Jaw Muscle Activity Research Articles

Treatment of Bruxism with Trihexiphenidyl, a Case Series

Bruxism is a sleep related movement disorder defined by repetitive jaw muscle activity that causes clenching or grinding of the teeth. Bruxism can lead to teeth and jaw damage and disturbs sleeping process. Although gastro-esophageal reflux, smoking and disturbances in CNS dopaminergic system implicated in etiology of bruxism but no clear etiology is defined. There are plenty of treatments were used for these patients included biofeedback, hypnosis, occlusal splints, beside drugs. Pharmacological treatments such as Clonidine, Clonazepam, Hydroxizine, Sodium valproate, selective serotonin reuptake inhibitors (SSRIs) sometimes induce bruxism. Case reports showed that SSRIs induced bruxism resolved by Buspirone but tricyclic antidepressants were not supported to be effective treatment for bruxism in papers. It is hypothesized that the direct and indirect pathways of the basal ganglia are involved in the coordination of movements is disturbed in bruxer like in Parkinson disease. Based on these facts we had thought Trihexyphenidyl may be effective in resistant patients. This study describes 4 patients whom suffered from bruxism which resisted to usual treatments. Trihexiphenidyl (Artane) an anticholinergic drug reduced symptoms in all cases. Anticholinergic drugs can be considered for treating bruxism. Both night and day types of bruxism, as a movement disorder was relieved in response to Thp, probably due to anticholinergic effects in basal ganglia. These isolated cases could not be generalized. Further placebo controlled clinical trials are needed to evaluate and proof the efficacy of anticholinergic drugs such as Thp for treating of bruxism.

The Application of Temporal Dominance of Sensations (TDS) for Oral Processing Studies: An Initial Investigation

AbstractSensory trajectories of foods can be described using the temporal dominance of sensations method (TDS). This study aims to investigate the influence of TDS on oral processing variables and understand the optimum number of subjects required for oral processing studies. The work was carried out with a solid model food system (biscuits). Formulation differences in the model biscuits influenced texture perception but did not affect oral processing parameters apart from chewing frequency. Completing the TDS task influenced both mastication duration and the number of chews, although the different natural chewing behaviors observed between products were not affected. Training of subjects resulted in quicker attribute selection and greater dominance rates being observed even though the resulting TDS curves were similar. Analysis using a correlation technique suggests that 15–20 untrained subjects may be required to generate useful TDS curves for oral processing research assessing food properties.Practical ApplicationsThe dynamic and simple nature of temporal dominance of sensations (TDS) has given the technique great potential for use while simultaneously measuring oral processing parameters such as jaw movement, muscle activity and food bolus assessment. This study shows the differences in basic oral processing behavior between subjects who are, and are not, using the TDS technique. It shows that TDS can influence oral processing, but it has also potential for use with oral processing research. The research shows that slightly greater number of subjects than those commonly used in oral processing trials may be needed to generate a TDS curve effectively.

Optimization of jaw muscle activity and fine motor control during repeated biting tasks

ObjectiveTo investigate if repeated holding and splitting of food morsel change the variability of force and jaw muscle activity in participants with natural dentition. MethodsTwenty healthy volunteers (mean age=26.2±3.9 years) participated in a single session divided into six series. Each series consisted of ten trials of a standardized behavioural task (total 60 trials) involving holding and splitting a flat-faced tablet (8mm, 180mg) placed on a bite force transducer with the anterior teeth. The hold and split forces along with the electromyographic (EMG) activity of the left and right masseter (MAL and MAR), left anterior temporalis (TAL) and digastric (DIG) muscles were recorded. A series (ten trials) of natural biting tasks was also performed before and after the six series of the behavioural task. ResultsThe mean hold force (P<0.001) but not the mean split force (P=0.590) showed significant effect of number of series. No significant effect of series was seen on the variability of hold and split force and the EMG activity except for the variability of EMG activity for MAL during the hold phase (P=0.021) and DIG during the split phase (P<0.001). The behavioural task had no effect on the EMG activity of the natural biting task. ConclusionThere was no evident optimization of jaw motor function in terms of reduction in the variability of bite force values and muscle activity, when this simple task was repeated up to sixty times in participants with normal intact periodontium.

Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol.

BackgroundBruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition. The two clinical manifestations of the condition (sleep and awake bruxism) are thought to have unrelated aetiologies but are palliated using similar techniques. The lack of a definitive treatment has prompted renewed interest in biofeedback, a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs. This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism; to assess the efficacy and acceptability of biofeedback therapy in management of awake bruxism and, separately, sleep bruxism in adults; and to compare findings between the two variants.MethodsA systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults. We will search electronic databases and the grey literature using a predefined search strategy to identify randomised and non-randomised studies, technical reports and patents. Searches will not be restricted by language or date and will be expanded through contact with authors and experts, and by following up reference lists and citations. Two authors, working independently, will conduct screening of search results, study selection, data extraction and quality assessment and a third will resolve any disagreements. The primary outcomes of acceptability and effectiveness will be assessed using only randomised studies, segregated by bruxism subtype. A meta-analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met, otherwise the data will be summarized in narrative form. Data from non-randomised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues. PROSPERO registration number: CRD42013006880.DiscussionBiofeedback is not new, but its place in the clinical management of bruxism remains unclear. New research, and the availability of miniaturized consumer-grade devices, makes a systematic review timely to guide treatment decisions and inform future research.

Posterior scissors‐bite: masticatory jaw movement and muscle activity

Scissors-bite is a malocclusion characterised by buccal inclination or buccoversion of the maxillary posterior tooth and/or linguoclination or linguoversion of the mandibular posterior tooth. This type of malocclusion causes reduced contact of the occlusal surfaces and can cause excessive vertical overlapping of the posterior teeth. This case-control study is the first to evaluate both masticatory jaw movement and masseter and temporalis muscle activity in patients with unilateral posterior scissors-bite. Jaw movement variables and surface electromyography data were recorded in 30 adult patients with unilateral posterior scissors-bite malocclusion and 18 subjects with normal occlusion in a case-control study. The chewing pattern on the scissors-bite side significantly differed from that of the non-scissors-bite side in the patients and of the right side in the normal subjects. These differences included a narrower chewing pattern (closing angle, P < 0.01; cycle width, P < 0.01), a longer closing duration (P < 0.05), a slower closing velocity (P < 0.01) and lower activities of both the temporalis (P < 0.05) and the masseter (P < 0.05) muscles on the working side. In 96% of the patients with unilateral posterior scissors-bite, the preferred chewing side was the non-scissors-bite side (P = 0.005). These findings suggest that scissors-bite malocclusion is associated with the masticatory chewing pattern and muscle activity, involving the choice of the preferred chewing side in patients with unilateral posterior scissors-bite.

Analysis of brain and muscle activity during low‐level tooth clenching – a feasibility study with a novel biting device

In electromyographic (EMG) and functional magnetic resonance imaging (fMRI) studies, muscle and brain activity was compared during low levels of tooth clenching using a novel biting device to control bite force. A total of 21 healthy subjects performed motor tasks, comprising tooth clenching at 5, 10 and 20 N. During all measurements, subjects kept the novel bite device between the anterior teeth during tooth clenching. The EMG study (n = 15) characterised jaw muscle activity for the three motor tasks and demonstrated significant differences in root mean square (RMS) EMG amplitude between 5-, 10- and 20-N tooth clenching (F = 46.21, P < 0.001). There were no differences in variability of muscle activity between the three tooth-clenching levels. In an fMRI pilot study (n = 6), statistical comparisons were used to identify brain regions with significant activation in the subtraction of baseline from 5- or 20-N tooth-clenching activity. 5- and 20-N tooth clenching significantly and bilaterally activated the sensorimotor cortex, supplementary motor area, cerebellum and basal ganglia (P < 0.05, corrected for multiple comparisons). However, activation of each brain region did not differ significantly between two tooth-clenching tasks. Based on these preliminary findings, we propose that the novel biting device may be useful in further fMRI studies on controlled jaw muscle activation patterns in different craniofacial pain conditions. In addition, our fMRI result suggests that there are no significant differences in brain activity within low levels of tooth clenching with controlled force.

Is there a first night effect on sleep bruxism? A sleep laboratory study.

Sleep bruxism (SB) is reported to vary in frequency over time. The aim of this study was to assess the first night effect on SB. A retrospective polysomnographic (PSG) analysis was performed of data from a sample of SB patients (12 females, 4 males; age range: 17-39 years) recorded in a sleep laboratory over 2 consecutive nights. Sleep parameters and jaw muscle activity variables (i.e., rhythmic masticatory muscle activity [RMMA]) for SB were quantified and compared between the 2 nights. Subjects were classified into groups according to severity of RMMA frequency, such as low frequency (2-4 episodes/h and/or < 25 bursts/h) and moderate-high frequency (≥ 4 episodes/h and ≥ 25 bursts/h). Overall, no first night effects were found for most sleep variables. However, total sleep time, sleep efficiency, and stage transitions showed significant time and group interactions (repeated measures ANOVAs, p ≤ 0.05). The RMMA episode index did not differ between the 2 nights, whereas the second night showed significantly higher burst index, bruxism time index, and mean burst duration (repeated measure ANOVAs, p ≤ 0.05). Five patients of 8 in the low frequency group were classified into the moderate-high frequency group on the second night, whereas only one patient in the moderate-high frequency group moved to the low frequency group. The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed by a second night based on the patient's medical and dental history.

Contingent electrical stimulation inhibits jaw muscle activity during sleep but not pain intensity or masticatory muscle pressure pain threshold in self-reported bruxers: a pilot study

This study investigated the effect of contingent electrical stimulation (CES) on present pain intensity (PI), pressure pain threshold (PPT), and electromyographic events per hour of sleep (EMG/h) on probable bruxers with masticatory myofascial pain. The study enrolled 15 probable bruxers with masticatory myofascial pain in 3 phases: (1) baseline EMG/h recording, (2) biofeedback treatment using a CES paradigm (active group, n = 7) or inactive device (control group, n = 8), and (3) posttreatment EMG/h recording. PI and PPT were assessed after each phase. Analysis of variance models were used to compare results at a 5% significance level. Patients in the active group had 35% lower EMG/h in P2 and 38.4% lower EMG/h in P3, when compared with baseline. There were no differences in PI or PPT levels at any phase. CES could reduce EMG activity associated with sleep bruxism in patients with masticatory myofascial pain but did not influence perceived pain.

Preliminary analysis of mastication dynamics and fragmentation during chewing of brittle cereal foods

We studied the masticatory behaviour of five commercial brittle cereal foods, with different formulations, shapes and mechanical properties, chewed by an individual. The investigation of oral behaviour consisted in a simultaneous recording of jaw kinematics and muscle activity by electromyography (EMG) and we also determined the food size distribution at the swallowing point by image analysis. Similar behaviour was found for the evolution of all criteria, and especially the predominance of compression, which could be attributed to the brittle behaviour of the foods. The amplitude of the jaw motion decreased with the number of chewing cycles, or sequence duration, whereas the maximum mastication force led to the larger fragments of cereal foods when bolus was close to the swallowing point. Despite similar texture, mechanical properties, assessed by Kramer shear cell, influenced mastication work and bolus homogeneity.

Effect of experimental jaw muscle pain on EMG activity and bite force distribution at different level of clenching

Bite force at different levels of clenching and the corresponding electromyographic (EMG) activity in jaw-closing muscles were recorded in 16 healthy women before, during and after painful stimulation of the left masseter muscle. Experimental pain was induced by infusion of 5·8% hypertonic saline (HS), and 0·9% isotonic saline (IS) was infused as a control. EMG activity was recorded bilaterally from the masseter and temporalis muscles, and static bite force was assessed by pressure-sensitive films (Dental Pre-scale) at 5, 50 and 100% of maximal voluntary contraction (MVC) during each session. Visual feedback was applied by showing EMG activity to help the subject perform clenching at 5, 50 and 100% MVC, respectively. EMG activity at 100% MVC in left and right masseter decreased significantly during painful HS infusion (1·7-44·6%; P<0·05). EMG activity at 5% and 50% MVC was decreased during HS infusion in the painful masseter muscle (4·8-18·6%; P<0·05); however, EMG activity in the other muscles increased significantly (18·5-128·3%; P<0·05). There was a significant increase in bite force in the molar regions at 50% MVC during HS infusion and in the post-infusion condition (P<0·05). However, there were no significant differences in the distribution of forces at 100% MVC. In conclusion, experimental pain in the masseter muscle has an inhibitory effect on jaw muscle activity at maximal voluntary contraction, and compensatory mechanisms may influence the recruitment pattern at submaximal efforts.

The combined effects of midazolam and propofol sedation on muscle power

We performed a randomised, crossover study to investigate the effects of intravenous sedation on grip strength and bite force. Twenty male volunteers received a bolus intravenous injection of midazolam (0.02 mg.kg(-1)) together with a 30-min propofol infusion designed to achieve an effect-site concentration of 1.0 μg.ml(-1). Observed variables included bispectral index, observer's assessment of alertness/sedation, correct answer rate of Stroop colour-word test, grip strength and bite force. Grip strength decreased from a median (IQR [range]) of 483 (443-517 [380-586]) N to 358 (280-405 [108-580]) N (p < 0.001) during sedation and recovered following flumazenil administration, while bite force increased from 818 (593-1026 [405-1406]) N to 1377 (1243-1585 [836-2357]) N (p < 0.001) during sedation. Although bite force gradually returned to baseline following flumazenil administration, it remained increased throughout the experimental period. We conclude that bite force increased during intravenous sedation and that this may have clinical implications.

Activity changes in jaw motor neurons induced by egg-laying hormone contribute to the feeding suppression during egg-laying behavior in Aplysia kurodai

Egg-laying behavior in Aplysia is accompanied by behavioral changes such as feeding suppression. We investigated the effects of the egg-laying hormone (ELH) on food intake, the activity patterns of jaw muscles, and the activity of buccal neurons (multi-action neuron [MA1] and jaw-closing motor neuron [JC2]), which are elements of the feeding neural circuits controlling jaw movements in Aplysia kurodai. Injection of ELH into the body cavity inhibited the intake of seaweed. After ELH application, the rhythmic activity of jaw muscles that was induced by preferred taste stimulation elicited fewer ingestion-like responses and increased the number of rejection-like responses. ELH applied to the buccal ganglia increased the firing activity of JC2 during spontaneous rhythmic responses and during the rhythmic feeding-like responses that were evoked by electrical stimulation of the esophageal nerves. In the 2 types of rhythmic responses, the Dn (normalized value of the delay time of JC2 firing onset) decreased after ELH application as compared with the control. Furthermore, ELH decreased the size of MA1-induced inhibitory postsynaptic currents in JC2. These results suggest that ELH changes the buccal motor program from ingestion to rejection on the basis of our previous results, and may contribute to a decrease in food intake during egg laying.

Estrogen status and psychophysical stress modify temporomandibular joint input to medullary dorsal horn neurons in a lamina-specific manner in female rats

Estrogen status and psychological stress contribute to the expression of several chronic pain conditions including temporomandibular muscle and joint disorders (TMJD). Sensory neurons that supply the temporomandibular joint (TMJ) region terminate in laminae I and V of the spinal trigeminal nucleus (Vc/C1–2 region); however, little is known about lamina-specificity and environmental influences on the encoding properties of TMJ brainstem neurons. To test the hypothesis that Vc/C1–2 neurons integrate both interoceptive and exteroceptive signals relevant for TMJ nociception, we recorded TMJ-evoked activity in superficial and deep laminae of ovariectomized rats under high and low estradiol (E2) and stress conditions. Rats received daily injections of low (LE) or high (HE) dose E2 and were subjected to forced swim (FS) or sham swim conditioning for 3days. The results revealed marked lamina-specificity in that HE rats displayed enhanced TMJ-evoked activity in superficial, but not deep, laminae independent of stress conditioning. By contrast, FS conditioned rats displayed increased background firing and TMJ-evoked activity of neurons in deep, but not superficial, laminae independent of E2 status. FS also enhanced TMJ-evoked masseter muscle activity and suggested the importance of deep dorsal horn neurons in mediating evoked jaw muscle activity. In conclusion, E2 status and psychophysical stress play a significant role in modifying the encoding properties of TMJ-responsive medullary dorsal horn neurons with a marked lamina-specificity.

Changes in activity and structure of jaw muscles in Parkinson's disease model rats

Parkinson's disease (PD), a major neurological disease, is characterised by a marked loss of dopaminergic neurons in the substantia nigra. Patients with PD frequently show chewing and swallowing dysfunctions, but little is known about the characteristics of their stomatognathic functions. The purpose of this study was to evaluate the influence of PD on jaw muscle fibre and functions. PD model rats were made by means of the injection of 6-hydroxydopamine (6-OHDA) into the striatum of 8-week-old Sprague-Dawley male rats. Five weeks after the injection, a radio-telemetric device was implanted to record muscle activity continuously from the superficial masseter and anterior belly of digastric muscles. Muscle activity was recorded for 3days and was evaluated by the total duration of muscle activity per day (duty time). After recording the muscle activities, jaw muscles were isolated for immunohistochemical and PCR analyses. In PD model rats, the following findings of the digastrics muscles verify that compared to the control group: (i) the higher duty time exceeding 5% of the peak activity level, (ii) the higher expression of the mRNA of myosin heavy chain type I, and (iii) the tendency for fast to slow fibre-type transition. With respect to the masseter muscle, there were no significant differences in all analyses. In conclusion, PD leads to the changes in the jaw behaviours, resulting in a PD-specific chewing and swallowing dysfunctions.

Influence of malocclusion on the development of masticatory function and mandibular growth

To verify the hypothesis that appropriate acquisition of masticatory function and normal growth of the mandible are modified by malocclusion. Eighteen Jcl:ICR mice were divided into two groups. In one group we shifted the mandible laterally using an occlusal guidance appliance, creating a posterior crossbite at 5 weeks of age. The other group served as control. After 10 weeks, three-dimensional jaw movements and muscle activities were recorded simultaneously during mastication. Microcomputed tomography scans were obtained in vivo to evaluate morphometric changes in the mandible. (1) The jaw movement pattern in the sagittal plane showed significantly less anteroposterior excursion in the malocclusion group during the late-closing phase (power phase). (2) Electromyography showed significantly less masseter activity in the malocclusion group. (3) The condylar width and mandibular bone mineral density (BMD) were significantly reduced in the malocclusion mice compared to the normal mice. These findings suggest that optimization of the chewing pattern and acquisition of appropriate masticatory function is impeded by malocclusion. Altered mechanical loading to the mandible may cause significant reduction of condylar width and mandibular BMD.

Longitudinal evaluation of jaw muscle activity and mandibular kinematics in young patients with Class II malocclusion treated with the Teuscher activator

Objectives: A longitudinal study was performed to evaluate the jaw muscle activity and mandibular kinematics after Teuscher activator treatment and at 2 years after orthodontic treatment completion. Material and Methods: Twenty-seven children with Class II division 1 malocclusion were evaluated before treatment (T0; mean: 11.6 years), after functional treatment (T1; mean: 12.8 years), and 2 years after orthodontic treatment (T2; mean: 18 years). Bilateral surface electromyographic activities of the anterior temporalis, posterior temporalis, masseter, and suprahyoid muscle areas were analyzed at rest and during clenching, swallowing, and mastication. Kinematic recordings of the mandibular maximum opening, lateral shift, right and left lateral excursions, and protrusion were evaluated. Results: Compared to T0, the left masseter activity during clenching was decreased at T1 but increased at T2, similar to the other evaluated muscles. The suprahyoid activity during swallowing was increased at T1 but decreased at T2. The masseter activity during mastication was increased at T1 and further increased at T2. The left and right lateral excursions and protrusion did not show significant changes throughout the experiment. Conclusions: Teuscher activator and subsequent fixed orthodontic treatment improved jaw muscle function; however, a long period was needed to attain complete neuromuscular adaptation. Key words:Class II malocclusion, jaw muscles, mandibular kinematics, sEMG, Teuscher activator.

Fusion of locomotor maneuvers, and improving sensory capabilities, give rise to the flexible homing strikes of juvenile zebrafish

At 5 days post-fertilization and 4 mm in length, zebrafish larvae are successful predators of mobile prey items. The tracking and capture of 200 μm long Paramecia requires efficient sensorimotor transformations and precise neural controls that activate axial musculature for orientation and propulsion, while coordinating jaw muscle activity to engulf them. Using high-speed imaging, we report striking changes across ontogeny in the kinematics, structure and efficacy of zebrafish feeding episodes. Most notably, the discrete tracking maneuvers used by larval fish (turns, forward swims) become fused with prey capture swims to form the continuous, fluid homing strikes of juvenile and adult zebrafish. Across this same developmental time frame, the duration of feeding episodes become much shorter, with strikes occurring at broader angles and from much greater distances than seen with larval zebrafish. Moreover, juveniles use a surprisingly diverse array of motor patterns that constitute a flexible predatory strategy. This enhances the ability of zebrafish to capture more mobile prey items such as Artemia. Visually-guided tracking is complemented by the mechanosensory lateral line system. Neomycin ablation of lateral line hair cells reduced the accuracy of strikes and overall feeding rates, especially when neomycin-treated larvae and juveniles were placed in the dark. Darkness by itself reduced the distance from which strikes were launched, as visualized by infrared imaging. Rapid growth and changing morphology, including ossification of skeletal elements and differentiation of control musculature, present challenges for sustaining and enhancing predatory capabilities. The concurrent expansion of the cerebellum and subpallium (an ancestral basal ganglia) may contribute to the emergence of juvenile homing strikes, whose ontogeny possibly mirrors a phylogenetic expansion of motor capabilities.

睡眠中における咀嚼リズム発生に関わる神経網の実験的賦活

睡眠中における咀嚼リズム発生に関わる神経網の実験的賦活

Effect of contingent electrical stimulation on jaw muscle activity during sleep: A pilot study with a randomized controlled trial design

Objective. To determine the effect of contingent electrical stimulation (CES) on jaw muscle activity during sleep in a double-blinded randomized controlled trial (RCT). Materials and methods. Eleven patients with myofascial TMD (mean age 37 years) and with a clinical diagnosis of bruxism were included. EMG activity (Grindcare®) was recorded from the anterior temporalis muscle during sleep and analyzed online. Jaw muscle activity related to clenching or grinding triggered an electrical square-wave pulse train (450 ms) adjusted to a clear, but non-painful intensity. TMD patients were randomized into two groups: active treatment with CES or no CES (placebo). Number of EMG episodes/hour sleep was the primary outcome parameter. The following variables were assessed as secondary outcome parameters; number of painful muscles, maximum pain-free jaw opening, characteristic pain intensity, depression scores and Oral Health Impact Profile scores. Numerical Rating Scale scores for self-reported pain and muscle tension were registered for at least 4 nights per week during the experiment. Results. The number of EMG episodes/hour sleep was significantly reduced (52 ± 12%) in the CES group during the sessions with CES (ANOVA: p = 0.021) compared to baseline. There were no significant differences in the secondary outcome parameters (ANOVA: p > 0.513) or pain or muscle tension scores between groups (p = 0.645). The average duration of sleep hours during the nights with and without CES was not significantly different (p = 0.646). Conclusions. These results demonstrate a significant inhibitory effect of CES on jaw muscle EMG activity during sleep in a RCT, but with no effects on self-reported pain.

Bruxism defined and graded: an international consensus

To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined bruxism as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism has two distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism). For the operationalisation of this definition, the expert group proposes a diagnostic grading system of 'possible', 'probable' and 'definite' sleep or awake bruxism. The proposed definition and grading system are suggested for clinical and research purposes in all relevant dental and medical domains.