scholarly journals Diagnosis of hypertonicity of the masticatory muscles at a dental appointment

2021 ◽  
Vol 19 (3) ◽  
pp. 190-199
Author(s):  
Yu. A. Makedonova ◽  
A. A. Vorobev ◽  
A. N. Osuko ◽  
A. V. Alexandrov ◽  
D. Yu. Dyachenko ◽  
...  

Summary. The purpose of the study. Hypertonus of the masticatory muscles is a fairly common pathology that leads to the development of parafunctional masticatory activity. At the same time, the nature of the course of the pathology becomes long-lasting, leading to irreversible consequences. Patients often do not pay attention to minor pain in the area of the masticatory muscles, so hypertonus of the masticatory muscles is diagnosed randomly. In view of the variety of clinical symptoms from headaches to the phenomena of oral stomalgia, the diagnosis of hypertension is extremely difficult. Also, there is currently no single algorithm for the management of such patients.Materials and methods. In the presented scientific study, a survey of 189 patients who applied to a dental clinic for the treatment of dental caries and its complications, a professional examination was conducted. All patients were examined according to the method of diagnosis of muscle hypertonus developed by us. The methodology includes a thorough collection of anamnesis, questionnaires (PSM-25, VAS, MAS, author's methods), the use of objective research methods, including: OPTG, CT, ultrasound, the author's method of determining the degree of mouth opening.Results. Muscle hypertonus of varying severity was diagnosed in 80% of cases, high stress level on the PSM-25 scale in 71% (135), the presence of morning pain in the area of the masticatory muscles in 55%(104). An assessment of muscle tone on the MAS scale confirmed a significant increase in masticatory muscle hypertonicity in 34% of cases. These additional methods of investigation confirmed the presence of hypertonicity of the masticatory muscles in patients with an objective clinical picture. In the study of this area, the main role is played by the clinician, only if all the diagnostically valuable information is available, it is possible to formulate an optimal treatment plan and avoid aggravation of the patient's condition due to incorrect diagnosis and treatment.Conclusions. The application of the developed diagnostic method contributes to the random detection of parafunctional activity of the masticatory muscles at a dental appointment, as well as to the final diagnosis of masticatory muscle hypertonus. 

2018 ◽  
Author(s):  
Dr Malathi Dayalan ◽  
Dr Sudeshna Sharma ◽  
Dr Shweta Poovani ◽  
Dr Saher Altaf

BACKGROUND Masticatory system is a complex functional unit, primarily engaged in chewing, swallowing and breathing functions, and some parts are involved in taste recognition and determination of food consistency. Sophisticated functional performances of speech and emotional expressions are specifically human qualities. Irregularities in occlusion appears to be the precipitating factor in the pathogenesis of myofascial pain dysfunction syndrome. Tek- Scan III records the bite length, number, distribution, timing, duration and the relative force of each tooth contact. It also records the sequence of occlusal contacts in terms of time and the associated force with each occlusal contact. The aim of this study was to treat masticatory muscle disorders with occlusal equilibration, and compare the efficacy of treatment outcomes between selective grinding and stabilization splints using Tek-Scan III. OBJECTIVE Objective of this study was to compare the efficacy of occlusal equilibration achieved through selective griding and stabilization splints using Tek-Scan III. METHODS In this in vivo study, 40 patients with masticatory muscle disorders were selected based on the inclusion and exclusion criteria. The occlusal discrepancies were analyzed using Tek-Scan III. The selected 40 subjects were then randomly divided into 2 groups based on the treatment they recieved; Group I – Selective grinding group (20) and Group II – Stabilization splint group (20). Comparison of pre-treatment and post treatment results were evaluated in terms of pain, mouth opening, left and right side force percentage as recorded through Tek-Scan III and reduction of disclusion time. Statistical analysis was carried out with Kolmogorov Smirnov test, Wilcoxon matched pair test and Mann-Whitney U test. RESULTS Wilcoxon matched pairs test demonstrated that there was statistically significant results ( p = 0.0007) in both the groups for reduction of disclusion time, elimination of pain and improved mouth opening. Patients in Group I showed better results as compared to Group II in terms of disclusion time, pain and mouth opening. CONCLUSIONS Occlusal equilibration brought about by reducing the disclusion time using the Tek- Scan III reduced the symptoms of pain in masticatory muscles. Patients in group I (Selective grinding) however showed better results when compared to patients in group II (Stabilization splints).


2012 ◽  
Vol 59 (2) ◽  
pp. 87-89 ◽  
Author(s):  
Ikumi Yamamoto ◽  
Satoki Inoue ◽  
Masahiko Kawaguchi ◽  
Tetsuji Kawakami ◽  
Tadaaki Kirita ◽  
...  

Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new disease entity characterized by limited mouth opening due to contracture of the masticatory muscles, resulting from hyperplasia of tendons and aponeuroses. In this case series, we report what methods of airway establishment were conclusively chosen after rapid induction of anesthesia. We had 24 consecutive patients with MMTAH who underwent surgical release of its contracture under general anesthesia. Rapid induction of anesthesia with propofol and rocuronium was chosen for all the cases. In 7 cases, intubation using the Macintosh laryngoscopy was attempted; however, 2 of those cases failed to be intubated on the first attempt. Finally, intubation using the McCoy laryngoscopy or fiber-optic intubation was alternatively used in these 2 cases. In 7 cases, the Trachlight was used. In the remaining 10 cases, fiber-optic intubation was used. Limited mouth opening in patients with MMTAH did not improve with muscular relaxation. “Square mandible” has been reported to be one of the clinical features in this disease; however, half of these 24 patients lacked this characteristic, which might affect a definitive diagnosis of this disease for anesthesiologists. An airway problem in patients with MMTAH should not be underestimated, which means that other intubation methods rather than direct laryngoscopy had better be considered.


2020 ◽  
pp. 81-90
Author(s):  
A.M. Boyan ◽  
V.I. Bessonov

Abstract. The article is concerned with the most relevant and insufficiently studied problems of modern orthopedic dentistry. Objective. To study the dynamics of patients state with muscle and joint dysfunction of TMJ, which decided to complete the treatment after elimination of their disease symptoms achieved by using the occlusion equipment and not go through the finish the treatment. Materials and Methods. 25 patients were involved in the study: 8 (32.0%) men and 17 (68.0%) women aged from 35 to 60 years (average age 46.16 ± 1.47 years), which among 360 patients were diagnosed a muscle and joint dysfunction of TMJ and successfully underwent treatment in 2015-2019 in a multi-field dental clinic (Kharkiv, Ukraine). Methods of general clinical examination of the state of the dento maxillofacial complex were used. These patients underwent examination before treatment, then after eliminating the symptoms of the disease and restoring the normal masticatory process using occlusal splints, and then 1 month after stopping wearing the splint, and 1 and 1.5 years after the end of treatment. Conclusions. The examination confirmed the diagnosis in all 25 patients: "muscle and joint dysfunction of TMJ of occlusal origin." All 25 (100%) patients had occlusion disorders due to an edentulous space in the lateral parts of the lower and / or upper jaw. An individual treatment plan was developed for each patient in accordance with the algorithm considered in the article using the author's modified method of percutaneous electroneurostimulation and the proposed occlusal splint structure. Because of the treatment carried out during 3.5 ± 0.7 months, all 25 patients haven’t had any clinical aspects of muscle and joint dysfunction of the TMJ and all of them have had normal physiological functioning of the masticatory muscles and TMJ, which was confirmed by objective examination methods, including special ones. These 25 patients refused to complete the final stage of treatment (the manufacture of temporary and permanent prostheses), but agreed to remain at the regular or periodical medical check-up. In two weeks after the stop of wearing the equipment, 17 of 25 patients (68.0%) gradually began to fill certain symptoms of dysfunction: severity and discomfort in the TMJ, tightness and tenderness of the masticatory muscles. 4 weeks after examination determined that 24 out of 25 patients (96.0%) had a disease recurrence, their condition almost returned to the primary state, and was confirmed by objective methods of examination. However, after 4 weeks of wearing the newly manufactured medical occlusal splint, all the symptoms of dysfunction in all patients disappeared, the electromyograms and arthrophonorgamm values returned to normal. The patients underwent the final stage of treatment - temporary and then permanent prostheses were made. Examinations conducted in one and one and a half years after the fixation of permanent prostheses showed that disease recurrence was not observed, there were no complaints from patients. Conclusions. In patients with muscle and joint dysfunction of TMJ of occlusal origin, it is unacceptable to stop treatment at the stage of eliminating only the clinical symptoms of the disease, since in 96% of cases it leads to a disease recurrence within the first month after the termination of wearing the occlusal splint. A prerequisite for ensuring long-term stable results of treatment of TMJ dysfunction of occlusal origin in patients with edentulous spaces is a full treatment cycle, an integral component of which is rational prosthetics, which is confirmed by control examinations carried out in 1 and 1.5 years after the end of treatment.


2021 ◽  
Vol 10 (16) ◽  
pp. 3459
Author(s):  
Grzegorz Zieliński ◽  
Michał Ginszt ◽  
Magdalena Zawadka ◽  
Katarzyna Rutkowska ◽  
Zuzanna Podstawka ◽  
...  

The aim of the study was to analyze the relationship between stress measured by the perceived stress scale (PSS-10) questionnaire and masticatory muscle activity. Experimental design assumed the study of healthy young women without temporomandibular disorders, dividing them into three groups depending on the result of the stress level and then comparing these groups in terms of bioelectrical activity of the masticatory muscles. After the exclusion criteria were applied, 63 female students (mean age: 22.3 ± 2.4 years) from Medical University of Lublin were included in the study. The subjects were then divided into 3 groups: with low (n = 18), medium (n = 18) and high stress level (n = 27), according to PSS-10 results. Resting and functional activity of temporalis anterior (TA) and masseter (MM) muscles were measured by electromyograph BioEMG III. There were statistically significant effects of group on the absolute value of asymmetry index (AsI) of TA and MM during maximum voluntary clenching on dental cotton rollers (both p = 0.02). Post hoc analysis shows that there were statistically significant differences between medium and high stress groups in AsI TA (p = 0.01) and between low and high stress groups in AsI MM (p = 0.02). Perceived stress measured by PSS-10 questionnaire seems to be associated with changes in muscular asymmetry in functional clenching activity.


Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Yin-Hwa Shih ◽  
Zhen-Rong Hong ◽  
Shih-Min Hsia ◽  
Shang-Yu Yang ◽  
Tzong-Ming Shieh

<b><i>Introduction:</i></b> The prevalence of malnutrition among inpatient older adults is as high as 20∼50%. Masticatory performance is known to affect the nutritional status of individuals. However, an objective measurement to reflect the real status of masticatory muscle performance is lacking at the bedside. <b><i>Methods:</i></b> This pilot study analyzed the masticatory performance using surface electromyography (sEMG) of masticatory muscles that measures both muscle strength and muscle tone at the bedside. The nutritional status was measured using the Mini Nutritional Assessment tool. The handgrip strength was measured using a hand dynamometer. The statistical data were analyzed using SPSS 25 software. <b><i>Results:</i></b> The data revealed that female inpatient older adults more frequently had substandard handgrip strength (<i>p</i> = 0.028), an at-risk and poor nutritional status (<i>p</i> = 0.005), and a higher masseter muscle tone (<i>p</i> = 0.024). Inpatient older adults with an at-risk and poor nutritional status had an older age (<i>p</i> = 0.016), lower handgrip strength (<i>p</i> = 0.001), and higher average masseter muscle tone (<i>p</i> = 0.01). A high masseter muscle tone predicted the risk of having an at-risk and poor nutritional status. The at-risk or poor nutritional status predicted having a substandard handgrip strength by 5-fold. <b><i>Conclusions:</i></b> A high masticatory muscle tone predicts malnutrition and frailty. Medical professionals should combat masticatory dysfunction-induced malnutrition by detecting masticatory muscle performance using sEMG and referring patients to dental professionals. Additionally, encouraging inpatient older adults to perform oral motor exercise is recommended.


Vestnik ◽  
2021 ◽  
pp. 97-101
Author(s):  
М.А. Алиев ◽  
М.Ж. Мирзабаев ◽  
В.С. Караваев

Грыжа диска (ГД) является распространенным заболеванием и наносит большой вред как физическому, так и психическому здоровью пациентов, страдающих этим заболеванием. Главным этиологическим фактором заболевания служит дегенерация диска. В настоящее время общее определение грыжи межпозвонкового диска в клинической медицине довольно запутанно. В настоящее время общее определение грыжи межпозвонкового диска в клинической медицине довольно запутанно. Окончательный диагноз ГД основывается на совокупности анамнеза, клинических симптомов и результатах визуализации. Herniated disc is a common disease and causes great harm to both the physical and mental health of patients suffering from this disease. The main etiological factor of the disease is disc degeneration. Currently, the general definition of a herniated disc in clinical medicine is quite confusing. Currently, the general definition of a herniated disc in clinical medicine is quite confusing. The final diagnosis of HD is based on a combination of anamnesis, clinical symptoms, and imaging results.


Revista CEFAC ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 702-711 ◽  
Author(s):  
Taysa Vannoska de Almeida Silva ◽  
Maria das Graças Wanderley de Sales Coriolano ◽  
Carla Cabral dos Santos Accioly Lins

ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.


10.3823/2607 ◽  
2019 ◽  
Vol 12 ◽  
Author(s):  
Ching-Hsiang Wang ◽  
Jenq-Shyong Chan ◽  
Chung-Chi Yang ◽  
Po-Jen Hsiao

The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy.


2022 ◽  
pp. 98-100
Author(s):  
A. A. Sultanov ◽  
Y. Y. Pervov ◽  
A. K. Yatsenko ◽  
M. A. Sultanova ◽  
D. O. Drozdova

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.


2018 ◽  
Vol 24 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Alexis Kahn ◽  
Helios Bertin ◽  
Pierre Corre ◽  
Morgan Praud ◽  
Arnaud Paré ◽  
...  

Introduction: Temporomandibular disorders (TMD) are a common and invalidating disease sometimes difficult to treat. Current international recommendations favour reversible and non-invasive treatments, including the injection of botulinum toxin (BTX) into masticatory muscles. There is no strong evidence of its effectiveness. Objective: The main goal of this study was to assess the effectiveness of BTX six months following injection, in terms of pain, mouth opening, improvement of symptoms and duration of effect. Materials and methods: A retrospective study carried out at Nantes University Hospital between 2014 and 2016. Results: Thirty-four patients were included. The mean age was 37 years (17–76) and seventy six percents were female. Eighty percent of patients reported a significant improvement, notably in cases of arthralgia, which decreased in 8/18 (44%) patients (p < 0.05). The mean duration of measured efficacy was 4.2 months. Discussion: Significant improvement in cases of arthralgia and a tendency for improvement in cases of myalgia, with a mean duration of action of 4.2 months. Although BTX injection do not guarantee complete resolution of myofascial pain, it have been shown to have beneficial effects on some symptoms have been shown. Conclusion: Botulinum toxin should be considered as an alternative treatment when other conservative methods fail to yield satisfactory results. A thorough multicentre assessment is necessary in the future to scientifically validate its use.


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