Algorithm for analyzing the movement pattern of the temporomandibular joint musculararticular system based on multichannel electromyogram processing

Musculoskeletal system disorders is one of the priority directions in dentistry. They can manifest as Kosten's syndrome, snapping jaw, painful dysfunction syndrome, increased tooth abrasion, splits, breaks, pain and spasms in muscles, etc. The study set the following objectives: to develop an algorithm for analyzing the movement pattern of the muscular-articular system by developing an algorithm for recording, analyzing, filtering and processing multichannel electromyograms of the maxillofacial muscles. Analysis of the proposed algorithm for processing multichannel electromyograms showed that 7.2 % of multichannel electromyograms could not be analyzed due to patients' violations of the movement algorithm; 8.7 % of electromyogram checkpoint values were corrected. The group without dysfunctions of the temporomandibular joint is characterized by the prevalence of the relaxation coefficient of the left temporal muscle over the coefficient of the right muscle. The dysfunctioned group has the opposite result. The value of the compression ratio of the temporal muscles exceeding 2.5 is typical for the group with dysfunctions of the temporomandibular joint. The studied groups differ as much as possible when analyzing the relaxation coefficients of the temporal muscles. When analyzing this coefficient, it was possible to truly determine the presence or absence of violations in 50 %, falsely – in 16 % of cases. The coefficient of relaxation of the masticatory muscles made it possible to obtain a true state of 24 %, a false one – in 8 %. We concluded that the compression ratio is less suitable for separating patients with and without dysfunction of the temporomandibular joint.

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Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction

Pacific Medical Journal ◽

10.34215/1609-1175-2021-4-98-100 ◽

2022 ◽

pp. 98-100

Author(s):

A. A. Sultanov ◽

Y. Y. Pervov ◽

A. K. Yatsenko ◽

M. A. Sultanova ◽

D. O. Drozdova

Keyword(s):

Physical Examination ◽

Temporomandibular Joint ◽

Orthodontic Treatment ◽

Clinical Case ◽

Mouth Opening ◽

Integrated Approach ◽

Masticatory Muscles ◽

Temporomandibular Joint Dysfunction ◽

The Right ◽

Masseter Muscles

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.

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Wind Instrumentalists and Temporomandibular Disorder: From Diagnosis to Treatment

Dentistry Journal ◽

10.3390/dj6030041 ◽

2018 ◽

Vol 6 (3) ◽

pp. 41 ◽

Cited By ~ 5

Author(s):

Miguel Clemente ◽

Joaquim Mendes ◽

André Moreira ◽

Ricardo Vardasca ◽

Afonso Ferreira ◽

...

Keyword(s):

Performing Arts ◽

Temporomandibular Disorder ◽

Infrared Camera ◽

Masticatory Muscles ◽

Cervical Region ◽

Performing Arts Medicine ◽

Temporal Muscle ◽

Piezoresistive Sensors ◽

Professional Musician ◽

The Right

Introduction: Temporomandibular disorders (TMD) involve the presence of pain or dysfunction on certain areas of the Cranio-Cervico-Mandibular Complex (CCMC), such as the masticatory muscles, the temporomandibular joint (TMJ) and associated structures like the postural muscles of the cervical region, can be considered as a sub-group of musculoskeletal disorders. Wind instrument players, as a consequence of their musical performance and its relation with the CCMC, can develop a TMD associated to muscle hyperactivity of certain elevator muscles, or even an increase of the intra-articular pressure in the functioning of the TMJ throughout musical activity. Aim: The objective of this paper is to describe the necessary and elementary steps in the diagnoses and treatment of a wind instrumentalist with a temporomandibular disorder, with the introduction of infrared thermography during this procedure. This case study also has the purpose of presenting the usefulness of piezoresistive sensors in the analysis of the clarinettists’ embouchure. Methodology: A Caucasian, 30-year-old female clarinettist was assessed through a clinical examination following the Diagnostic Criteria for TMD (RDC/TMD), as a complementary tool of diagnosis, a thermal imaging infrared camera, Flir E60 (Wilsonville, OR, USA), was used in order to analyse the above referred articular and muscular regions. The complementary examination protocol implemented with this clarinet player also involved the analyses of the embouchure with the support of piezoresistive sensors. Results: The clinical outcomes resulting from this work were based on the RDC/TMD diagnoses indicated that the clarinet player had an internal derangement on both TMJ, with an osteoarthritis on the left TMJ and an anterior disc displacement with reduction on the right TMJ. The infrared thermograms that were analysed, verified the existence of a temperature differential of the anterior temporal muscle (0.1 °C), the TMJ (0.1 °C) and the masseter muscle (0.7 °C), and after the occlusal splint therapy the asymmetry related to the master muscle reduced to 0.3 °C. The high pitches can reach values of 379 g of force induced to the tooth 21 comparing to the 88 g of force applied on tooth 11. The embouchure force measurements consistently presented greater forces during the higher notes, followed by the medium notes and finally the low notes and this happened with higher pressures being transmitted always to tooth 21. Conclusion: Performing arts medicine should understand the major importance of the dentistry field in the daily life of a professional musician, and the significance of implementing routine screening procedures of dental examinations, with infrared thermograms examination of distinct areas of the CCMC, as well as the use of sensors on the analyses of an eventual asymmetrical embouchure. Employing these techniques in dentistry will create the chance of preventing the overuse of some anatomical structures, with an early diagnosis and the correct monitoring of these areas.

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Standardized mastication increases the coordination in masticatory activity in women with chronic temporomandibular joint disorders: a case control study.

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2019.17.731 ◽

2020 ◽

pp. 1-7

Author(s):

Carlos Eduardo Fassicollo ◽

Maylli Daiani Graciosa ◽

Daiane Lazzeri de Medeiros ◽

Licerry Palma Soares ◽

Luis Mochizuki ◽

...

Keyword(s):

Temporomandibular Joint ◽

Motor Pattern ◽

Movement Pattern ◽

Masticatory Muscles ◽

Temporomandibular Joint Disorders ◽

Electromyographic Activity ◽

Emg Signal ◽

Joint Disorder ◽

Agonist And Antagonist ◽

And Control

Background: The effects of jaw movement pattern on masticatory activity during chewing remains unclear in chronic temporomandibular joint disorders individuals. Objective: to assess the effect of habitual and non-habitual mastication patterns based upon the activation of the masseter and temporalis muscles in individuals with or without temporomandibular joint disorder (TMJD). Methods: Fifty-four participants (age: 18–44 years) were divided into two groups: the TMJD (n=27) and control (n=27) groups. TMJD was identified using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Electromyographic activity of the masticatory muscles was measured during 2 tasks: habitual mastication with parafilm (HM) and non-habitual mastication with parafilm (NHM). MATLAB software was used to process electromyography (EMG) signals. The root mean square, symmetry index (SI%), anteroposterior coefficient (APC%) and torque coefficient (TC%) were determined from the processed EMG signal. Results: Reduced right masseter activation was observed for the TMJD group (p<0.05) during jaw agonist phase. During the jaw agonist phase, all muscles presented with more activation during NHM. Symmetry of temporalis (ST%) and APC% were the lowest for HM. TC% was increased for HM. Conclusion: Habitual and non-habitual mastication differ in masticatory activity during jaw agonist and antagonist phase and TMJD individuals presented a different way to recruit muscles under these circumstances. Non-habitual mastication has a more coordinating and stable motor pattern in masticatory activity and has less variability than habitual mastication to assess masticatory activity.

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Biofotogrametric and electromyographic analysis in different position in women with temporomandibular disorder.

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2016.14.317 ◽

2020 ◽

pp. 1-7

Author(s):

Muriel Priebe e Silva ◽

Jovana de Moura Milanesi ◽

Fernanda Pasinato ◽

Helenize Veron ◽

Ana Gabrieli Ferreira Antunes ◽

...

Keyword(s):

Electrical Activity ◽

Masticatory Muscles ◽

The Body ◽

Sitting Position ◽

Temporal Muscle ◽

Horizontal Alignment ◽

Cervical Muscles ◽

Upper Trapezius ◽

Seventh Cervical Vertebra ◽

The Right

Introduction: The relationship established between TMJ (Temporomandibular Joint), cranium and cervical spine requires the synchrony of these structures for the proper performance of stomatognathic functions and muscle balance in this region. Objective: Evaluate the craniocervical posture and the electrical activity of masticatory and cervical muscles in sitting and standing positions in patients with TMD, correlating these variables. Method: The participants were 21 women, with mean age 28 ± 5.33 years and severe TMD. The participants were evaluated by electromyography of the masseter, anterior temporal and sternocleidomastoid (SCM) and upper trapezius muscles, bilaterally, in standing and sitting position. The body posture was evaluated by biophotogrammetry, with analysis of the Head Horizontal Alignment (HHA) and Acromion Horizontal Alignment (AHA) in frontal view and the Head Vertical Alignment (HVA) and Head Horizontal Alignment related to seventh cervical vertebra (HHAc7) in lateral view. Results: The electrical activity of masticatory muscles during resting did not differ between the different evaluated positions. During maximum intercuspation, the electrical activity was significantly lower in the left masseter (p=0.016), higher in the left anterior temporal muscle (p=0.046) and higher in the right (p=0.005) and left (p=0.015) upper trapezius muscles, in standing position when compared to sitting position. The photogrammetric values found were within the normal range. There was a significant and moderate negative correlation between the left SCM muscle and the right (r=0.386) and left (r=0.428) HHAc7 angle. Conclusions: Muscular electrical activity was modified with the change between sitting and standing positions, with an increase in cervical muscle recruitment and asynchrony of the masticatory muscles. Thus, it can be inferred that there is a postural destabilization with possible head anteriorization during maximum intercuspation, reinforcing the relation of synergy between the masticatory and cervical muscles.

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Cervical spine range of motion, posture and electromyographic activity of masticatory muscles in temporomandibular disorders

Fisioterapia em Movimento ◽

10.1590/1980-5918.033.ao25 ◽

2020 ◽

Vol 33 ◽

Author(s):

Franciele Aparecida Amaral ◽

Simone Mader Dall’Agnol ◽

Gabriela Socolovski ◽

Camila Kich ◽

Gilson Cesar Nobre Franco ◽

...

Keyword(s):

Cervical Spine ◽

Temporomandibular Joint ◽

Work Ability ◽

Temporomandibular Disorders ◽

Masticatory Muscles ◽

Temporomandibular Joint Disorders ◽

Pain Level ◽

Jaw Function ◽

The Right ◽

Cervical Rotation

Abstract Introduction: Temporomandibular joint disorders (TMD or TMJD) involve clinical problems and symptoms affecting the temporomandibular joint (TMJ) and associated structures. The temporomandibular joints are anatomically connected to the cervical region, where cervical spine movements occur simultaneously to masticatory muscle activation and jaw movements. Objective: Our study sought to assess the relationship between the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), surface electromyography (sEMG) of the masticatory muscles, posture and cervical flexibility in women with TMD. Method: Fifty women with an average age of 27.0 ± 6.37 years, diagnosed with TMD according to RDC/TMD, were assessed for craniocervical posture, cervical flexibility and sEMG of the masticatory muscles. Results: There were no differences in jaw function limitations, depression, pain level and its interference in work ability and daily activities, posture and sEMG between TMD diagnoses or between muscle classification (p > 0.05). Depression scores were higher among participants with biarticular dysfunction (p = 0.023). The group with bruxism exhibited a higher pain level at assessment (p = 0.001) and a greater reduction in work ability (p = 0.039). Subjects with muscular and mixed TMD showed less cervical rotation to the right when compared with those with articular TMD. Conclusion: There was no difference in posture or sEMG values for TMD diagnoses, joint and muscle dysfunctions and the presence of bruxism. Muscle dysfunction is associated with reduced cervical rotation to the right. Jaw function limitations did not interfere in posture or sEMG and depression was associated with pain.

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Non-invasive approach in the treatment of temporomandibular joint osteoarthritis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200611079m ◽

2020 ◽

pp. 79-79

Author(s):

Andjela Milojevic-Samanovic ◽

Dejan Zdravkovic ◽

Stefan Velickovic ◽

Milica Jovanovic ◽

Marko Milosavljevic

Keyword(s):

Temporomandibular Joint ◽

Muscle Tension ◽

Masticatory Muscles ◽

Invasive Approach ◽

Non Invasive ◽

Temporomandibular Joint Osteoarthritis ◽

Patient Reported ◽

Orofacial Region ◽

The Right ◽

Bone Structures

Introduction. Temporomandibular dysfunction (TMD) is a set of disorders that involve the masticatory muscles, the temporomandibular joint (TMJ) and its associated structures. Osteoarthritis (OA), as one of the forms of TMD, leads to permanent changes in the bone structures of TMJ. These changes can be the cause of serious functional disorders of the TMJ. Case outline. This article describes a case of a 24-year-old female patient who sought help due to pain and swelling in the area of the right and left TMJ, accompanied by muscular tension, severe headaches, which did not respond to medication. ?fter establishing the diagnosis, we have applied a therapy in the treatment of the bilateral OA of TMJ, where we used non-invasive methods. Six months later, the patient reported the absence of pain, swelling, headache, and muscle tension in the orofacial region. Conclusion. There is no ?gold standard? for the management of ?? of ???. In our study, non-invasive therapy had a positive effect, where we achieved success in eliminating pain, increasing range of motion of the lower jaw, stopping the progression of the disease and advancing quality of life.

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ASSESSMENT OF PHYSIOLOGICAL PARAMETERS OF THE TRIGEMINAL AND COCHLEOVESTIBULAR SYSTEMS IN TEMPOROMANDIBULAR JOINT PAIN DYSFUNCTION

Journal of Ural Medical Academic Science ◽

10.22138/2500-0918-2020-17-2-110-120 ◽

2020 ◽

Vol 17 (2) ◽

pp. 110-120

Author(s):

N.D. Sorokina ◽

◽

L.R. Shahalieva ◽

S.S. Pertsov ◽

L.V. Polma ◽

...

Keyword(s):

Nervous System ◽

Evoked Potentials ◽

Temporomandibular Joint ◽

Differential Diagnostics ◽

Autonomous Nervous System ◽

Dental Diseases ◽

Grade Ii ◽

The Right ◽

Distal Occlusion ◽

The Brain

One of the most common causes of chronic pain in the facial region, including in the trigeminal nerve link, which is not associated with dental diseases, is pain dysfunction of the temporomandibular joint. At the same time, there is evidence in the literature that there are relationships between pain dysfunction of the temporomandibular joint, abnormal occlusion, cervical-muscular tonic phenomena, postural disorders, dysfunction of the Autonomous nervous system and cochleovestibular manifestations. At the same time, neurophysiological indicators of functional disorders in the maxillofacial region and intersystem interactions in pain dysfunction of the temporomandibular joint are insufficiently studied.Goal. The aim of the work is to evaluate the neurophysiological features of trigeminal afferentation in terms of trigeminal somatosensory evoked potentials (TSWP) and the auditory conducting system of the brain in terms of acoustic stem evoked potentials (ASVP) in distal occlusion of the dentition with pain dysfunction of the temporomandibular joint (TMJ) in comparison with physiological occlusion in students 18-21 years old. Material and methods. The main study included 41 students with distal occlusion (21 girls and 20 boys), (grade II Engl, symmetrically right and left in 14 people, and grade II Engl on the left and grade I on the right in 12 people, grade I on the left and grade II on the right in 15 people). All respondents with distal occlusion and who were practically healthy signed an informed consent to participate in the study. We used complex orthodontic methods of examination, subjective degree of severity and intensity of pain in the TMJ, assessment of the Autonomous nervous system (samples and tests), and neurophysiological methods for assessing TSVP and ASVP. Results. Significant differences in ASEP parameters were found in the group of respondents with distal occlusion in the form of a decrease in the latency period of peak I, III, and V compared to physiological occlusion, that correlated with the subjective assessment (in points) of cochleovestibular disorders. According to the TSVP study, a decrease in the duration of latent periods was found, which indicates an increased excitability of non-specific brain stem structures at the medullo-ponto-mesencephalic level compared to the control group. Conclusions. The results obtained are supposed to be used for differential diagnostics, including such dental diseases as TMJ pain dysfunction, occlusion abnormalities accompanied by pain syndrome. Additional functional diagnostics of multi-modal VP of the brain (acoustic evoked potentials, trigeminal evoked potentials) can be performed in conjunction with indicators of autonomic nervous system dysfunction, with parameters of severity of clinical symptoms of cochleovestibular disorders, musculoskeletal dysfunction the maxillofacial area, with indicators of pain, which will determine the tactics and effectiveness of subsequent treatment.

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Temporomandibular Disorders and Bruxism Prevalence in a Portuguese Sample

Medical Sciences Forum ◽

10.3390/msf2021005037 ◽

2021 ◽

Vol 5 (1) ◽

pp. 37

Author(s):

João Belo ◽

André Almeida ◽

Paula Moleirinho-Alves ◽

Catarina Godinho

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Masticatory Muscles ◽

Diagnostic Aspects ◽

Relevant Role

Temporomandibular disorder (TMD) encompasses a set of disorders involving the masticatory muscles, the temporomandibular joint and associated structures. It is a complex biopsychosocial disorder with several triggering, predisposing and perpetuating factors. In the etiology of TMD, oral parafunctions, namely bruxism, play a relevant role. The study of bruxism is complicated by some taxonomic and diagnostic aspects that have prevented achieving an acceptable standardization of diagnosis. The aim of this study was to analyze the prevalence of temporomandibular disorders and bruxism in a Portuguese sample.

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Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00123-8 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Kaoutar Cherrabi ◽

Hind Cherrabi

Keyword(s):

Septic Arthritis ◽

Temporomandibular Joint ◽

Nutritional Assessment ◽

Acute Otitis Media ◽

Clinical Signs ◽

Rare Condition ◽

Pediatric Emergency ◽

Ear Infections ◽

The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

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Smartphone addiction and the relationship with head and neck pain and electromiographic activity of masticatory muscles

Work ◽

10.3233/wor-203398 ◽

2021 ◽

pp. 1-8

Author(s):

Fabiana Foltran Mescollotto ◽

Érica Brito Gonçalves ◽

Ester Moreira de Castro Carletti ◽

Ana Beatriz Oliveira ◽

Elisa Bizetti Pelai ◽

...

Keyword(s):

College Students ◽

Neck Pain ◽

Head And Neck ◽

Muscle Activity ◽

Neck Region ◽

Masticatory Muscles ◽

Smartphone Addiction ◽

Before And After ◽

Smartphone Use ◽

The Right

Background: Excessive use of smartphones may be associated with behavioral and physical health changes and might cause musculoskeletal alterations in the head and neck region. Objective: To evaluate the prevalence of smartphone addiction in college students and its correlation with symptoms of head and neck pain and masticatory and trapezius muscle activity while resting, before and after smartphone use. Methods: Twenty university students participated in the study. They answered the Smartphone Addiction Scale and the Fonseca Anamnestic Index. Next, the participants were seated and prepared for electromyography through the placement of surface electrodes on the masseter, temporal, and trapezius muscles. Rest condition data were collected for 10 seconds before and after 30 minutes of smartphone use. Results: The results showed that 35% of the evaluated individuals were classified as smartphone addicted and 35% reported no head or neck pain in the previous 30 days. There was no association between smartphone use and head and neck pain. In the electromyography, there was an increase in RMS values after smartphone use in the right and left masseter muscles and the left trapezius. Conclusion: College students presented a high prevalence of smartphone addiction and head and neck pain, but these were not statistically associated. There was a change in muscle activity only in the right trapezius muscles before and after 30 minutes of smartphone use. These findings are contrary to the current belief that the use of smartphones correlates with pain in the neck region and changes in the electrical muscle activity, leading to fatigue in the cervical muscles.

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