Combined Acquisition Method of Image and Signal Technique (CAMIST) for Assessment of Temporomandibular Disorders in Performing Arts Medicine.

Abstract

This pilot study investigated the morphological and functional aspects of an English horn player, who presented at a dental appointment with temporomandibular disorder (TMD), using the "combined acquisition method of image and signal technique" (CAMIST) in the diagnosis. Cephalometric analysis was obtained after carrying out three lateral cephalograms using a standardized radiographic technique. The first one was taken with the teeth in the normal occlusion and the lips relaxed, the second with the oboe embouchure, and the last was performed with the English horn. To understand the pressures involved during the embouchure and musical performance of the English horn and oboe, a system was developed using force sensors placed on the double-reed mouthpiece. Finally, infrared imaging was used to better understand the anatomy-physiology of specific structures of the cranio-cervico-mandibular complex. Cephalometry of the musician showed more significant changes in the retrusion of the mandibular pogonion. The embouchure pressures measured during musical practice showed that the English horn induced a higher pressure on the lower lip than on the upper, while the inverse happened with the oboe. Thermography confirmed the painful site on the left temporomandibular joint (TMJ), and this was also observed in the muscle tenderness/discomfort on the right superficial masseter by the differential temperature of these areas. Techniques such as lateral teleradiography, infrared imaging, and force sensors can be useful screening tools with added value for the diagnosis of TMDs in performing artists.