Masticatory Muscles In Patients Research Articles

Ultrasonographic examination of masticatory muscles in patients with TMJ arthralgia and headache attributed to temporomandibular disorders.

This study used ultrasonography to compare the thickness and cross-sectional area of the masticatory muscles in patients with temporomandibular joint arthralgia and investigated the differences according to sex and the co-occurrence of headache attributed to temporomandibular disorders (HATMD). The observational study comprised 100 consecutive patients with TMJ arthralgia (71 females and 29 males; mean age, 40.01 ± 17.67years) divided into two groups: Group 1, including 86 patients with arthralgia alone (60 females; 41.15 ± 17.65years); and Group 2, including 14 patients with concurrent arthralgia and HATMD (11 females; 33.00 ± 16.72years). The diagnosis of TMJ arthralgia was based on the diagnostic criteria for temporomandibular disorders. The parameters of the masticatory muscles examined by ultrasonography were subjected to statistical analysis. The pain area (2.23 ± 1.75 vs. 5.79 ± 2.39, p-value = 0.002) and visual analog scale (VAS) score (3.41 ± 1.82 vs. 5.57 ± 12.14, p-value = 0.002) were significantly higher in Group 2 than in Group 1. Muscle thickness (12.58 ± 4.24mm) and cross-sectional area (4.46 ± 2.57 cm2) were larger in the masseter muscle than in the other three masticatory muscles (p-value < 0.001). When examining sex-based differences, the thickness and area of the masseter and lower temporalis muscles were significantly larger in males (all p-value < 0.05). The area of the masseter muscle (4.67 ± 2.69 vs. 3.18 ± 0.92, p-value = 0.004) and lower temporalis muscle (3.76 ± 0.95 vs. 3.21 ± 1.02, p-value = 0.049) was significantly smaller in Group 2 than in Group 1. An increase in VAS was significantly negatively correlated with the thickness of the masseter (r = - 0.268) and lower temporalis (r = - 0.215), and the cross-sectional area of the masseter (r = - 0.329) and lower temporalis (r = - 0.293). The masseter and lower temporalis muscles were significantly thinner in females than in males, and their volumes were smaller in patients with TMJ arthralgia and HATMD than in those with TMJ arthralgia alone. HATMD and decreased masseter and lower temporalis muscle volume were associated with increased pain intensity.

Assessment of the functional state of the chewing muscles in patients with a changeable bite who use chewing gum

INTRODUCTION. The relevance of the study is related to the increased uncontrolled consumption of chewing gum by children.AIM. The aim is to study the functional state of masticatory muscles in patients with changeable dentition using chewing gum in different modes.MATERIALS AND METHODS. The study was carried out on 31 children, the average age of whom was 8.5 ± 1.2 years. It is at this age there is an active formation of facial morphology, which is directly related to the activity of the masticatory muscles. Therefore, it is very important to assess the condition of the masticatory musculature in order to timely identify imbalance in muscle activity, hypo and hypertonus of the musculature and to start therapy. Electromyographic study was performed on the Synapsis apparatus.RESULTS. There is a violation of coordination in the work of masticatory muscles with predominance in the work in the right temporal muscle and left proper masticatory muscle. This is due to the fact that additional chewing was present in this group.CONCLUSION. The provided analysis of masticatory function showed that children who frequently use chewing gum have a pronounced discoordination and imbalance in the work of masticatory muscles.

Evaluation of the thickness of masticatory muscles in patients with chronic periodontitis by ultrasonography.

Periodontitis is one of the most common chronic inflammatory diseases. It causes changes in the biting abilities of individuals. However, periodontal treatment has positive effects on masticatory function. The aim of this study is to determine the effect of periodontitis and periodontal treatment on masticatory abilities by measuring masseter and temporal muscle thicknesses with ultrasonography before and after periodontal treatment in chronic periodontitis patients. The patients included in the study were determined by clinical and radiological examination. The thickness of the masseter and temporal muscles of the patients were measured by ultrasonography. Periodontal measurements and treatments of the patients were completed by a single physician. IBM SPSS 20.0 (IBM Corp., Armonk, NY) statistical program was used for statistical analysis. A statistically significant difference was found between the values of periodontal measurements before and after treatment (p<0.05). In the ultrasonography measurements of the thickness of masseter and anterior temporal muscles, a statistically significant increase was observed in both rest and contraction values at all time intervals (p<0.05). Muscle thicknesses of male patients were higher than female patients. Periodontitis negatively affects the masticatory performance of individuals. Chronic periodontitis patients should be referred for periodontal treatment without wasting time.

Клінічне та патофізіологічне обґрунтування доцільності застосування функціональної терапії при лікуванні больової дисфункції скронево-нижньощелепних суглобів

Summary: Our study made it possible to trace and analyze the changes in the masticatory muscles of patients that occur during the treatment of temporomandibular joint dysfunction (TMJ) and testify to its effectiveness. In patients with TMJ dysfunction, the qualitative and quantitative indicators of electromyography are closely correlated with the stages of development of the pathology and correspond to its clinical manifestations. In this study, for the first time, the relationship between the change in the parameters of the frequency of muscle contractions and the subjective feeling of pain in the area of the specified masticatory muscle in patients was analyzed. The aim of this study is to study and compare the nature and degree of changes in the electromyographic activity of the main and auxiliary masticatory muscles in patients with TMJ dysfunction before and after the use of myorelaxing splints. Research materials and methods. A five-year study of patients with TMJ dysfunction (92 people). A total of 342 electromyograms before and during the stages of patient treatment were submitted to the overall analysis. The results of the analysis of the effectiveness of the use of myorelaxation splints in the treatment of TMJ dysfunction allow to improve the quality of treatment of this pathology in patients. The results obtained after 6 months indicate that the effectiveness of the treatment of CG I patients (with the lowest intensity of TMJ dysfunction symptoms) reached 89.1±1.3%; CG II - up to 78.3±1.3%; CG III – 77.3±1.3%. Key words: electromyography, dysfunction, temporomandibular joint, masticatory muscles, bioelectric activity, bioelectric rest, myorelaxation splint, occlusion

Evaluation of the efficiency of the method of biological feedback in complex therapy of patients with hypertonus of the chewing muscles

The study included 40 patients aged 20 to 32 years with complaints of fatigue and discomfort in the area of chewing muscles, teeth compression during the day, nocturnal bruxism, crowding of teeth. Two groups were formed: the study group, whose patients underwent splint therapy in combination with biofeedback therapy trainings; in the control group, patients received treatment with splint therapy without the use of biofeedback therapy. Electromyography of the masticatory muscles at rest and during compression were used to diagnose hypertonicity of the masticatory muscles. To assess the psycho-emotional state, a medical and social questionnaire was conducted using questionnaires: «Health Questionnaire», Beck Depression Inventory, Spielberger-Khanin Anxiety Scale, SF-16 Quality of Life Scale. A decrease in the level of depression, anxiety was revealed with the stabilization of emotional sensitivity in relation to other people, emotional involvement in everyday life, and an increase in the quality of life. When comparing electromyographic data at rest and during clenching of teeth in patients of the study group the indicators were lower than in the control group. The effectiveness of biofeedback therapy at the stages of orthodontic treatment using splint therapy was established in the form of a decrease in the activity of masticatory muscles in patients of the study group. In the control group, the index of masticatory muscle activity decreased to a lesser extent. Biofeedback methods have shown a high level of effectiveness in reducing the symptoms of anxiety and depression, improving the quality of life.

Effect of pre-orthodontic trainer treatment on the masticatory and perioral muscles in patients with class II subdivision 1 malocclusion evaluated by surface EMG.

Myofunctional appliances have been shown to have a positive effect on the muscles in the facial area. Surface electromyography (sEMG) is one of the reliable methods used to investigate these effects.

BRUXCHECKERS-АНАЛИЗ ПАРАФУНКЦИОНАЛЬНОЙ АКТИВНОСТИ ЖЕВАТЕЛЬНЫХ МЫШЦ У ПАЦИЕНТОВ C АБФРАКЦИОННЫМИ ДЕФЕКТАМИ ЗУБОВ

In order to improve the quality of diagnostics of the state of the dental system of patients with abfractive defects of teeth, the features of the dental status of 128 patients aged 30-49 years were studied. The study of dental status included generally accepted methods (complaints, anamnesis, examination) and functional analysis of occlusive-articulatory relationships of dentition with the use of BruxChecker diagnostic mouthguards. A high frequency of complaints of hypersensitivity of teeth has been established. Significant symptoms were functional overload, enamel cracks, pathological tooth abrasion. The periodontal condition of teeth with abfractive defects was characterized by a roller-like gum recession without inflammation of the gingival margin and periodontal pockets. Comparative Bruxcheckers analysis by Fisher's exact criterion of the parafunctional activity of the masticatory muscles revealed significantly significant differences F=21.702 (p &lt;0.001) between the examined with abfractive defects of teeth (average class 5.06±0.4) and intact teeth (average class 1.81±0.2). BruxChecker-analysis of the topography of occlusal contacts of teeth during nocturnal movements of the lower jaw confirmed the assumption of the presence of parafunctional activity of the masticatory muscles in patients with abfractive defects of teeth. The highest percentage of observations occurred in the fifth (28.9%, 95% CI:21.1-36.8) and sixth (42.2%, 95% CI: 33.6 – 50.7) classes. This indicated that the chewing system was in the stage of decompensation. The obtained data substantiate the inclusion in the algorithms of treatment of patients with abfractive defects of methods for eliminating sensitivity and restoring the anatomical shape of teeth with preliminary correction of the parafunctional activity of the dental system.

Pressure release technique versus placebo applied to cervical and masticatory muscles in patients with chronic painful myofascial temporomandibular disorder: A randomised clinical trial.

The therapeutic approach to myofascial TMD should focus on pain relief and rehabilitation of function. This study investigated whether pressure release technique (PRT) is effective for reducing pain in people with chronic myofascial temporomandibular disorders (TMD). A single-blinded randomised parallel-group trial, with 3 months follow-up was conducted. A total of 72 patients were randomly allocated to receive PRT or sham PRT. Primary outcome was pain assessed with a visual analogue scale (VAS). Secondary outcomes included pressure pain thresholds (PPTs), range of opening of the mouth (ROM), Neck Disability Index (NDI), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK-11), State-Trait Anxiety Index (STAI) and State-Trait Depression Index (ST-DEP). All parameters were assessed at baseline, at the end of the treatment and at 3 months follow-up. Statistical analysis was performed by ANOVA. There were significant main effects of time, group and interaction between time and group (F ≥ 21.92; p < .001) on VAS pain. Post hoc tests showed a significant reduction in VAS pain scores in the PRT group (≥31.9%; p < .001). Effect sizes were moderate in the PRT group at all follow-up periods (≥1.25 Cohen's d). Also, there were significant effects of time in secondary outcomes (F ≥ 9.65; p < .001), and there were also interactions between time and group (F ≥ 3.82; p < .002) with better effects in the PRT group. The inclusion of PRT to conventional management with occlusal splints and self-care management appears to be effective to improve self-reported levels of pain in patients with chronic myofascial TMD pain. Retrospectively registered (ClinicalTrials.gov: NCT03619889).

Ultrasound assessment of the state of the masticatory muscles in patients with injuries of the lower jaw with various methods of surgical treatment

Summary. The paper presents a comparative analysis of the results of ultrasound examination of the masticatory muscles proper in patients with fractures of the branch and articular process of the lower jaw at various stages of treatment using the endoscopic method and traditional osteosynthesis.Research objective. To assess the morphological state of the masticatory muscles in patients with a fracture of the branch and articular process of the lower jaw using the endoscopic method and traditional osteosynthesis using ultrasound technologies.Resources and Methods. The results of ultrasound examination of the masticatory muscles in 82 patients with a fracture of the branch and articular process of the lower jaw, hospitalized in N.I. Pirogov State Clinical Hospital No. 1 for 2021, were analyzed.Research results. Based on the results of an ultrasound examination of patients aged 19 to 40 years with a mandibular fracture, it was found that the use of intraoral access using endoscopic technologies contributes to an earlier normalization of the morphological state of the masticatory muscles proper compared to traditional osteosynthesis.

DYNAMICS OF CHANGES IN THE ELECTROMYOGRAPHIC INDICATORS OF MASTICATING MUSCLES DURING THE PROSTHETIC REHABILITATION OF PATIENTS WITH PATHOLOGICAL ABRASION OF TEETH WHEN USING REMOVABLE PARTIAL FIXED DENTURES

Pathological abrasion of teeth is a fast process, accompanied by changes in the dental tissues and tissues of periodontium, as well as a disorder of the functions of the masticatory muscles and TMJ (temporomandibular joint). According to different authors, the prevalence of pathological abrasion of hard dental tissues ranges from 4% to 57% at a younger age and reaches 91% in the elderly age. The difficulties of prosthetic rehabilitation of this category of patients are caused by combined morpho-functional disorders. Therefore, the ability to assess the condition of the masticatory muscles is quite important for the further development of the doctor's actions and the preparation of a treatment plan.&#x0D; The aim of the study was to determine the state of the masticatory muscles using electromyographic studies in individuals with a generalized form of pathological abrasion, namely, with those forms which are combined with defects of dental rows of different localization before treatment and in the distant periods after treatment compared to the norm.&#x0D; For clinical assessment of the quality of prosthetic results, we recruited a clinical observation group and a control group. All patients of the clinical group were made constructions of removable partial fixed dentures. To achieve the aim, we used the electromyographic recording of the masticatory muscles’ biopotentials during the masticatory movements in the specified time.&#x0D; The results of our research work indicate that after 1 year of use of the above-mentioned dentures, the amplitude indicator during voluntary compression is 602.92±5.98 μV, which is close to the norm (641.58±10.01 μV) and almost three times more than before using this type of dentures (191.16±9.16 μV). A similar pattern is observed during voluntary chewing: the amplitude approaches the norm (643.92±9.11 μV) and is 628.54±5.77 μV compared to the results before using dentures (203.86±9.21 μV).&#x0D; The integral indicator of electromyographic research (coefficient “K”) which shows the neuro-reflex activity of the masticatory muscles in patients who used removable partial fixed dentures evidenced a tendency towards positive dynamics of changes in this indicator (1.02±0.01 in the norm versus 1.31 ±0.06 after 1 month, 1.20±0.04 after 6 months and 1.06±0.02 after 1 year).

Effect of manual physical therapy on sleep quality and jaw mobility in patients with bruxism: A biopsychosocial randomized controlled trial.

This study aimed to investigate the effects of deep-stripping and trigger-point pressure release massage on the Pittsburgh Sleep Quality Index (PSQI), jaw mobility, and pressure pain threshold (PPT) of masticatory muscles in patients with sleep bruxism. A randomized controlled trial was conducted among 45 patients diagnosed with sleep bruxism. The patients were randomly assigned to three groups. Group I was the control group and included five men and 10 women; Group II was the deep-stripping massage group, which included two men and 13 women; and Group III was the pressure release group, which involved four men and 11 women. Patients were tested two times, before and after 6 weeks. Group I received transcutaneous electrical nerve stimulation and passive stretching; Group II received a deep-stripping massage; and Group III received a trigger-point pressure release massage. Findings revealed significant improvements in PSQI (p = 0.0001), jaw opening (p = 0.0001), jaw protrusion (p = 0.0001), jaw left lateral movement (p = 0.004), jaw retraction (p = 0.0001), right temporalis PPT (p = 0.0001), left temporalis PPT (p = 0.0001), right master PPT (p = 0.001), left master PPT (p = 0.001), right lateral pterygoid PPT (p = 0.001), left lateral pterygoid PPT (p = 0.001), right digastric muscle PPT (p = 0.001), and left digastric muscle PPT (p = 0.001) in the post-test condition in Group II compared with Group I and Group III. Deep-stripping massage improved PSQI, jaw mobility, or PPT of the masticatory muscles compared with trigger-point pressure release massage and traditional treatment techniques in patients with sleep bruxism.

Comparative study of surface electromyography of masticatory muscles in patients with different types of bruxism.

BACKGROUNDBruxism is a rhythmic masticatory muscle activity that occurs involuntarily in a non-physiologically functional state. There is a lack of research classifying the functional status of masticatory muscles in patients with different mandibular movement types (centric clenching or eccentric grinding) of bruxism.AIMTo assess the differences of the masticatory muscle activity in patients with different types of bruxism.METHODSA total of 21 subjects with centric bruxism (CB) and 21 subjects with eccentric bruxism (ECB) were screened from college students according to a questionnaire and their tooth wear features. Sixteen subjects with no bruxism were also recruited. The surface electromyography (EMG) signals of the temporalis anterior (TA) and superficial masseter muscle (MM) were measured in different mandibular positions and during the chewing task. The EMG amplitude and chewing cycle duration parameters were then analyzed.RESULTSThe CB group showed fewer muscle maximal motor units, with the MM being more pronounced, a higher proportion of muscle contractions to be recruited for the same load of chewing activity, and a longer chewing cycle. The ECB group showed more TA maximal motor units and higher MM activity on the non-working side in unilateral chewing.CONCLUSIONCB mainly affects the MM, and patients with CB show reduced masticatory muscle contraction efficiency and chewing cycle efficiency. ECB mainly affects the TA, and patients with ECB show enhanced contraction of non-functional lateral muscle bundles.

Use of Intermaxillary Traction Appliances and Exercises to Strengthen the Masticatory Muscles of Patients with Anterior Open Bite Caused by Temporomandibular Joint Osteoarthritis: Case Reports

Use of Intermaxillary Traction Appliances and Exercises to Strengthen the Masticatory Muscles of Patients with Anterior Open Bite Caused by Temporomandibular Joint Osteoarthritis: Case Reports

EMG-CHARACTERISTICS OF MASTICATORY MUSCLES IN SUBJECTS WITH BRUXISM

Today, bruxism is a fairly common phenomenon. Bruxism is often defined as the parafunctional activity of the masticatory and facial muscles. Parafunction is called increased inappropriate activity, tension or even spasm of the masticatory and facial muscles, as well as the muscles of the tongue. However, the peculiarity of the work of masticatory muscles during the day in patients with signs of bruxism remains insufficiently studied.&#x0D; The aim of our study was to determine the features of EMG-activity of masticatory muscles in patients with bruxism.&#x0D; Materials and methods of research. We performed a clinical examination and superficial electromyography (EMG) of the masticatory muscles in 13 subjects aged 25 to 43 years. There were 7 women (53.8%), 6 men (46.2%). All examined subjects were somatically healthy, had no bad habits and defects of the dental arches. The mean age of the subjects was 32.5 ± 5.4 years. In the sample of patients, there were clinical signs of bruxism such as pathological abrasion of the hard tissues of the teeth; point dentin exposure; cracks in tooth enamel; hyperesthesia; pain or feeling of tension and discomfort in the masticatory muscles. All patients were performed superficial electromyography of the anterior temporal and masseter muscles using a 4-channel computerized electromyograph, according to the recommendations by Ferrario V., Sforza C. Electrical biopotentials of masticatory muscles were registered in tests lasting 10 s each: maximum bilateral teeth clenching, clenching of teeth on the left side; clenching of teeth on the right side. The data obtained during the EMG were processed using Synapsis software from Neurotech. We analyzed the indicators of maximum amplitude, mean amplitude (μV) of each muscle in every test. For objective evaluation of the results, we performed electromyography of masticatory muscles of 15 subjects comparable in age and sex without clinical signs of bruxism (control group, mean age was 33.4 ± 6.1 years).&#x0D; Research results. We determined the characteristics of EMG-activity of masticatory muscles in the control group in the test of bilateral maximum teeth clenching: symmetrical activity of masseter and temporal muscles on the left and right sides (p&gt; 0.05), the value of maximum amplitude of contractions did not exceed 1200 μV. It was found higher EMG-activity of the masseter and temporal muscles on a working side, compared to a balancing one in the test of unilateral teeth clenching, that was statistically confirmed (p&lt;0,05).&#x0D; In patients with bruxism, the EMG-activity of the masticatory muscles differed from the control group. Thus, the maximum amplitude of muscle contractions in all tests was significantly higher (p &lt;0.05) among people with bruxism. EMG-activity of masseter muscles in the majority of cases (10 subjects – 76.9%) was greater than the temporal. In tests of unilateral teeth clenching, the EMG-activity of the temporal and masseter muscles was slightly higher on the working side, but the difference with the indicators on the balancing side was not statistically confirmed (p&gt; 0.05). We found the peculiarity of the EMG-activity of the masticatory muscles in subjects with bruxism: the presence of pathological rhythmic peaks of activity in the resting phase. Differences in the indicators of EMG-activity between the subjects with bruxism and control group were evaluated using analyses of Student’s paired t-test. The hypotheses were verified at the level of significance p&lt;0,05.&#x0D; Conclusions. Bruxism is a complex problem of the whole human body, characterized by neuromuscular activity. In our study, some features of EMG-activity of masticatory muscles were studied and established. Patients with clinical signs of bruxism had significantly higher values of maximum, mean amplitude, which are 2.3-3.5 times higher than normal. In most cases, the EMG-activity of the masseter muscles was higher than the temporal. Presence of pathological rhythmic peaks of activity in the resting phase was found. In the future, it is planned to study individual changes in EMG-activity of masticatory muscles in patients with bruxism at different stages of total dental rehabilitation.

Assessment of the bioelectric activity of the masticatory muscles in orthopedic treatment with partial removable plate prostheses

Relevance. According to a number of authors, it is known that full adaptation to complete removable dentures occurs within 3 months [3–5, 9]. The main criterion for patients getting used to removable dentures is the synchronization of the work of the masticatory muscles and, as a consequence, the normalization of the chewing function. The aim of the study was to evaluate the bioelectrical activity of the masticatory muscles in patients using the CSPP.Materials and methods. In patients of the control (n = 23) and main (n = 63) groups, electromyographic examination was performed using the electroneuromyographic system "Synapsis" (Neurotechnology, Russia). Registration of the bioelectric activity of the chewing muscles was carried out directly on the day of applying the prostheses, after 1 and 3 months, respectively.Results and discussion. The electromyographic indices of the masticatory muscles in the patients of the control group decreased within one month after the treatment and amounted to 231 ± 18.2 μV for the right and 229 ± 16.1 μV for the left proper chewing muscles. The values were also reduced for the right and left temporal muscles – 228 ± 15.2 μV and 225 ± 24.1 μV (p &lt; 0.05). It should be noted that the electromyographic parameters in patients of the main group were comparable to the lower limit of the norm and amounted to 269 ± 16.5 μV and 256 ± 20.4 μV, respectively, after one month of treatment.Conclusions. In the treatment of dysfunction of the temporomandibular joint with the use of thermoplastic prostheses, an increase in the biopotentials of the masticatory muscles is observed. In the orthopedic treatment of patients with terminal dentition defects using thermoplastic prostheses, the electromyographic parameters of the masticatory muscles are most close to normal after 3 months of using these prostheses.

Effects of Therapeutic and Aerobic Exercise Programs on Pain, Neuromuscular Activation, and Bite Force in Patients with Temporomandibular Disorders.

Pain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles’ pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles’ pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.

Temporomandibular Disorder Patients Benefit From Intramuscular Botulinum Toxin Type a Injections.

The aim of this study was to analyze the clinical outcome of the use of botulinum toxin type A (BTX) intramuscular injections to the head and neck, particularly the masticatory muscles of patients with temporomandibular disorder (TMD). The medical records of all patients who had received intramuscular BTX injections between 2005 and 2018 at Päijät- Häme Central Hospital, Lahti, Finland were analyzed retrospectively. Gender, age, previous medical history, number of injections, injection areas, and therapeutic results were collected and analyzed. The outcome was divided into three categories based on the patients' subjective reports: not beneficial, beneficial, and highly beneficial. A total of 68 patients had received intramuscular BTX injections in our unit for TMD symptoms. Clinical effectiveness could be analyzed from 63 patients. Overall, 87% of them reported fävorable outcomes. 8 (13%) reported BTX injections as not beneficial, 15 (24%) as beneficial, and 40 patients (63%) as highly beneficial.Most patients had already received conventional treatment with an occlusal splint (93%) combined with pain medication (60%) in the primary care units before they were referred to our hospital.There were 59 (83%) female patients, and they responded better to BTX therapy than the male patients: 91% versus 57% (P value = 0.04). Average age at the first BTX injection visit was 44.6 years (range 17.8-77.2). Most commonly (65%), BTX was divided bilaterally to the masseter and temporalis muscles. BTX injections had good therapeutic outcomes for our TMD patients. However, most patients require multiple injection visits.

Diagnosis of hypertonicity of the masticatory muscles at a dental appointment

Summary. The purpose of the study. Hypertonus of the masticatory muscles is a fairly common pathology that leads to the development of parafunctional masticatory activity. At the same time, the nature of the course of the pathology becomes long-lasting, leading to irreversible consequences. Patients often do not pay attention to minor pain in the area of the masticatory muscles, so hypertonus of the masticatory muscles is diagnosed randomly. In view of the variety of clinical symptoms from headaches to the phenomena of oral stomalgia, the diagnosis of hypertension is extremely difficult. Also, there is currently no single algorithm for the management of such patients.Materials and methods. In the presented scientific study, a survey of 189 patients who applied to a dental clinic for the treatment of dental caries and its complications, a professional examination was conducted. All patients were examined according to the method of diagnosis of muscle hypertonus developed by us. The methodology includes a thorough collection of anamnesis, questionnaires (PSM-25, VAS, MAS, author's methods), the use of objective research methods, including: OPTG, CT, ultrasound, the author's method of determining the degree of mouth opening.Results. Muscle hypertonus of varying severity was diagnosed in 80% of cases, high stress level on the PSM-25 scale in 71% (135), the presence of morning pain in the area of the masticatory muscles in 55%(104). An assessment of muscle tone on the MAS scale confirmed a significant increase in masticatory muscle hypertonicity in 34% of cases. These additional methods of investigation confirmed the presence of hypertonicity of the masticatory muscles in patients with an objective clinical picture. In the study of this area, the main role is played by the clinician, only if all the diagnostically valuable information is available, it is possible to formulate an optimal treatment plan and avoid aggravation of the patient's condition due to incorrect diagnosis and treatment.Conclusions. The application of the developed diagnostic method contributes to the random detection of parafunctional activity of the masticatory muscles at a dental appointment, as well as to the final diagnosis of masticatory muscle hypertonus.

Myofunctional parameters in patients using full removable dentures with progenic and prognathic ratio of the anterior segments of the edentulous jaws

The aim study was to construct artificial dentitions based on the method of mathematical modeling with the progenic and prognatic ratios of toothless frontal segments and to analyze the functional activity of the masticatory muscles in patients using dentures made in this way, compared with standard prosthetic structures. To compare and interpret the data obtained, electromyographic studies were performed in the control group (16 people), whose teeth were made using the traditional method, and the main group (22 people), whose artificial teeth were formed according to individual mathematical calculations, taking into account the size of the sagittal gap of the frontal segments of the progenic and prognatic ratio of toothless jaws. Statistical processing of the results of the electro-myographic study was carried out using the Statistica application software package. The digital data were processed by the method of variational statistics using the Student's t-test. The analysis of the obtained data showed the advantages of using individual mathematical calculations when solving the issue of tactics for constructing dentitions in the frontal segment of toothless jaws, taking into account the degree of the sagittal gap in the progenic and prognatic correlation of the jaws and their possible combinations.

СРАВНИТЕЛЬНАЯ ОЦЕНКА ПОКАЗАТЕЛЕЙ БИОЭЛЕКТРИЧЕСКОЙ АКТИВНОСТИ МЫШЦ У ПАЦИЕНТОВ СО СЪЕМНЫМИ ПОКРЫВНЫМИ ПРОТЕЗАМИ С ОПОРОЙ НА ИМПЛАНТАТЫ ПРИ ПОЛЬЗОВАНИИ В ТЕЧЕНИЕ 12 МЕСЯЦЕВ

Subject. A comparative assessment of the state of the stomatognathic system on the example of the bioelectrical activity of temporal and masticatory muscles in patients who used removable implant-supported overdentures with bar fixation system, made by two different methods: traditional and using digital methods of treatment planning and manufacturing was carried out.&#x0D; Objectives. To compare the changes of bioelectrical activity of temporal and masticatory muscles in patients with removable implant-supported overdentures made by two different methods: traditional and digital, who used dentures for a long time (12 months).&#x0D; Methods. Bioelectrical activity and symmetry of temporal and masseter muscles were investigated clinically by surface electromyography. Electromyography was performed in five probes: Rest, Light CO, Natural Swallowing, Maximal Volitional Clench (MVC) and Clench on Cotton Rolls (MVCCR).&#x0D; Results. In patients using overdentures produced in traditional way, no normal values of muscle activity were observed in any of the probes at the end of the study. In patients who used overdentures, made with the use of digital technologies, we noted a decrease of bioactivity of the muscles in the probes of Rest and Light CO, and an increase of biopotentials in the probes of MVC and MVCCR. The values obtained at the end of the study were characterized as normal or acceptable.&#x0D; Conclusions. The application of a digital method of treatment planning and fabrication of removable implant-supported overdentures with a bar fixation system allows to achieve more physiological values of temporal and masticatory muscles biopotentials, which can be interpreted as recovery of the functional integrity of the stomatognathic system.