Abstract

Myasthenia Gravis (MG) is characterised by muscle weakness and increased fatigability. The aim of this pilot study was to investigate if patients with MG demonstrate different functional chewing patterns and report more complaints related to mastication as compared with healthy controls. Twelve patients (median 60 years Q1–Q3: 46–70) with generalised MG and nine healthy controls (median 57 years Q1–Q3: 55–63) participated. All participants underwent dental and oral examination and were asked to fill in a questionnaire concerning oral health. Static maximum bite force was measured with a bite force transducer, electromyography in the masseter, temporalis, and suprahyoid muscles were recorded, and jaw movement was tracked, during a 5-minute gum chewing test. The patients had more oral complaints (oral health impact profile total score 22.6 vs 7.5 P < 0.01) and had lower peak bite force than controls (18.8kgf (11.1;26.4) (95% CI) vs 29.5 kgf (21.6; 37.4) (P = 0.04)). In contrast, fatigability of the masticatory muscles, as defined by number of chewing cycles during the gum-chewing test, did not differ between patients and controls (P = 0.10). In conclusion, patients had more oral complaints and lower bite force than controls, but did not show significantly different functional chewing patterns. Future studies should aim at integrating measurement of peak force into functional tests. Attention should be given to oral complaints of patients with MG.

Highlights

  • Myasthenia Gravis (MG) is an autoimmune disease at the neuromuscular junction where autoantibodies against the postsynaptic membrane molecules result in impaired neuromuscular transmission (Gilhus, 2016; Gwathmey & Burns, 2015; Conti-Fine, Milani & Kaminski, 2006; Tuzun & Christadoss, 2013)

  • The clinical examination included the ‘‘Research Diagnostic Criteria for Temporomandibular Disorders’’ (RDC/TMD) to detect and evaluate any painful temporomandibular joint dysfunction (TMD) such as myalgia or arthralgia lead to exclusion of the participant from the study

  • The RDC/TMD evaluation did not lead to exclusion of any of the 21 participants due to jaw muscle pain and temporomandibular joint problems

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Summary

Introduction

Myasthenia Gravis (MG) is an autoimmune disease at the neuromuscular junction where autoantibodies against the postsynaptic membrane molecules result in impaired neuromuscular transmission (Gilhus, 2016; Gwathmey & Burns, 2015; Conti-Fine, Milani & Kaminski, 2006; Tuzun & Christadoss, 2013). The antibodies target either acetylcholine receptors or related functionally molecules (LRP4 and muscle specific kinase) (Gilhus, 2016). The main clinical characteristic in MG is fluctuating muscle weakness with increased fatigue during continuous muscle activity (Gwathmey & Burns, 2015). The prevalence of MG is reported to be 140–150 in one million patients and the incidence ranges between. Oral function in patients with myasthenia gravis.

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