Clinical and Instrumental TMJ Evaluation in Children and Adolescents with Juvenile Idiopathic Arthritis: A Case—Control Study

To investigate temporomandibular joint (TMJ) involvement signs such as muscle pain, the ratio of masseter and temporal muscle activity, mouth opening width and jaw deviation during mouth opening in children and adolescents with juvenile idiopathic arthritis (JIA), a group of 32 subjects with JIA and a control group of 32 healthy subjects were evaluated. Data were collected clinically by muscle palpation (masseters, anterior temporalis and sternocleidomastoids) and instrumental analysis (electromyography and kinesiography). Higher pain was registered in the masseter and sternocleidomastoid muscles on both sides and in the right anterior temporalis in the JIA group compared to the control group (p < 0.05). Electromyography showed no statistically significant difference in the frequency of the pathological ratio of masseter and temporal muscle activity (MM/TA < 1) both in the JIA group and in the control group. Kinesiography showed a statistically significant difference in mouth opening width and jaw deviation during mouth opening between the groups (p < 0.05): JIA subjects showed lower mouth opening values and wider deviation on mouth opening; 29 out of 32 JIA subjects showed jaw deviation towards the right side. JIA affects the TMJ, causing myalgia in the head and neck muscles, a reduction in mouth opening width and an increase in jaw deviation during mouth opening.

Masticatory Dysfunction After Computed Tomography–Guided Plasma Ablation vs. Radiofrequency Ablation on Gasserian Ganglion for Idiopathic Trigeminal Neuralgia: A Randomized Controlled Trial

Objective We aimed to evaluate masticatory dysfunction after two different types of ablation on the Gasserian ganglion for the treatment of idiopathic trigeminal neuralgia. We hypothesized that low-temperature plasma radiofrequency ablation (LTP-RFA) was noninferior to radiofrequency thermocoagulation (RFT) with respect to initial efficacy. Methods In the randomized, single-blind, parallel-group, noninferiority trial, 204 participants with idiopathic trigeminal neuralgia were randomly allocated to receive plasma ablation in the LTP-RFA group and radiofrequency ablation in the RFT group in a 1:1 ratio, with random block sizes of four or six. Participants were examined at baseline (T0), on the day of discharge (T1), and at the 6-month follow-up (T2). The primary end point was the clinincal effective rate in the LTP-RFA group compared with that in the RFT group after intervention on the day of discharge. Noninferiority was prespecified at -10%. Results The intention-to-treat analysis revealed that the initial efficacy rates were 91.2% in LTP-RFA group and 93.1% in RFT group (rate ratio [RR] = 0.979, 95% confidence interval [CI]: 0.904–1.061, P = 0.795). The difference between the two groups was 1.9% (95% CI: -5.6% to 9.4%), which showed that LTP-RFA demonstrated noninferiority compared with RFT in initial efficacy. Compared with the RFT group, the LTP-RFA group exhibited a significantly greater improvement in the maximum voltage of the masseter muscles with mean differences of 11.40 (95% CI: 10.52 to 12.27, P &lt; 0.001) at T1 and 17.41 (95% CI: 14.68 to 20.13, P &lt; 0.001) at T2, respectively. Similar results were observed for the asymmetry index of occlusion, the maximum voltage of the anterior temporalis, and the activity index of anterior temporalis / masseter muscles. No serious adverse events were observed in either group. Conclusions Compared with the RFT group, noninferior efficacy for pain relief and improvement of masticatory function was revealed in the LTP-RFA group.

Electromyographic Comparison of Lips and Jaw Muscles between Children With Competent and Incompetent Lips: A Cross Sectional Study

Objective: This cross-sectional study evaluates the electromyographic (EMG) activity of lips and anterior temporalis muscles of children with competent or incompetent lips. Study design: Forty children were classified clinically according to their lip competence into two groups of 20 each: 1) competent lips group (CLG), and 2) incompetent lips group (ILG). Surface EMG activity of the superior orbicularis oris (SOO), inferior orbicularis oris (IOO), and anterior temporalis (AT) muscles was recorded with the children seated in the upright position during the following tasks: 1) at rest; 2) speaking; 3) swallowing; 4) puffing out the cheeks. Results: ILG showed lower EMG activity than CLG in the SOO and IOO muscles at rest, similar activity in both muscles during speaking, similar activity in the SOO muscle and lower in the IOO during swallowing. ILG showed significantly higher activity than CLG in both muscles while puffing out the cheeks. In the AT muscle, ILG showed lower activity than CLG at rest, during speaking and swallowing, whereas activity was similar while puffing out the cheeks. Conclusion: The difference in EMG activity recorded in children with incompetent lips and with competent lips suggests that the status of their musculature could affect the position and stability of their upper/lower anterior teeth.