Abstract
BACKGROUND AND OBJECTIVES:Understanding the importance of surface electromyography as a complementary method to understand the myofunctional status of the stomatognathic system, this study aimed at analyzing the frequency of altered and normal electromyographic indices in a sample of subjects with temporomandibular disorders, in addition to their relation with pain complaint.METHODS:Participated in the study 44 individuals with temporomandibular disorder signs and symptoms (11 males and 33 females), with mean age of 39 years, who were submitted to surface electromyography. Pain intensity was measured by the visual analog scale. Total Asymmetry Index (AStotal), Masseter Asymmetry Index (ASMM), Temporal Asymmetry Index (ASTA), Activation Index (ACtotal) and Torque Index (TOtotal) were calculated. Correlation between pain intensity and electromyographic indices was checked by Pearson correlation test and sample characterization with regard to investigated indices was done by descriptive analysis.RESULTS:Means of all indices were within previously established normality patterns. The frequency of altered electromyographic indices in our sample was high (ASMM=68%; ASTA=64%; TOtotal=64%; AStotal=55%). With regard to ACtotal, there has been predominance of masseter activity as compared to temporal activity, both for normal and altered values. Among individuals with altered indices, the left side had superior activity. No correlation was found between pain intensity and the level of electromyographic indices alterations (p>0.05).CONCLUSION:The frequency of electromyographic indices alterations in individuals with temporomandibular disorders is high, pointing to the possible presence of myofunctional disorders of the stomatognathic system. These indices have no direct relation with pain complaint but show muscular activity imbalance, which may not be useful to diagnose pain, but may help the correct referral to relevant muscle therapies.
Highlights
Orofacial pain includes temporomandibular disorders (TMD), conditions in which multiple painful conditions are added, generating body maps of pain which are as or more important than pain reported in the primary complaint[1]
A previous study[8] has developed electromyographic indices able to evidence different relationships between masseters and anterior temporal muscles. Among such relationships it has established Asymmetry Index and Activation Index, for which normality standards were established as reference for clinical-scientific application[9]
A study aiming at investigating the frequency of electromyographic alterations in a TMD case series, would add information to the literature about the real usefulness of this tool, as it happens in cases needing referral for specific evaluation of stomatognathic functions and speech therapy, and not informing TMD diagnosis and severity
Summary
Orofacial pain includes temporomandibular disorders (TMD), conditions in which multiple painful conditions are added, generating body maps of pain which are as or more important than pain reported in the primary complaint[1]. Understanding that TMDs in general influence stomatognathic system muscle functions, this study aimed at evaluating the frequency of altered and normal electromyographic indices in a sample of TMD patients, as well as their relationship with pain complaint, which is their primary symptom. Understanding the importance of surface electromyography as a complementary method to understand the myofunctional status of the stomatognathic system, this study aimed at analyzing the frequency of altered and normal electromyographic indices in a sample of subjects with temporomandibular disorders, in addition to their relation with pain complaint. CONCLUSION: The frequency of electromyographic indices alterations in individuals with temporomandibular disorders is high, pointing to the possible presence of myofunctional disorders of the stomatognathic system These indices have no direct relation with pain complaint but show muscular activity imbalance, which may not be
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