Relationship between facial asymmetry and masseter reflex activity

Abstract

Purpose: In this study, we evaluated the tonic vibration reflex (TVR) of the masseter muscles in patients with facial asymmetry. Subjects and Methods: The study was conducted with 10 volunteers without facial asymmetry and 12 orthognathic patients with facial asymmetry. Subjects were seated in a chair and held a stimulator composed of an electric motor and an acrylic bite block between the upper and lower dentitions at facial midline, to elicit TVR. Electromyographic activity was recorded using a pair of silver electrodes affixed bilaterally with adhesive tape to the skin over the superficial masseter. The amount of mandibular deviation was measured on the frontal cephalogram. The reflex response was evaluated with the following:TVR index (%) = ∫TVR × 100/∫maximum voluntary contraction (MVC), and with the TVR ratio: ∫TVR on the high MVC side/∫TVR on the low MVC side. Results: In the patient group, the average TVR index on the deviated side was significantly higher than that on the nondeviated side. In all subjects, including the control and patient groups, a negative correlation between the amount of mandibular deviation and the side-to-side difference in TVR index was seen (r = −0.536, P <.05, n = 22). In addition, patients with a lower MVC on the deviated side than on the nondeviated side showed a significantly higher TVR ratio than did the control group. Conclusions: These results suggest that the difference between the right and left reflex responses elicited by TVR might be related to frontal craniofacial morphology. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:298-303, 2003