

Results: Unilateral more than bilateral complex symptoms of TMDs were related to the non-neurogenic masticatory rather than neck and shoulder girdle muscles dysfunctions at rest. A strong negative correlation between masticatory muscles activity at rest and during maximal contraction was found (r_s = ?0.778), mainly in the masseter muscle.

Conclusion: sEMG is a suitable tool for prosthodontists because it provides objective results on the stomatognathic system muscles function. Pain and other temporomandibular symptoms detected mostly unilaterally significantly increase muscle tension of the masticatory muscles and diminish muscle motor units recruitment during maximal contraction. Effects may spread to the neck and shoulder girdle muscles.     

Surface electromyographic patterns of masticatory, neck, and trunk muscles in temporomandibular joint dysfunction patients undergoing anterior repositioning splint therapy

The aim of this study was to investigate the surface electromyographic (sEMG) activity of neck, trunk, and masticatory muscles in subjects with temporomandibular joint (TMJ) internal derangement treated with anterior mandibular repositioning splints. sEMG activities of the muscles in 34 adult subjects (22 females and 12 males; mean age 30.4 years) with TMJ internal derangement were compared with a control group of 34 untreated adults (20 females and 14 males; mean age 31.8 years). sEMG activities of seven muscles (anterior and posterior temporalis, masseter, posterior cervicals, sternocleidomastoid, and upper and lower trapezius) were studied bilaterally, with the mandible in the rest position and during maximal voluntary clenching (MVC), at the beginning of therapy (T0) and after 10 weeks of treatment (T1). Paired and Student's t-tests were undertaken to determine differences between the T0 and T1 data and in sEMG activity between the study and control groups. At T0, paired masseter, sternocleidomastoid, and cervical muscles, in addition to the left anterior temporal and right lower trapezius, showed significantly greater sEMG activity (P = 0.0001; P = 0.0001; for left cervical, P = 0.03; for right cervical, P = 0.0001; P = 0.006 and P = 0.007 muscles, respectively) compared with the control group. This decreased over the remaining study period, such that after treatment, sEMG activity revealed no statistically significant difference when compared with the control group. During MVC at T0, paired masseter and anterior and posterior temporalis muscles showed significantly lower sEMG activity (P = 0.03; P = 0.005 and P = 0.04, respectively) compared with the control group. In contrast, at T1 sEMG activity significantly increased (P = 0.02; P = 0.004 and P = 0.04, respectively), but no difference was observed in relation to the control group. Splint therapy in subjects with internal disk derangement seems to affect sEMG activity of the masticatory, neck, and trunk muscles.     

Activity index and isometric contraction velocity of human jaw muscles

To determine the relative contribution of the masseter and anterior temporalis muscles to global isometric bite force, activity indices were constructed on the basis of the peak mean voltage (microV) and the integrated voltage (microV.s) of bipolar surface electromyograms obtained during brief maximum voluntary teeth clenching (MVC). The index that was based on integrated myoelectrical activity showed that the masseter muscle contributed the major part of the isometric MVC force. The index that was based on instantaneous peak myoelectrical activity also showed that activity in the masseter muscle predominated over that in the anterior temporalis muscle. In addition, the latter index showed a negative linear association with the initial (0-50% MVC) isometric contraction velocities of the masseter and anterior temporalis muscles. Both indices appear to be promising clinical diagnostic tools.     

Jaw-motor effects of experimental jaw-muscle pain and stress in patients with deep bite and matched control subjects

ObjectiveThe effect of experimental jaw-muscle pain and stress on masticatory muscle activity in TMD-patients has been discussed. Furthermore, associations between TMD and deep bite patients have been studied. Accordingly in the present study, comparison of EMG responses at rest, maximal clenching, during evoked pain and stress between deep bite patients and controls was investigated.DesignIn 30 deep bite patients and in 30 sex-/age-matched controls with neutral occlusion EMG activity was recorded bilaterally from masseter and anterior temporalis muscles before and during evoked pain and before and during a stress task. Evoked pain was induced by injections of glutamate into the masseter (local pain) and brachioradialis (remote pain) muscles and resting EMG activity was recorded before and after 1, 2, 3, 4, 5 and 10 min. A precision task was used to simulate a stressful condition and EMG activity was recorded twice during the task. Maximal EMG activity was recorded during maximal clenching.ResultsResting and maximal EMG activity were significantly different between groups and age with no gender differences. EMG activity during local pain and during the precision task were significantly different between groups, gender, age and time, whereas no time effect was found for the EMG activity during remote pain.ConclusionsPatients with deep bite have significantly different jaw motor responses to painful stimulation of the trigeminal region and manual precision tasks suggesting a differential integration of both somatosensory and behavioural stimuli.     

The influence of masticatory hypofunction on developing rat craniofacial structure

The purpose of this study was to use botulinum neurotoxin type A (BoNT/A) selectively to evaluate the influence of localized masticatory atrophy and paresis on craniofacial growth and development. 60 growing rats, 4 weeks old, weighing approximately 120 g, were randomly divided according as follows (Long-Evans, N = 15 per group): I (Mb + Tns); II (Mns + Tb); III (Mb + Tb); IV (Mns + Tns), where Mb or Tb is the BoNT/A-injected masseter or temporalis muscles (1.0 U/muscle, 2.5 ml) and Mns or Tns is the saline-injected muscles (2.5 ml). After 7 weeks, the mature rats were killed, the muscles dissected and mean muscle mass recorded. Anthropometric cranial, maxillary and mandibular measurements were taken from the dried skulls. Changes in animal weight during the growth period were not statistically significant. The mean masticatory muscle mass was smaller for the BoNT/A-injected muscles of Mb and Tb. Anthropometric measurements of bony structures inserted by masseter and temporalis muscles revealed a significant treatment effect. The measurements showed a facial morphology typical of a dolichofacial profile: short upper face accompanied by a long lower face with an extended mandibular length and ramus height and constricted bicoronoidal and bigonial widths. The results suggest that induction of localized masticatory muscle atrophy with BoNT/A alters craniofacial growth and development.     

Assessment of electromyographic activity in patients with temporomandibular disorders and natural mediotrusive occlusal contact during chewing and tooth grinding

Objectives: The aim of this study was to investigate whether the presence of a natural mediotrusive contact influences electromyographic (EMG) pattern activity in patients with temporomandibular disorders (TMDs).

Method: Bilateral surface EMG activity of the anterior temporalis (AT), masseter (MM), and sternocleidomastoid (SCM) muscles was recorded in 43 subjects during unilateral chewing and tooth grinding. Thirteen patients had TMD and a natural mediotrusive contact (Group 1), 15 had TMD without a natural mediotrusive contact (Group 2), and 15 were healthy subjects without mediotrusive contacts (Group 3). All subjects were examined according to the Research Diagnostic Criteria for TMD (RDC/TMD). All EMG values were standardized as the percentage of EMG activity recorded during maximum isometric contraction on cotton rolls.

Results: EMG activity from all muscles measured showed no significant differences between groups during chewing and grinding. Overall, in all groups, the EMG activity during chewing was higher in the working side than the non-working side in AT and MM muscles. During grinding, these differences were only found in masseter muscles (mainly in eccentric grinding). SCM EMG activity did not show significant differences during chewing and grinding tasks. Symmetry, muscular balance, and absence of lateral jaw displacement were common findings in all groups.

Discussion: EMG results suggest that the contribution of a natural mediotrusive occlusal contact to EMG patterns in TMD patients is minor. Therefore, the elimination of this occlusal feature for therapeutic purposes could be not indicated.     

Quantitative description of masseter muscle involvement in craniofacial microsomia

Masseter deficits are common in craniofacial microsomia (CFM), however studies on masseter muscle involvement are limited. The aim of this study was to describe the morphology and functional involvement of the masseter muscles quantitatively. Ninety-eight patients with CFM who underwent three-dimensional computed tomography and surface electromyography were included. The mean action potential during maximum voluntary contraction in the intercuspal position was recorded. Asymmetry of the compound muscle action potential (ACMAP) was calculated as an indicator of functional involvement. Differences between the affected and unaffected sides, the correlation between morphology and function, and the relationship between ACMAP and the OMENS-Plus classification were assessed by paired t-test, Pearson correlation analysis, and Spearman correlation analysis. The masseter muscle was absent on the affected side in 11 patients. In the remaining 87 patients, the mean volumes of the affected and unaffected masseters were 5.22 ± 2.47 cm³ and 9.62 ± 3.30 cm³, respectively, with mean action potentials of 41.40 ± 28.52 uV and 73.78 ± 45.90 uV, respectively. Both morphology and the function of the masseter showed moderate correlation with the OMENS ‘M’ classification. No significant correlation was found between ACMAP and the OMENS-Plus soft tissue grading. A masseter function classification is proposed: type I, ACMAP < 0.2; type II, ACMAP 0.20–0.34; type III, ACMAP 0.35–0.54; type IV, ACMAP ≥ 0.55. The masseter function classification may be a beneficial tool in patients with CFM.     

Asymmetric activation of temporalis, masseter, and sternocleidomastoid muscles in temporomandibular disorder patients

The aim of this study was to analyze the symmetry of the electromyographic (EMG) activity of the temporalis, masseter, and sternocleidomastoid (SCM) muscles in volunteers divided into a control group and a temporomandibular disorder (TMD) group. The surface EMG recordings were made during mandibular rest position, maximal intercuspal position, and during the chewing cycle. Normalized EMG waves of paired muscles were compared by computing a percentage overlapping coefficient (POC). The difference between the groups and between the static and dynamic clenching tests was analyzed through repeated measures, ANOVA. Symmetry of the temporalis, masseter, and SCM muscles activity was smaller in the TMD group compared to the control group. The mandibular postures were also significantly different among themselves. The asymmetric activation of jaw and neck muscles was interpreted as a compensatory strategy to achieve stability for the mandibular and cervical systems during masticatory function.     

Assessment of thickness and function of masticatory and cervical muscles in adults with and without temporomandibular disorders

Objective

The aim of this study was to evaluate the maximal bite force (MBF), electromyographic (EMG) activity and thickness of the masseter, anterior part of the temporalis and sternocleidomastoid (SCM) muscles in a group of young adults with and without temporomandibular disorders (TMDs).

Design

Nineteen individuals comprised the TMD group (6 males/13 females, aged 25.4 ± 3.8 years), classified based on the Research Diagnostic Criteria for TMD (RDC/TMD), and 19 comprised the control group (6 males/13 females, aged 24.1 ± 3.6 years). The MBF was determined with a transducer placed between the dental arches at the first molars level (N). The muscles were evaluated bilaterally at rest and during maximal voluntary clenching (MVC) by assessing EMG activity and performing ultrasonography (USG). The mean values of these measures for both sides of the mouth were used. The normality of the distributions was assessed by the Shapiro–Wilks test. Variables between groups and genders were compared using two-way factorial ANOVA test and correlated using the Spearman coefficient (α = 0.05). Unpaired t test was used to compare variables between TMD subgroups. Logistic regression analysis was used to identify the variables associated with the presence of TMD.

Results

MBF, EMG and USG data were similar among clinical groups and among TMD subgroups. The thickness of masseter and SCM muscles in the relaxed and clenching states were significantly higher in males than females. On the other hand, the EMG of the temporalis muscle in the rest state was significantly higher in females than males. Additionally, the MBF was positively correlated with the USG characteristics of masseter and SCM muscles, as well as with the EMG activity of masseter and temporalis muscles in the TMD group. In this group, there was also a positive correlation between the thickness of the masseter muscle and its activity. On the other hand, the thickness of the SCM muscle was negatively correlated with its activity. A lower MBF was independently associated with the presence of TMD.

Conclusions

Subjects with TMD exhibited similar values of MBF, thickness and electrical activity of masticatory and cervical muscles when compared with controls; positive correlations observed between these variables may suggest a muscular alteration in TMD patients and a co-activation of masticatory and cervical muscles during mandibular movement. This fact may also be confirmed by the negative association between bite forces and presence of TMD.