Ｃｈｉｎ ｔａｐ ｓｉｌｅｎｔ ｐｅｒｉｏｄの時間的要素に関する研究 筋活動量ならびにかみしめ度合の関係について

The Journal of Orthopaedic & Sports Physical Therapy is pleased to publish selected abstracts of the Congresso Internacional de Reabilitação Neuromusculoesquelética e Esportiva, which took place in Vitória, Brazil, May 18 to 21, 2011. This collection of abstracts provides a brief summary of the research presented at that meeting. These abstracts do not permit a full evaluation of the scientific rigor with which the work was conducted, but they provide an idea of the type of clinical questions being researched by individuals participating in that meeting. J Orthop Sports Phys Ther 2011;41(10):A1–A4. doi:10.2519/jospt.2011.0301

To explore the effects of head and neck posture training on the electrical activity of the temporalis and masseter muscles in patients with myogenic temporomandibular disorder(TMD) under different head and neck postures. Fourteen patients with TMD who attended Hainan West Central Hospital from July 2022 to February 2023 with presence of head forward posture were selected for the study. All patients received head and neck posture training for 4 weeks, 2-3 times per week for 30 min each time. Changes in the electrical activity of bilateral temporalis and masseter muscles were compared between pre- and post-intervention patients in the natural relaxed position, the teeth lightly touching position, and the neutral head and neck position. Mandibular function, pain intensity, and maximal pain-free mouth opening were assessed for pre- and post-comparisons. In TMD patients, the electromyographic amplitude of the anterior fasciculus of the left temporalis muscle and the right masseter muscle was higher in the natural relaxed position than in the neutral head and neck position (3.4±1.4 vs. 2.5±1.0, 2.4±1.6 vs. 1.8±1.1, P＜0.05). After head and neck posture training, the patients had lower basal EMG amplitudes of bilateral temporalis and left masseter muscles in the natural relaxed position and the neutral head and neck position compared with the pre-treatment position, and the mandibular function scores and pain were significantly improved(P＜0.05). Different head and neck postures can affect the basal electromyographic amplitude of the masticatory muscles in patients with myogenic TMD, and postural training can effectively relax the temporalis and masseter muscles in patients with TMD, resulting in pain reduction and promoting functional recovery.

Introduction. Temporomandibular joint (TMJ) dysfunction is the second most common musculoskeletal disease, affecting up to 33 % of people during their lifetime. The multicomponent etiopathogenesis of the disease actualizes the use of diagnostic criteria for the early symptoms of developing functional disorders. The algorithm for preclinical examination of the TMJ must be used already in the dentist′s office, which will allow to avoid the unpredictable results of dental rehabilitation and in time to attract other specialists to the complex therapy of the patient. The etiopathogenesis of TMJ dysfunction indicates the need for a closer study of the mutual infl uence of structural imbalances in the body and dentition, the determination of the primary disorder, which will help to develop a system for the prevention of TMJ dysfunctions, and may also affect the sequence, volume and nature of the treatment for this pathology.The goal of research — to identify the relationship of structural imbalances in the body and temporomandibular joint dysfunction.Materials and methods. From September to December 2019, a prospective study of 70 volunteers among university students was conducted at the Department of Orthopedic Dentistry of Omsk State Medical University. During the processing of clinical material, 6 people retired in accordance with exclusion criteria. All subjects underwent an assessment of the state of the dentofacial system, primarily the TMJ (using a short Hamburg test) and structural imbalances of the body (using the Notch Interfaces Inc. motion capture and reconstruction system). To assess the cervical-cranial relationship in the subjects who had 3–6 points according to the results of the Hamburg test, a head X-ray was make in lateral projection, and cephalometric analyzes were performed according to Rocabado and Sassuni. The presence and strength of the linear relationship between the phenomena was determined using the Pearson coefficient.Results. According to the results of the Hamburg test, a functional norm was revealed in only 12,5 % of the examined; TMJ dysfunction was revealed in the vast majority of volunteers (57,9 %). Structural imbalances of the body were detected in 82,8 % of cases. Patients with established by the results of the Hamburg test TMJ dysfunction were underwent cephalometric analysis. Structural changes in the TMJ were not found in the subjects according to the X-ray studies results. There was a high positive relationship between functional TMJ dysfunction and pelvic hyperfl exion (ρ=0,72, p<0,05), and an average positive relationship (ρ=0,55, p<0,05) between the head and neck forward tilting. A positive weak relationship was observed between the risk of TMJ dysfunction developing (2 points according to the Hamburg test) and pelvic hyperfl exion (ρ=0,31, p<0,05).Conclusion. The study showed a strong positive relationship between pelvic hyperfl exion and TMJ dysfunction signs; an average positive relationship between TMJ functional impairment and head and neck forward tilting. It was also found that in individuals with TMJ dysfunction signs there were no radiological signs of structural changes in the joint, which indicates the potential reversibility of the revealed disorders and the need for their timely detection and correction. This study is pilot and will be continued in a broader format.

Background: The controversy surrounding the role of occlusion in temporomandibular joint (TMJ) dysfunction led to this study. Temporomandibular joint (TMJ) dysfunction has been the subject of considerable study for decades, yet despite voluminous literature, the multifactorial aetiology of temporomandibular dysfunction, is even today a cryptic issue.The cause of the signs and symptoms of TMJ dysfunction is not clearly understood and various opinions on their aetiology have been offered. The aim of study was to evaluate the effects of the occlusal interference with fixed prosthesis on the position of the terminal hinge axis and to stady the role of the occlusal interference with fixed prosthesis in the etiology of Temporomandibular joint dysfunction by using cadiax compact 2. Material and methods this study was carried out on 32 patients who came to the teaching hospital in the college of dentistry at university of al Mustansiria suffering from missing teeth and need for substitution by fixed partial denture. Everyone of the selected sample was examined in three visits with a new computerized axiography technology for recording the transverse hinge axis and Bennett movement by cadiax compact 2 and an evaluation for TMD was done by Helkimo index which was used to collect the TMJ dysfunction data, The 1st record in the 1st visit at the starting date before dental preparation, the 2nd record immediately after cementation of fixed prosthesis and the 3rd recorded 1 month after the 2nd record. Result: The results of this study showed that no effect of occlusion adjustment on TMD by using fixed partial denture even if patients have change in position of hinge axis and Bennett angle .the comparison between the angle changes in the same side of treatment shows no significant changes (p value >0.05) and that is shown also by Helkimo index because there was no score for all the patients. Conclusion Occlusion interferance does not play a major role in the aetiology of TMD; the impact of occlusion is not zero, however, and should be determined in each individual case.

Effect of experimental jaw muscle pain on bite force during mastication

Differential diagnosis of facial pain and guidelines for management

An electromyographic investigation of the masseter muscles was undertaken under standardized conditions. The masseteric silent periods (MSP) in healthy volunteers were compared with silent periods (SP) in patients with temporomandibular joint (TMJ) dysfunction syndrome before and after electrical stimulation treatment by Transcutaneous Electrical muscle stimulation. About 87% of the patients with TMJ dysfunction showed prolonged silent periods in the masseter muscles. Initially, 80% of the silent periods became normal range immediately after the electrical stimulation treatment. However, 24 hours after the treatment the silent periods returned to the abnormal range.

Despite the association of masticatory function with head posture and mandible movement, the impact of head posture on masseter muscle electrical activity remains unclear. This study aimed to investigate the electrical activity of the anterior temporal, masseter, superior trapezius, and sternocleidomastoid muscles in temporomandibular disorder (TMD) patients in three different head positions and compare the findings with those for healthy subjects. The study included 16 TMD patients and 17 healthy subjects. Surface electromyography (sEMG) was used to assess the bilateral anterior temporalis, masseter, superior trapezius, and sternocleidomastoid muscle activities. The maximal voluntary contraction (MVC) and root mean square (RMS) sequence of each muscle were measured in three head positions. Mixed analysis of variance was used to evaluate the effects of head posture on muscle electrical activity in each group. The group differences for the bilateral masseter muscles were significant in the relaxation position, neutral head position (NHP), and relaxation position with tooth contact (P<0.05). In both groups, the basal RMSs of the bilateral anterior temporalis muscle in the relaxation position with tooth contact was significantly higher than that in the NHP (P<0.05). In both groups, the basal RMSs of the bilateral masseter muscles in the relaxation position with tooth contact was higher than that in the relaxation position and NHP, with significant differences (P<0.05). During the management of TMD patients, physical therapists should focus on patient education regarding maintenance of a relaxed position and establish appropriate rehabilitation programs to reduce muscle activity.

Bite force and activity in temporal and masseter muscles during biting and chewing were recorded in 19 control subjects and 23 subjects with symptoms and signs of functional disorders of the craniomandibular system. The entire group comprised 13 men and 29 women, 14-63 yr of age. Maximal unilateral bite force was 480 Newton (N) in control subjects and 387 N in patients, with corresponding bilateral values of 347 N and 230 N. At predetermined levels of contraction, temporalis and masseter activity were linearly related. Correlations of bite force and activity in short static contractions were significant with respect to unilateral, but not to bilateral force measurements. Only in the masseter muscle was strength of dynamic contractions during chewing significantly correlated to bite force. With the present method it was demonstrated that unilateral bite force is a simple clinical indicator of mandibular elevator strength as a whole, but inadequate to disclose asymmetric conditions. During isometric contraction, relative strength of electromyographic activity fairly accurately imaged the output of mechanical activity.

BackgroundTo evaluate the EMG activity and thickness of right masseter (RM), left masseter (LM), right temporal (RT) and left temporal (LT) muscles and bite force in children with temporomandibular disorders (TMD).Material and MethodsForty five children (mean age 8.8 years; 22 boys and 23 girls) were examined on the basis of the RDC/TMD and the Faces Pain Scale-Revised (FPS-R) was used to determine the level of severity of the signs and symptoms of TMD, resulting in four groups: GI - without TMD (n=10); GII - with mild TMD (n=18), GIII: with moderate TMD (n=12) and GIV: with severe TMD (n=5). The data of electromyographic activity, maximum bite force and muscle thickness were tabulated and submitted to statistical analysis (ANOVA, P≤0.05).ResultsChildren with TMD signs and symptoms had lower EMG activity than children of the control group. There was significant difference among the groups for the LT at rest (P=0.01), right (P=0.03) and left (P=0.05) laterality, and for the LM (P=0.01) and LT (P=0.03) muscles in maximum voluntary contraction. There were no statistically significant differences among the groups regarding muscle thickness. The bite force was lower in the TMD groups than children of the control group, with significant statistical difference for the right region (P=0.03).ConclusionsThe severity of TMD signs and symptoms affected the EMG activity and the molar bite force in children. However, structural changes in the thickness of masticatory muscles are not perceptible in children with TMD signs and symptoms. Key words:Children, temporomandibular disorders electromyographic, bite force, ultrasound.

Context: Temporomandibular disorders are musculoskeletal condition presenting with pain and dysfunction in masticatory muscles, temporomandibular joint (TMJ) and related structure. Aim: To determine the role of myofascial release technique on mobility and function in TMJ Disorder patients with neck pain. Settings and Design: Experimental study design conducted in Dr. D.Y. Patil College of Physiotherapy, Pimpri, Pune. Subjects and Methods: Overall 30 subjects who fulfilled the inclusion criteria were randomly divided into two groups. Experimental group (Group A) was given nonsteroidal anti-inflammatory drugs (NSAID's) and myofascial release to Upper trapezius, Sternocleidomastoid, Masseter and Temporalis three times a week for 2 weeks. Control group (Group B) was given NSAID's. At the end of treatment prepost comparison was done for temporomandibular (TM) joint range of motion and function. Statistical Analysis Used: Data was analysed with Primer software using Wilcoxon signed rank sum test and Mann–Whitney U-test. Results: Mobility in terms of mouth opening and lateral excursion post intervention in both groups have been significantly improved, however, in the experimental group significant improvement was seen in lateral excursions only. Limitation of daily function score reduced from 22.2 to 5 in the experimental; group and 21.3–13.5 in the control group. However more statistical reduction was seen in the experimental group (P = 0.001). Conclusions: Myofascial release technique along with NSAIDSs was able to improve mobility and function among the TM joint disorder patients with neck pain.

the incidence and duration of the masseteric silent period (SP) during tooth tapping. Six subjects (5 males and 1 female, 24 to 27 years in age) with normal occlusion and no signs of temporomandibular joint (TMJ) syndrome were investigated. Electromyographic recordings were made from their masseter muscles with bipolar surface electrodes. The TA induced by the occlusal contact during tooth tapping was recorded with an accelero-pickup placed on the forehead of the subject. The following results and conclusion were obtained: 1. The incidence of the SP decreased according to the decrease of TA. A marked reduction of less than 0. 3 G of TA was observed. 2. The duration of the SP increased according to the decrease of TA. The relationship between the duration of the SP and TA could be approximated with a logarithmic function. 3. The relationship between the TA and the incidence or the duration of the SP can be useful for the diagnosis of the masticatory system and TMJ syndrome.

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Subject. Questions of diagnostics and revealing of the reasons of temporo-mandibular joint (TMJ) disorders are very significant now. Realities of modern stomatology have a significant impact, namely, use of materials with high durability and rigidity, widely available of total restorations and orthodontic treatment, insufficiency of the high-grade diagnostics of maxillofacial pathology for revealing latent, compensated TMJ disorders before stomatologic intervention. All these factors leads to occurrence of patients with the expressed, developed semiology. The purpose. To consider interrelation of various occlusion derangements, lateral displacement of the mandible and internal TMJ disorders (or dislocations of the TMJ disc, intraarticulate elements). Methodology. The estimation of frequency of occurrence of TMJ disc dislocations according to literary sources is carried out, various etiological factors of internal TMJ disorders are considered, in particular, some types of pathological occlusion, which may have an essential impact on the violation of the ratio of intraarticulate elements. Two clinical cases of patients with TMJ disorders with similar semiology and presence of transversal malocclusion due to improper jaws growth and presence of the acquired pathology as result of stomatologic intervention as an example. Results of research. According to the domestic and foreign literature the role of occlusion factors in development of TMJ disorders is represents approximately 10―20 %, however there are researches by types of occlusal disorders which almost always lead to those or other TMJ disorders. Conclusion. It is revealed, that transversal malocclusion most often provokes TMJ dysfunction and internal joint disorders. In the future it is planned to reveal occlusal factors which able to provoke the development of TMJ disorders with high probability, mechanism of their influence and methods of revealing.

The incidence of temporomandibular joint dysfunction in women reaches 80% of the total number of patients. The symptoms of temporomandibular joint dysfunction are varied and were first described by otorhinolaryngologist J.B. Costen. In his honor, the entire symptom complex of this disease is named "Costen's syndrome" in specialized literature and in the International Classification of Diseases of the tenth revision. The symptom complex includes joint pain, sometimes radiating to the neck, back of the head, temple, ear, clicks in the joint during movements of the lower jaw, trismus, hearing loss, dull pain in the middle and outside the ear, pain and burning sensation of the tongue, dry mouth; dizziness, pain on the side of the affected joint and even facial pains like trigeminal neuralgia. It is clinically difficult to isolate all these symptoms in patients with dysfunction of the temporomandibular joint, because its pathogenic and etiological manifestation is characterized in most cases only by one or several symptoms.&#x0D; Temporomandibular joint dysfunction is polyetiological, has a varied clinical picture and is directly dependent on the hormonal state, and especially the gynecological status. Much attention is drawn to the study of estrogen, which, in addition to regulating the functioning of the reproductive system in a woman's body, also performs a number of other important functions, including helping the joint to remain healthy - preventing calcium leaching, stimulating collagen recovery and the work of osteoblasts.&#x0D; The aim of the study was to determine the frequency of temporomandibular joint dysfunction in women along with hormonal changes and to trace their correlation.&#x0D; Materials and methods. The study involved 169 students of the third year at the Department of Propedeutics of Surgical Dentistry of the Faculty of Dentistry of the Ukrainian Medical Stomatological Academy. The research methods were based on conducting an anonymous survey. The questions were written for both men and women and were characterized by general dental status. Questions on gynecological status were asked separately for women.&#x0D; Results and discussion. The study group consisted of 169 people, including 89 women and 80 men aged 18 to 28 years. 61% of men and 26% of women did not have complicated dental status, among those surveyed. At the same time, 35% of men (of their total number) and 28% of women (of their total number) had orthodontic pathology. The presence of individual symptoms of temporomandibular joint dysfunction in men was observed in 6% of the total number of patients, in women - 19% (4% of them had already consulted a dentist, but did not receive adequate treatment). It is worth noting that patients with suspected temporomandibular joint pathology complained only of clicks when opening their mouths or chewing.&#x0D; Among 89 women studied, 8% had temporomandibular joint dysfunction, but did not have pathologies of the reproductive system. In 20% of women who did not have temporomandibular joint dysfunction, pathology of the reproductive system was noted. 11% had temporomandibular joint dysfunction and pathology of the reproductive system. 26% of women were clinically healthy.&#x0D; Out of 10 women with temporomandibular joint dysfunction who had a pathology of the reproductive system, but never had problems with the dentition, 10% of the women in the group (1% of all women examined) suffered from menstrual irregularities and had human papillomavirus in their anamnesis. 20% had a suspicion of temporomandibular joint pathology along with problems in their gynecological status and a history of orthodontic treatment, 10% had menstrual irregularities (algodismenorrhea) and were treated by a gynecologist with hormonal contraceptives for up to 1.5 years. 30% of women had temporomandibular joint pathology with problems in their gynecological status and previous therapeutic treatment (presence of fillings in the oral cavity). Of these, 20% have menstrual irregularities, and 10% have cervical erosion. 40% of the total number of women had temporomandibular joint pathology with orthodontic treatment in the past and fillings in the oral cavity along with problems in their gynecological status, where all had menstrual irregularities. 10% of them had metaplasia, erosion of the cervix and uterine polyp, 10% - erosion of the cervix.&#x0D; It should be noted that out of 89 women, 14 (17.5%) did not have any complaints about the condition of the joint, but had fillings and orthodontic treatment in the past, as well as pathology of the reproductive system. 11 of them (14%) had menstrual irregularities. In 3 (4%) patients out of the total number of women, there was an increased level of androgens, progesterone, estradiol and a history of treatment by a gynecologist.&#x0D; Based on the results obtained, it is possible to confirm the forced frequency of women visiting the dentist. Among the total number of women with temporomandibular joint dysfunction and pathology of the reproductive system, there was only 1 patient out of 89 persons without any dental interventions in the past. This does not give us a reason to associate gynecological status with the etiology of temporomandibular joint dysfunction. But in view of the greater prevalence of temporomandibular joint dysfunction along with gynecological pathologies, it gives us a basis for active further research on this topic.