Occlusal control of mandibular elevator muscles

Occlusal stability and mandibular elevator muscle function was studied in 25 women (20–30 yr of age). They had 27–32 fully erupted teeth with few treated occlusal surfaces, and craniomandibular function including mandibular mobility was normal. The aim was to analyze the influence of natural patterns of occlusal contact on electromyographic activity, unaffected by pain and functional disorders. Occlusal stability was assessed in the intercuspal and in lateral contact positions as the number of teeth with physical contact and the number of opposing pairs of teeth in contact. Electromyographic activity was recorded by surface electrodes over anterior and posterior temporalis and masseter muscles. In general, positive correlations were found between occlusal stability in intercuspal position and moderate to strong static and dynamic contractions, most significant in masseter muscles, indicating that forceful contraction of these muscles implies stable occlusion. Systematically, the duration of activity during chewing was negatively correlated with occlusal stability in the intercuspal position, most pronounced in working-side muscles. This pointed to shorter contractions with stable occlusion and is interpreted as the result of less need for stabilizing activity. It is concluded, that the correlations between occlusal stability and elevator muscle function are probably based on feedback mechanisms from periodontal pressoreceptors.     

Mandibular elevator muscles: physiology, action, and effect of dental occlusion

In spite of differences in embryologic origin, central nervous organization, and muscle fiber distribution, the physiology and action of mandibular elevator muscles are comparable to those of skeletal muscles of the limbs, back, and shoulder. They also share the same age-, sex-, and activity-related variations of muscular strength. With respect to pathogenesis, the type of muscular performance associated with the development of fatigue, discomfort, and pain in mandibular elevators seems to be influenced by the dental occlusion. Clinical research comparing the extent of occlusal contact in patients and controls as well as epidemiologic studies have shown reduced occlusal support to be a risk factor in the development of craniomandibular disorders. In healthy subjects with full natural dentition, occlusal support in the intercuspal position generally amounts to 12–14 pairs of contacting teeth, with predominance of contact on first and second molars. The extent of occlusal contact clearly affects electric muscle activity, bite force, jaw movements, and masticatory efficiency. Neurophysiologic evidence of receptor activity and reflex interaction with the basic motor programs of craniomandibular muscles tends to indicate that the peripheral occlusal control of the elevator muscles is provided by feedback from periodontal pressoreceptors. With stable intercuspal support, especially from posterior teeth, elevator muscles are activated strongly during biting and chewing with a high degree of force and masticatory efficiency, and with relatively short contractions, allowing for pauses. These variables of muscle contraction seem, in general, to strengthen the muscles and prevent discomfort. Therefore, occlusal stability keeps the muscles fit, and enables the masticatory system to meet its functional demands.     

[牙合]垫对牙齿重度磨耗患者口颌功能影响的临床研究

目的：研究殆垫对牙齿重度磨耗患者口颌功能的影响。方法：用殆垫恢复10例牙齿重度磨耗患者的垂直距离,分别检测治疗前、治疗后1个月、3个月、6个月的咬合平衡性、咬肌及颞肌前束的肌电幅值、颌位及殆的稳定性以及边缘运动的平滑度及对称性的变化。结果：①咬合平衡性、颌位及胎的稳定性以及边缘运动轨迹的平滑度及对称性在治疗后呈逐渐改善趋势,治疗6个月后80％的患者恢复正常;②治疗后各组的息止位肌电幅值均较治疗前显著降低（P〈0．05）,正中颌位紧咬时肌电幅值在治疗后3个月组和6个月组较治疗前显著增加（P〈O．05）。结论：通过6个月的治疗和观察,聆垫对重度磨耗患者的口颌功能的影响呈现持续改善趋势。     

Effects of occlusal contact on the level of mandibular elevator muscle activity during maximal clenching in lateral positions

The aim of this study is to clarify the normal relationship between jaw elevator muscle activity and occlusal contact in lateral positions in order to assess the appropriate anterior guidance of lateral jaw movements for occlusal reconstruction and treatment. The EMG-activity of the right and left masseter, anterior temporal, and posterior temporal muscles of 9 healthy subjects with full, natural dentition was measured with bipolar surface electrodes during two different biting efforts, one involves bite registration by a silicone material containing carbonate powder (BRS) and another is maximal voluntary clenching (MVC), at the right and left canines' edge to edge positions and intercuspal position. The difference in muscle activity between MVC and BRS, which was regarded as the actual muscle activity necessary for MVC, was calculated as a representative value for each muscle activity. When working-side occlusal contact was restricted by the anterior teeth, including the canines, the total actual EMG activity of the 6 jaw muscles had a significantly strong correlation with the frontal angle of the lateral incisal path and the occlusal contact area at the lateral occlusion. This result suggested the possibility that canine guidance would control the muscle activity during lateral tooth clenching.     

A review of masticatory muscle function

Current reports of the actions of the major muscles of mastication are reviewed for clenching tasks in centric occlusion and eccentric jaw positions, mandibular opening, and unilateral chewing. The relationship of the mandible to the maxillae in the intercuspal position and, consequently, the relationship of the condyle to the fossa of the temporomandibular joint may be controlled by the clinician. Similarly, the number and site of tooth contacts in the intercuspal position and in eccentric jaw positions may be altered. These alterations all produce alteration of muscle activity during functional and parafunctional acts. Some of these alterations are now predictable. Nevertheless, much more study needs to be done before the outcomes of morphologic changes on the muscular system can be accurately predicted. Even now, however, clinicians must understand the nature of clenching and chewing muscle activity and how it can be altered to a more favorable situation for each individual. This review indicates that: The elevator muscles demonstrate maximum activity when even bilateral occlusal contacts occur during clenching in the intercuspal position. The elevator muscles are activated together in the intercuspal zone of tooth contact during chewing when the occlusal contacts are balanced bilaterally in this intercuspal position. Increasing the number of eccentric tooth contacts increases the muscle activity during both chewing and clenching. The medial pterygoid muscle is variable in its action. This variability appears to be related to the chewing pathway and the type of occlusion. Its action is enhanced during laterally directed chewing actions of the mandible. The inferior head of the lateral pterygoid muscle has a reciprocal role with the medial pterygoid muscle during chewing and contributes to forward and lateral bracing of the condyle of the mandible. Although the superior head of the lateral pterygoid muscle appears to be active during mandibular closing, the significance of this finding is not fully understood.     

Influence of group function and canine guidance on electromyographic activity of elevator muscles

A comparative EMG study was done between two types of occlusal guidances: group function and canine guidance. The purpose was to determine which of the two occlusal schemes causes a greater reduction in muscle activity and thereby a decrease in muscle tension in eccentric mandibular positions. Full-coverage occlusal splints were made for six test subjects with normal function of the stomatognathic system. Left- and right-side integrated EMG recordings were made of the masseter and temporal muscles during static (clenching) and dynamic (lateral excursion and clenching) maximal contractions. The results showed an EMG activity reduction of the elevator muscles with group function relative to their activity in centric occlusion. A more marked reduction was observed on the mediotrusive side, mainly in the temporal muscle. With canine guidance, the reduction in elevator muscle activity is much greater, more significant, and mainly in the temporal muscle of the mediotrusive side. The clinical implications of this study suggest the use of canine guidance in laterotrusion for therapy with full-coverage occlusal splints.     

An electromyographic and roentgen cephalometric study of occlusal morphofunctional disharmony in children.

In a sample of children with dual bite and symptoms in the masticatory system, the activity of the anterior temporal and masseter muscles was studied electromyographically during clench and light tapping in the posterior occlusal contact position and centric occlusion and in protrusive bite on the incisors. The findings indicated that the optimal muscle function during maximal clench and tapping with displayed in the posterior occlusal contact position, which in the present subjects was situated, on the average, 0.5 to 1 mm. anterior to the centric jaw relation. It should therefore be recommended that, in orthodontic treatment of children with dual bite, the intercuspal position (centric occlusion) should be established in the posterior occlusal relationship. This is in accordance with the opinion of several authors who have emphasized the use of the retruded contact position (the centric jaw relation) as key reference position in orthodontic treatment and occlusal rehabilitation. These authors have further emphasized the importance of stable occlusal contacts in centric relation, centric occlusion, and the various jaw excursions in obtaining and maintaining a harmonious function between the dentition, the temporomandibular joints, and the neuromuscular system.     

Clenching and Grinding: Effect on Masseter and Sternocleidomastoid Electromyographic Activity in Healthy Subjects

Abstract

This study compares the effect of clenching and grinding on masseter and sternocleidomastoid electromyographic (EMG) activity during different jaw posture tasks in the sagittal plane. The study included 34 healthy subjects with natural dentition, Class I bilateral molar Angle relationship, and absence of posterior occlusal contacts during mandibular protrusion. An inclusion criterion was that subjects had to be free of signs and symptoms of any dysfunction of the masticatory system. Bipolar surface electrodes were located on the right masseter and sternocleidomastoid muscles. EMG activity was recorded while the subjects were in standing position, during the following jaw posture tasks: A. maximal clenching in the intercuspal position; B. grinding from intercuspal position to edge-to-edge protrusive contact position; C. maximal clenching in the edge-to-edge protrusive contact position; D. grinding from edge-to-edge protrusive contact position to intercuspal position; E. grinding from retrusive contact position to intercuspal position. EMG activities in tasks B, C, D, and E were significantly lower than in task A in both muscles (mixed model with unstructured covariance matrix). EMG activity among tasks B, C, D, and E did not show significant differences in both muscles, except between tasks D and E in the masseter muscle. A higher effect was observed on the masseter than on the sternocleidomastoid muscle to avoid excessive muscular activity during clenching and grinding. The EMG patterns observed could be of clinical importance in the presence of parafunctional habits, i.e., clenching and/or grinding.     

The influence of altered working-side occlusal guidance on masticatory muscles and related jaw movement

The effect of four different occlusal situations (group function, canine guidance, working side occlusal interference, and hyperbalancing occlusal interference) on EMG activity in jaw elevator muscles and related mandibular movement was investigated on 12 subjects. With a computer-based system, EMG and displacement signals were collected simultaneously during specific functional (unilateral chewing) and parafunctional tasks (mandibular gliding movements and various tooth clenching efforts) and analyzed quantitatively. When a naturally acquired group function was temporarily and artificially changed into a dominant canine guidance, a significant general reduction of elevator muscle activity was observed when subjects exerted full isometric tooth-clenching efforts in a lateral mandibular position. The original muscular coordination pattern (relative contraction from muscle to muscle) remained unaltered during this test. With respect to unilateral chewing, no significant alterations in the activity or coordination of the muscles occurred when an artificial canine guidance was introduced. Introduction of a hyperbalancing occlusal contact caused significant alterations in muscle activity and coordination during maximal tooth clenching in a lateral mandibular position. A marked shift of temporal muscle EMG activity toward the side of the interference and unchanged bilateral activity of the two masseter muscles were observed. The results suggest that canine-protected occlusions do not significantly alter muscle activity during mastication but significantly reduce muscle activity during parafunctional clenching. They also suggest that non-working side contacts dramatically alter the distribution of muscle activity during parafunctional clenching, and that this redistribution may affect the nature of reaction forces at the temporomandibular joints.     

Contractile activity of the masseter muscle in experimental clenching and grinding of the teeth in man

Six human subjects exercised maximum voluntary tooth clenching and right-sided tooth grinding to determine the onset of fatigue in the right and left masseter muscle. Static and dynamic contractile activity of the two muscles was determined by surface electromyography. Muscle fatigue appeared after about 30s of isometric contractions (clenching), while 30s of combined concentric and eccentric contractions (grinding) induced no fatigue. In the right muscle the contractile activity of negative work (eccentric contractions of mandibular laterotrusion) was about 50% of that of positive work (concentric contractions of mandibular mediotrusion). During clenching an increased number of contacting teeth might have facilitated the contractile activity of the two muscles. During grinding the height of the cusps of the working side teeth might have contributed to a decrease of tension production by the right masseter muscle. Non-working side tooth contacts and peripheral receptors might have facilitated the contractile activity of the left masseter muscle during tooth grinding. Static contractile activity of the mandibular elevator muscles produced high levels of isometric tension and led to masseter muscle fatigue in about 30s. The same duration of dynamic contractile activity, resulting in low levels of tension during positive and negative work, did not induce fatigue.     

Response patterns of craniomandibular muscles with and without alterations in sensory feedback

1. Surface EMG recordings were made bilaterally from the anterior part of the temporal muscle, superficial masseter muscle, and the suprahyoid complex of muscles while tracking mandibular incisor movement in three planes. This was done in 20 normal subjects with 16 different responses. Some responses involved clenching whereas other responses occurred with actual mandibular movement. 2. Each muscle demonstrated a probability of recruitment dependent on the response that correlated with the intensity of recruitment. The higher the probability of recruitment, the greater the intensity of muscle activity. 3. The anterior temporal muscle demonstrated no statistically significant difference in any of the responses between the left and right muscles. The masseter muscle also demonstrated bilateral symmetry. 4. The anterior part of the temporal muscle was recruited in more than 60% of its trials (60% to 100%) in ipsilateral laterotrusion, retrusion, fast vertical raising, clenching on the ipsilateral or intercuspal position, and mastication. The temporal muscle was recruited in less than 60% of its trials in contralateral and incisor clenching, and less than 30% in contralateral laterotrusion, protrusion, and opening. 5. The superficial masseter muscle was recruited in more than 60% of its trials in protrusion, vertical raising, all clenches, and mastication. The masseter muscle was recruited less than 60% in retrusion, ipsilateral laterotrusion, and opening. 6. The suprahyoid group of muscles was recruited in more than 60% of its trials in protrusion, opening, and mastication. This group of muscles was recruited less than 60% of the time in clenching, lateral movements, and rapid vertical raising of the mandible. 7. Applying a maxillary splint to seven subjects significantly decreased the recruitment of the anterior temporal and masseter muscles during mastication. The splint also modified the use of the masseter muscle during protrusion so that it was less active, but increased its recruitment during contralateral clenching. The suprahyoid muscle group was unaffected by the maxillary splint. 8. These data support the concept that movement of the mandible from the intercuspal or rest position develops a coactivation pattern that will excite or inhibit a given muscle regardless of whether clenching with occlusal contacts or no occlusal contact is involved. 9. The data also demonstrate that the maxillary splint can alter the use of the jaw elevator muscles, predominantly in mastication.     

Stable tooth contacts in intercuspal occlusion makes for utilities of the jaw elevators during maximal voluntary clenching

Data are inconsistent concerning whether the level of the surface electromyographic (SEMG) activity of jaw‐closing muscles increases when biting forces elevated during maximal voluntary clenching (MVC). In this study, T‐Scan III system and BioEMG III system were used to record bite force, occlusal contacts and SEMG activity of the anterior temporalis (TA) and of the masseter muscles (MM) simultaneously. Recordings were obtained from 16 healthy young adult males during different conditions: (i) a fast MVC from resting position to intercuspal position (ICP); (ii) mandibular movements from ICP to protrusive or lateral edge‐to‐edge positions with teeth in contact with biting; (iii) a fast MVC in protrusive and lateral edge‐to‐edge positions. A higher level of SEMG activity was associated with a higher bite force during occluding movements (P < 0·05). However, during fast MVC from rest to ICP, the largest number of occlusal contacts was achieved and distributed more symmetrically, the highest level of biting force was obtained, but the SEMG activity of the jaw elevator muscles was reduced compared with its maximum level (P < 0·05). This phenomenon was not observed during the fast MVC in protrusive or lateral edge‐to‐edge positions. The present results that a lower SEMG activity was associated with the largest number of occlusal contacts and the highest level of bite force during centric MVC demonstrated a complex integration of jaw‐closing muscles when a stable occlusion is present.     

Masseter and temporalis surface electromyography in patients wearing complete dentures comparing anterior and posterior occlusal concepts — A pilot study

The activity of jaw elevator muscles (masseter and anterior temporal muscle) was studied by surface electromyography in 17 patients wearing complete dentures with anterior-canine guidance.
Baseline electromyography was recorded with the dentures and compared to recordings obtained with two different splints adapted to the upper denture, one providing anterior guidance leading to immediate disclusion of the posterior teeth during any jaw movement, the other providing posterior guidance buccally on the working side and lingually on the non-working side (bilaterally balanced occlusion).
Recordings were obtained during a sequence of different jaw movements: postural position, maximal tooth contact in intercuspal position, protrusive movement of the mandible (under tooth contact) and during lateral excursions, also carried out under tooth contact.
Muscle activity was not significantly different as recorded with dentures only versus with the splints providing anterior guidance. However, a significant increase in activity was observed with bilaterally balanced occlusion.
The results of this study in edentulous people are similar to those found in patients with natural teeth.     

Influence of Different Centric Functions on Electromyographic Activity of Elevator Muscles

This study compares eight different occlusal centric functions with splint contact on different teeth in order to determine their influence on mandibular elevator electromyographic (EMG) activity.

Maxillary occlusal splints were built for eight subjects without craniomandibular dysfunction. Investigators divided each splint into three parts, in order to record different occlusal schemes in the same subject without varying the vertical dimension. EMG activity in the left masseter and anterior temporal muscles was registered during maximum voluntary clenching.

Results showed higher masseter activity with the splint than without, and anterior temporal activity was similar. There was a significant decrease of EMG activity with the anterior section of the splint. There were no significant differences between the remaining centric functions and clenching with the complete splint, except for the centric function with contralateral posterior contact, in which elevator activity was significantly reduced.

Results suggest that bilateral posterior occlusal stabilization is critical for maximum interocclusal force.     

A possible biomechanical role of occlusal cusp–fossa contact relationships

Summary Biomechanical features of occlusal contacts are important in understanding the role of the occlusion contributing to masticatory function. Cusp–fossa contact is the typical pattern of occlusion between upper and lower teeth. This includes static relations, such as that during clenching, and dynamic relations when mandibular teeth contact in function along the maxillary occlusal pathways, as during mastication. During clenching in the maximum intercuspal position (ICP), cuspal inclines may take the role of distributing the occlusal forces in multi‐directions thus preventing excessive point pressures on the individual tooth involved. During chewing movement on the functional side, the mandible moves slightly from buccal through the maximum ICP to the contralateral side. The part of the chewing cycle where occlusal contacts occur and the pathways taken by the mandible with teeth in occlusal contacts are determined by the morphology of the teeth. The degree of contact is associated with the activity of the jaw muscles. To obtain repeatable static and dynamic occlusal contact information provided by the morphology of the teeth, maximum voluntary clenching and chewing movements with maximum range are needed. In conclusion, in addition to the standard occlusal concepts of centric relation/centric occlusion and group function/cuspid protection relation, biomechanics in static and dynamic cusp–fossa relationships should be included to develop an understanding of occlusal harmony which includes no interfering or deflective contacts in functional occlusal contact.     

Dental stability and maximal masticatory muscle activity

The electromyographical (EMG) activity of masticatory muscles during full clenching in the retruded contact position (RCP) and intercuspal position (IP) with and without a posterior stabilizing splint was studied. The linear envelope EMG signal from three bilateral muscles was recorded (masseter, anterior temporal and posterior temporal). Thirty-seven subjects were evaluated. Clenching in the RCP without the splint and with the presence of an unstable occlusal contact inhibited the masseter muscle activity and reduced anterior temporal and posterior temporal muscle activity. The masticatory muscle activity returned to normal when clenching in the RCP with a splint that permitted stability in the dentition. EMG activity was the same in the IP with and without the splint. The results indicate that the determinant of maximal masseter isometric muscle contraction is the amount of stability in the dentition rather than the jaw position. If the dentition takes the major role of stabilizing the mandible, i.e., there is good intercuspation, the masseter muscle can exert maximal isometric contraction. If the stability is not provided by the dentition, i.e., there is a premature contact, the jaw muscles must contribute to the stabilization and reduce the magnitude of the maximal contraction to avoid damage to the structures involved in the compensatory stabilization.     

Temporalis and masseter muscle activity in patients with anterior open bite and craniomandibular disorders

Activity in temporalis and masseter muscles, and traits of facial morphology and occlusal stability were studied in 22 patients (19 women, 3 men; 15-45 yr of age) with anterior open bite and symptoms and signs of craniomandibular disorders. Facial morphology was assessed by profile radiographs, occlusal stability by tooth contacts, and craniomandibular function by clinical and radiological examination. Electromyographic activity was recorded by surface electrodes after primary treatment with a reflex-releasing, stabilizing splint. Maximal voluntary contraction was reduced compared to reference values, particularly in subjects with muscular affection, but maximal activity increased significantly when biting on the splint. Maximal voluntary contraction was positively correlated to molar contact and negatively to anterior face height, mandibular inclination, vertical jaw relation and gonial angle. Relative loading of the muscles was markedly increased during resting posture. It was concluded that reduced occlusal stability and long-face morphology were associated with weak elevator muscle activity with disposition overload and tenderness. The results also indicated that increase of occlusal stability might lead to increased muscle strength and possibly reduce risk of physical strain.     

Asymmetry of masticatory muscle activity during the closing phase of mastication

The purpose of this study was to investigate the asymmetry of masticatory muscle activity between working and nonworking sides in the closing phase during mastication. Fifty adult subjects displaying normal oral function and occlusion participated in this study. Electromyographic (EMG) activity of the anterior temporalis and the superficial masseter muscle were recorded during mastication, simultaneously with motion data of the mandible. EMG activities of elevator muscles and their Asymmetry Index (AI) were analyzed depending on the vertical deviation of the lower incisal point with a two mm gap from the intercuspal position (ICP). EMG activities of both the anterior temporalis and the masseter on the working side were significantly greater than those on the nonworking side. Masseter muscles tended to show greater AI than the anterior temporalis muscles. Thus, asymmetry of the elevator muscles during mastication was a common finding in normal subjects. The normal range of variability of EMG activity and AI was confirmed in each section.     

Asymmetry of Masticatory Muscle Activity During the Closing Phase of Mastication

The purpose of this study was to investigate the asymmetry of masticatory muscle activity between working and nonworking sides in the closing phase during mastication. Fifty adult subjects displaying normal oral function and occlusion participated in this study. Electromyographic (EMG) activity of the anterior temporalis and the superficial masseter muscle were recorded during mastication, simultaneously with motion data of the mandible. EMG activities of elevator muscles and their Asymmetry Index (AI) were analyzed depending on the vertical deviation of the lower incisal point with a two mm gap from the intercuspal position (ICP). EMG activities of both the anterior temporalis and the masseter on the working side were significantly greater than those on the nonworking side. Masseter muscles tended to show greater AI than the anterior temporalis muscles. Thus, asymmetry of the elevator muscles during mastication was a common finding in normal subjects. The normal range of variability of EMG activity and AI was confirmed in each section.     

Electromyography of masticatory muscles in three jaw registration positions

The purpose of this study was to investigate whether anteroposterior changes in mandibular position affect masticatory muscle activity. The electromyographic (EMG) activity of masticatory muscles during full and partial (10%) clenching in three mandibular bite registration positions--retruded contact position (RCP), intercuspal position (IP), and muscular position (MP)--was studied. Three groups of subjects with different ranges of anteroposterior positioning of the condyles were evaluated (normal occlusion, Class II, Division 2 malocclusion, and dual bite malocclusion). A posterior stabilizing splint for each registration position was made. EMG data were obtained from three bilateral muscles (masseter, anterior temporal, and posterior temporal). Clenching in the RCP elicited the lowest masseter muscle activity during full clenching, and the highest anterior temporal and posterior temporal muscle activity during partial clenching. If the relationships of the masticatory muscles are analyzed through a ratio that represents the interaction between biting and positioning muscles (masseter/posterior temporal muscle ratio), the RCP as compared with other positions had the lowest ratio. The RCP required more positioning muscle activity and permitted less biting muscle activity. There was no significant difference in the muscle activity between the IP and MP registrations. Small changes in jaw position (anterior to RCP) are not critical for the masticatory apparatus provided there is good intercuspation. The results of this investigation suggest that intercuspation in RCP is not the optimal position.