Bruxism, characterized by involuntary teeth grinding and jaw clenching, is an uncommon but likely underrecognized adverse effect of selective serotonin reuptake inhibitors. Sertraline is generally considered safe for anxiety disorders, yet individual pharmacogenetic variability in CYP2C19 and CYP2D6 may predispose to serotonergic-dopaminergic imbalance and movement disorders. We describe a 42-year-old Indian woman with generalized anxiety disorder (baseline HAM-A 32) who was started on sertraline 25mg/day and titrated to 50mg/day on day 5. About 10days after initiation, she developed severe bruxism with jaw pain despite clear clinical improvement in anxiety (HAM-A 12). The patient's bruxism was predominantly awake bruxism, characterized by daytime jaw clenching and teeth grinding during stressful periods. A dental evaluation ruled out occlusal abnormalities, temporomandibular joint inflammation, and tooth wear, and a mouthguard was deemed ineffective. A dechallenge with tapering and discontinuation of sertraline led to the resolution of jaw pain and reduction in bruxism. Pharmacogenetic testing showed CYP2C19*2/*17 (intermediate metabolizer) and CYP2D6*2/*41 (normal metabolizer). On the basis of Clinical Pharmacogenetics Implementation Consortium recommendations, she was switched to venlafaxine 37.5mg twice daily, which achieved anxiety remission (HAM-A 6), but mild teeth grinding persisted. Adjunctive buspirone 5mg/day led to complete resolution within 4weeks. The temporal relationship, improvement on withdrawal, and a Naranjo score of 9 supported a probable sertraline-induced bruxism. This case highlights sertraline-induced bruxism as a less commonly recognized but clinically significant adverse drug reaction. It shows that pharmacogenetic-guided antidepressant selection, combined with buspirone augmentation, can optimize management in selective serotonin reuptake inhibitor-associated bruxism. Clinicians should screen for bruxism during early sertraline titration, especially in patients with CYP2C19-reduced function alleles.

Objectives: Strong cervical musculature is recognized as a protective factor against sports-related concussions. Evidence suggests that jaw clenching may activate cervical muscles, potentially reducing head acceleration during impact. Methods: This observational cohort study examined the immediate effects of a customized interocclusal orthotic (CIO) on cervical muscle performance. Forty-two healthy adults (≥18 years) underwent strength and endurance testing with and without a CIO using a digital pressure gauge and six directional isometric contractions. Descriptive statistics and two-way repeated-measures MANOVA models were applied to evaluate condition effects. Results: CIO use produced significant improvements in cervical muscle strength and endurance across all directions compared to non-use. Forward flexion strength increased by 12.96% (p < 0.001, ηp2 = 0.185), backward extension by 10.34% (p = 0.017, ηp2 = 0.091), right rotation by 19.03% (p < 0.001, ηp2 = 0.333) and left rotation by 19.86% (p < 0.001, ηp2 = 0.353). Endurance gains demonstrated large effect sizes, with flexor endurance improving by 44.57% (p < 0.001, ηp2 = 0.447). Conclusions: Optimized jaw alignment using a customized orthotic can elicit immediate, clinically meaningful enhancements in cervical strength and endurance, suggesting a promising adjunct for concussion risk mitigation in contact sports.

Abstract Introduction: Temporomandibular joint dysfunction (TMD) occurs from many causes including trauma, genetics, and arthritis and manifests as jaw pain, difficulty chewing, and/or lock jaw. The typical medical treatments are physical therapy, splint therapy, injections and surgery. However, osteopathic manipulative treatment (OMT) is a less explored approach and has some supporting evidence in the literature that may offer a less invasive and promising alternative. Case: A 67-year-old male was in a motor vehicle accident where he sustained jaw fractures three months prior to presenting to the Osteopathic Treatment Center with tinnitus, head injury, jaw pain with posterior right premature contact, and painful chewing. Initially, the patient was treated with maxillomandibular fixation, where pins were surgically placed for eight weeks. This was followed by intraoral osteopathic manipulative treatment (OMT), starting with osteopathic cranial manipulative medicine (OCMM), and then incorporating soft tissue techniques, myofascial release (MFR), muscle energy, and the Still technique. Discussion: This case illustrates the debilitating nature of temporomandibular joint dysfunction and how difficult it is to control and treat. TMD often requires a multimodal approach involving both conservative and invasive techniques such as utilizing OMT and the various modalities, including OCMM. The case presented here is unique due to the acute nature and development of the dysfunction and use of OMT within 3 months of his accident. Conclusion: This case study suggests that OMT can improve the quality of life for patients with TMD secondary to trauma. The use of cranial techniques followed by head and neck treatments was an effective management approach for this patient with TMD pain.

Background/Objective: Postural stability and motor coordination require precise regulation of agonist and antagonist muscle activities. Jaw clenching modulates neuromuscular control during static and reactive postural tasks. However, its effects on dynamic voluntary movement remain unclear. This pilot study aimed to investigate the effects of jaw clenching on muscle activity and kinematics during repetitive single-leg sit-to-stand task performance. Methods: Eleven healthy adults (age: 21.2 ± 0.4 years; 6 males and 5 females; height: 167.9 ± 9.6 cm; body weight: 59.7 ± 8.1 kg) performed repetitive single-leg sit-to-stand tasks for 30 s under jaw-clenching and control conditions. Electromyography (EMG) signals from eight muscles and kinematic data from 16 inertial measurement unit sensors were analyzed, focusing on the seat-off phase. Results: Jaw clenching resulted in a significantly lower success rate than the control condition (success rate: 0.96 ± 0.13 vs. 0.78 ± 0.29, p = 0.047). Under the jaw clenching condition, failed trials exhibited higher medial gastrocnemius and masseter EMG activity (p &lt; 0.001), lower erector spinae longus EMG activity (p &lt; 0.001), and altered kinematics, including increased trunk yaw and roll angles (p &lt; 0.001). Jaw clenching increased the coactivation of the gastrocnemius and tibialis anterior muscles (p &lt; 0.001), disrupting the reciprocal muscle patterns critical for task performance. Conclusions: These findings suggest that jaw clenching may reduce task performance by altering neuromuscular coordination during dynamic postural tasks.

Although mouth guards are traditionally used to prevent oral injury in contact sports, recent studies suggest that they can also contribute to improved performance in terms of strength, aerobic and anaerobic performance, agility, balance and flexibility. This improved performance is thought to be achieved by changes in the position of the temporomandibular joint, increasing the vertical dimension of the occlusion and the occurrence of the concurrent activation potentiation phenomenon as a result of jaw clenching. Based on the available literature, it can be concluded that custom-made mouth guards result in better performance in sports than boil-and-bite or standard mouth guards. In general, they will not negatively affect sports performance. Although it is not readily possible to predict whether and to what extent wearing a mouthguard will have a positive effect on individual athletes, athletes and coaches should be encouraged to consider the use of mouthguards not only from the perspective of safety, but also from the perspective of their potential performance-enhancing value.

ABSTRACTBackgroundSleep‐related and neuromuscular conditions affect the daily lives of individuals as they impact physical and cognitive well‐being. While not classified as a disorder, bruxism has emerged as a prevalent condition characterized by involuntary teeth grinding and jaw clenching, occurring either during sleep or wakefulness. Often left unnoticed, this unconscious behavior can contribute to severe dental damage, facial muscle fatigue, and temporomandibular joint disorders. These consequences require early detection and intervention to prevent long‐term complications. Traditionally, polysomnography (PSG) is widely used for bruxism assessments as it gives insights into the multimodal physiological data, but it lacks direct spatial mapping of neural regions involved in rhythmic masticatory muscular activity (RMMA) associated with bruxism.MethodologyThis research introduces functional Near Infrared Spectroscopy (fNIRS) as a neuroimaging tool to monitor cortical activity associated with RMMA, distinguishing bruxism from other masticatory activities. The data were acquired in a controlled simulated paradigm setup from 10 subjects in three trials via a 20‐channeled optode setup of fNIRS placed over the motor cortex region. A total of 12 temporal and frequency domain features were optimized by employing techniques of feature selection, feature importance, and feature reduction. Furthermore, synthetic data augmentation techniques of Synthetic Minority Oversampling Technique (SMOTE), Synthetic Minority Oversampling Technique for Nominal features (SMOTEN), and Adaptive Synthetic sampling (ADASYN) were compared to five machine learning classifiers including k‐Nearest Neighbors (kNN), Logistic Regression (LR), Naive Bayes (NB), Decision Tree (DT), and Random Forest (RF).ResultsThe kNN outperformed in detecting simulated bruxism among other mandible joint movements with an accuracy of 92%.ConclusionThe findings highlight the potential of fNIRS as a tool for identifying and distinguishing bruxism‐like motor activities from other jaw movements, contributing to the timely management and detection of bruxism in future studies.

Background: Obsessive-Compulsive Disorder (OCD) is defined by intrusive thoughts and repetitive actions. Although the cognitive and emotional aspects of OCD have been extensively examined, the physical aspect—especially compulsive behaviors related to the orofacial region—has not received as much attention. Objective: This narrative, based on hypotheses, investigates the possible connection between chronic orofacial compulsions in OCD and the progression of dental misalignment and temporomandibular joint disorders. Methods: A theoretical framework is presented that combines insights from psychiatry, neurology, and dental sciences to analyze how behaviors like jaw clenching, biting of lips or cheeks, and attempts at achieving symmetry may induce structural alterations in dental health over time. Results: The proposed model indicates that persistent low-level mechanical stress from habitual orofacial actions could contribute to enamel erosion, periodontal damage, changes in occlusion, and joint dysfunction. These outcomes might serve as a physical manifestation of the severity of compulsions and muscle hyperactivity driven by anxiety. Conclusion: Identifying orofacial compulsions as a somatic expression of OCD could create new avenues for interdisciplinary prevention and treatment approaches. Additional empirical studies are necessary to confirm this association and inform cooperative management strategies between psychiatric care and dentistry.

Recently, the incidence of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been increasing. Characterized by frequent epileptic seizures, this condition threatens patients’ lives. Anti-NMDAR encephalitis is an autoimmune disorder affecting the central nervous system. In our case, a 21-year-old female who experienced four episodes of convulsions within 2 days. Seizures were manifested as loss of consciousness, upward eye deviation, jaw clenching, and limb rigidity, each resolving spontaneously within 2–5 min. Neurological examination was unremarkable, head MRI demonstrated bilateral cerebral white matter hyperintensities. Cerebrospinal fluid (CSF) analysis showed normal routine and biochemical parameters. Anti-NMDA receptor antibody IgG was detected at titers of 1:10 in CSF and 1:32 in serum. Pelvic MRI revealed a cystic-solid mass, which was surgically resected and pathologically confirmed the presence of ovarian teratoma. Following treatment with intravenous immunoglobulin, methylprednisolone, and sodium valproate, the patient’s condition improved, and the seizures resolved. Fourteen days postoperatively, seizure recurrence occurred. Repeat CSF analysis showed anti-NMDAR antibody IgG titer of 1:3.2, with a corresponding serum titer of 1:10. Plasma exchange therapy led to clinical improvement, allowing for successful discharge. Previously, the abovementioned phenomenon was described as poor response to first-line immunotherapy; however, the underlying mechanisms remain elusive, potentially contributing to elevated mortality. We first proposed the concept of “delayed encephalopathy in anti-NMDAR encephalitis,” defined as the early recurrence of epileptic seizures following completion of first-line immunotherapy. This phenomenon linked to the ambiguity surrounding clinical treatment endpoints. Establishing antibody thresholds could help define clearer treatment endpoints and reduce recurrence risk.

We present EarEOG, a real-time wheelchair control system using around-ear electrooculogram (EOG) signals. Electrodes are placed in standard over-the-ear headphones to improve user comfort. By detecting around-the-ear signals from eye gestures and jaw clenching, EarEOG offers a non-invasive and intuitive approach to low-latency wheelchair control. We describe the methods for signal acquisition, as well as the algorithms used for signal processing and classification. The feasibility, robustness, and low latency of EarEOG were confirmed through two experiments. The algorithm demonstrated a classification accuracy of 94.1% for all motion signals, which further improved to 97.3% when personalized models were applied. To ensure stability, we examined electrode impedance and algorithm accuracy across multiple trials where participants operated simulated wheelchairs while wearing EarEOG. The results indicated that when the electrode impedance was below 1 MΩ, all participants successfully controlled the simulated wheelchair. Furthermore, EarEOG demonstrated low latency, with recognition delays of less than 125 ms.

Removing artifacts from electroencephalography (EEG) signals is a common technique. Although numerous algorithms have been proposed, most rely solely on EEG data. In this study, we introduce a novel approach utilizing a hybrid convolutional neural network–long short-term memory (CNN-LSTM) architecture alongside simultaneous recording of facial and neck EMG signals. This setup enables the precise elimination of artifacts from the EEG signal. To validate the method, we collected a dataset from 24 participants who were presented with a light-emitting diode (LED) stimulus that elicited steady-state visual evoked potentials (SSVEPs) while they performed strong jaw clenching, an action known to induce significant artifacts. We then assessed the algorithm’s ability to remove artifacts while preserving SSVEP responses. The results were compared against other commonly used algorithms, such as independent component analysis and linear regression. The findings demonstrate that the proposed method exhibits excellent performance, effectively removing artifacts while retaining the EEG signal’s useful components.

With three degrees of flexibility, the temporomandibular joint (TMJ) is a synovial bi-condylar joint. It has been observed that temporomandibular joint dysfunction (TMD) affects one-third of adults. Compared to men, females are more frequently impacted. While 75–80% of individuals with TMD require medical intervention and it can take up to three years for the full remission of symptoms, nearly 50% of patients with TMD do not require any treatment and the symptoms resolve on their own within a year of starting. TMD’s clinical manifestations include jaw clenching, clicking, and locking as well as occlusion brought on by bad posture. The diagnosis of temporomandibular disorder (DC/TMD) is based on axis I and axis II diagnoses, according to the 2014 diagnostic criteria for TMD. The purpose of this review is to give a general overview of TMD and look at the various treatment options. Numerous conservative treatment approaches, such as intra-articular injections, cognitive behavioural therapy, manual mobilisation, electrotherapy, dry needling, pharmaceutical treatment, physical therapy modalities, self-care strategies, dental treatment strategies, and surgical corrections, have been shown to be successful. BJMS, Volume: 24. Supplementary Issue 2025, Page : 59-62

Цель исследования — изучить функциональную активность собственно жевательных и височных мышц по данным поверхностной электромиографии (ЭМГ) в состоянии покоя и при максимальном сжатии зубов у пациентов с различными уровнями личностной и ситуативной тревожности, страдающих дисфункциональными нарушениями височно-нижнечелюстного сустава (ВНЧС). В исследовании участвовали 45 пациентов, 33 женщины и 12 мужчин от 19 до 36 лет. Основную когорту составили 33 пациента с признаками дисфункции ВНЧС и жевательных мышц; группа сравнения была представлена 12 участниками без признаков функциональных нарушений. Исходя из результатов МРТ ВНЧС пациентов основной когорты разделили на 3 группы: I — 12 пациентов с дислокациями суставных дисков ВНЧС без репозиции; II — 10 пациентов с дислокациями суставных дисков ВНЧС с репозицией; III — 11 пациентов без внутрисуставных изменений ВНЧС, но имеющие клинические проявления мышечной дисфункции (внесуставная дисфункция). Для определения уровня тревожности использовали методику Спилбергера—Ханина. С помощью ЭМГ височных и собственно жевательных мышц измеряли максимальную и среднюю амплитуду биоэлектрической активности жевательных мышц в состоянии физиологического покоя и при сжатии челюстей, вычисляли индекс симметрии височных мышц и индекс симметрии жевательных мышц. У пациентов с дисфункцией ВНЧС и жевательных мышц уровни ситуативной и личностной тревожности 3,5—3,9 и 3,5—3,8 в I группе, 3,5—3,9 и 3,5—3,8 во II группе, 2,5—2,8 и 2,3—2,9 в III группе были достоверно выше по сравнению с уровнями тревожности пациентов группы сравнения (1,5—1,9 и 1,3—2,0; p&lt;0,01). Максимальные и средние амплитуды биопотенциалов височных и собственно жевательных мышц пациентов с дисфункцией ВНЧС и жевательных мышц (850—911 и 55,4—58,3 мкВ в покое, 1289—1398 и 372—380 мкВ при сжатии челюстей соответственно) были достоверно выше соответствующих амплитуд биопотенциалов данных мышц пациентов группы сравнения (631—690 и 15,4—18,3 мкВ в покое, 954—1063 и 312—320 мкВ при сжатии соответственно; p&lt;0,01). У пациентов I и II группы с внутрисуставными нарушениями ВНЧС наблюдалась наиболее выраженное нарушение баланса функциональной активности между жевательными мышцами правой и левой сторон. Индекс симметрии височных мышц у пациентов I и II группы (80—81,2 и 77,7—103%) был достоверно ниже, чему у пациентов III и IV группы (85—85,5 и 85,7—93,7%; p&lt;0,01). Индекс симметрии жевательных мышц у пациентов I и II группы (95,2—100 и 98,6—100%) также был достоверно ниже, чему у пациентов III и IV группы (100%; p&lt;0,01). У пациентов, страдающих дисфункцией ВНЧС и жевательных мышц, наблюдается повышенная и асимметричная биоэлектрическая активность жевательных мышц. В связи с этим рекомендуется проведение ЭМГ жевательных мышц для контроля функциональной активности жевательной мускулатуры и оценки эффективности проводимых лечебных мероприятий. Кроме того, психологическое тестирование пациентов с дисфункцией ВНЧС рекомендуется проводить для определения уровня тревожности с целью включения в комплексный план лечения помощь психолога или психотерапевта. The aim of the study was to investigate the functional activity of the masticatory and temporal muscles according to surface electromyography (EMG) data at rest and with maximum clenching of the teeth in patients with different levels of personal and situational anxiety, suffering from dysfunctional disorders of the temporomandibular joint (TMJ). . The study involved 45 patients, 33 women and 12 men aged 19 to 36 years. The main cohort consisted of 33 patients with signs of dysfunction of the TMJ and masticatory muscles, the comparison group — 12 participants without signs of functional disorders. Based on the results of TMJ MRI, the patients of the main cohort were divided into 3 groups: I — 12 patients with dislocations of the TMJ articular discs without reposition; II — 10 patients with dislocations of the TMJ articular discs with reposition; III — 11 patients without intra-articular changes of the TMJ, but with clinical manifestations of muscle dysfunction (extra-articular dysfunction). To determine the level of anxiety in all participants, the Spielberger—Khanin method was used. Using EMG of the temporal and masticatory muscles, the maximum and average amplitude of bioelectrical activity of the masticatory muscles in a state of physiological rest and jaw compression were measured, the symmetry index of the temporal muscles and the symmetry index of the masticatory muscles were calculated. . In patients with dysfunction of the TMJ and masticatory muscles, the levels of situational and personal anxiety were 3.5—3.9 and 3.5—3.8 in group I, 3.5—3.9 and 3.5—3.8 in group II, 2.5—2.8 and 2.3—2.9 in group III, which was significantly higher compared to the anxiety levels of patients in the comparison group (1.5—1.9 and 1.3—2.0; p&lt;0.01). The maximum and average amplitudes of biopotentials of the temporal and masticatory muscles in patients with TMJ dysfunction and masticatory muscles (850—911 and 55.4—58.3 mV at rest, 1289—1398 and 372—380 mV during jaw clenching, respectively) were significantly higher than the corresponding amplitudes of biopotentials of these muscles in patients of the comparison group (631—690 and 15.4—18.3 mV at rest, 954—1063 and 312—320 mV during clenching, respectively; p&lt;0.01). In patients of groups I and II with intra-articular TMJ disorders, the most pronounced imbalance of functional activity between the masticatory muscles of the right and left sides was observed. The symmetry index of the temporal muscles in patients of groups I and II (80—81.2 and 77.7—103%) was significantly lower than in patients of groups III and IV (85—85.5 and 85.7—93.7%; p&lt;0.01). The symmetry index of the masticatory muscles in patients of groups I and II (95.2—100 and 98.6—100%) was also significantly lower than in patients of groups III and IV (100%; p&lt;0.01). . Patients with dysfunction of the TMJ and masticatory muscles have increased and asymmetric bioelectrical activity of the masticatory muscles. In this regard, it is recommended to conduct EMG of the masticatory muscles to monitor the functional activity of the masticatory muscles and assess the effectiveness of therapeutic measures. In addition, it is recommended to conduct psychological testing of patients with TMJ dysfunction to determine the level of anxiety in order to include the help of a psychologist or psychotherapist in a comprehensive treatment plan.

Bruxism is a parafunctional orofacial behavior. For diagnosis, wearable devices that use sounds as biomarkers can be applied to provide the necessary information. Human beings emit various verbal and nonverbal sounds, making it challenging to identify bruxism-induced sounds. We wanted to investigate whether the acoustic emissions of different oral behaviors have distinctive characteristics and if the placement of the transducer has an impact on recording the sound signals. Sounds from five oral behaviors were investigated: jaw clenching, teeth grinding, reading, eating, and drinking. Eight transducers were used; six were attached to the temporal, frontal, and zygomatic bones with the aid of medical tape, and two were integrated into two commercial earphones. The data from 15 participants were analyzed using time-domain energy, spectral flux, and zero crossing rate (ZCR). In summary, all oral behaviors showed distinct characteristic features except jaw clenching, though there was a peak in the recording, possibly due to tooth tapping, before its expected onset. For teeth grinding, the transducer placement did not have a significant impact (p > 0.05) based on energy, spectral flux, and ZCR. For jaw clenching, the transducer placement had an impact with regard to spectral flux (p < 0.01). For reading and eating, the transducer placement had a significant impact with regard to energy (p < 0.05 for reading, p < 0.01 for eating), spectral flux (p < 0.001 for reading, p < 0.01 for eating), and ZCR (p < 0.001 for both reading and eating). For drinking, the transducer placement only had a significant impact with regard to ZCR (p < 0.01). We were able to record the sounds of various oral behaviors from different locations on the head. However, the ears were an advantageous location to place the transducer, since they could compensate for various head movements and ear devices are socially tolerable.

Driving stress is a multifaceted phenomenon, and the experience of driving invokes stress. Driving causes the activation of stress-response mechanisms, leading to short-term and long-term stress responses resulting in physiological and behavioral changes. The aim of this study was to evaluate driving stress-initiated effects on orofacial functions and health behaviors in the Riyadh population. A cross-sectional survey was conducted in Riyadh using a pre-validated set of questionnaires for habitual information, a driving stress assessment using a driving-behavior inventory, and an assessment of parafunctional habits and effects on orofacial functions. The results indicate that nearly 50% of the sample spends more than two hours commuting, and more than 50% of the sample has inadequate sleep and insufficient exercise. Oral parafunctional habits like nail biting (p = 0.039) and lip or object biting (p = 0.029) had a significant correlation with aggressive driving behaviors, whereas the grinding of teeth (p = 0.011), the clenching of jaws (p = 0.048), lip or object biting (p = 0.018), and pain in mastication (p = 0.036) had a positive correlation with driving dislikes. Driving stress can be detrimental to one's health and not only impacts health behaviors but also induces oral parafunctional habits and adversely affects orofacial regions and functions. Acute driving stress responses may be transient. However, prolonged driving stress can be maladaptive and can increase the risk of chronic diseases including chronic temporomandibular joint disorders and parafunctional habit-related changes in the oral cavity.

A recent publication in the Nederlands Tijdschrift Voor Tandheelkunde (Dutch Journal of Dentistry) suggests botulinum toxin as a primary treatment for bruxism, especially for severe complaints of teeth grinding or jaw clenching. However, in the opinion of Lobbezoo et al., some outdated views on bruxism are used, and botulinum toxin is incorrectly classified as safe, according to them. In this Vision article, the authors describe the current insights into bruxism; they indicate how the presence of bruxism can be assessed in the clinic; when and how bruxism is treated; and finally, what the role of botulinum toxin is: an ultimum refugium. Therefore, regarding the use of botulinum toxin within the discipline of orofacial pain and dysfunction Lobbezoo et al. recommend: think twice!

Распространенность повышенной стираемости зубов среди населения России неуклонно растет и, по данным разных авторов, достигает 84%. Разнообразные клинические проявления заболевания (боль и напряженность жевательной мускулатуры, щелканье и хруст в ВНЧС, блокирование движений нижней челюсти, уменьшение межальвеолярного расстояния и высоты нижней части лица), сложность диагностики и большой процент неудачного исхода лечения требуют поиска новых терапевтических ресурсов, среди которых цифровые технологии становятся наиболее востребованными. Представлена выписка из истории болезни пациента К., 42 года, ортодонтическое лечение которого привело к появлению функциональных нарушений жевательно-речевого аппарата. Так, на этапе лечения появился гипертонус жевательной мускулатуры и щелканье в ВНЧС, а по окончании ортодонтической коррекции возникла диастема в области зубов 1.1 и 2.1 и рецессия в области зуба 3.1. Указанные симптомы заставили пациента обратиться за повторным стоматологическим лечением, которое было проведено с использованием цифровых методов функциональной диагностики. Были сняты цифровые оттиски, выполнены моделирование и 3D-печать гнатометра, а также поиск терапевтического положения нижней челюсти с последующей проверкой положения головок сустава с помощью компьютерной томографии, что позволило полностью устранить функциональные нарушения жевательно-речевого аппарата. Компьютерные технологии позволяют в полной мере провести грамотную диагностику и планирование лечения, а также осуществить контроль положения нижней челюсти на всех этапах комплексной реабилитации, что в конечном счете обеспечивает удачный исход лечения в долгосрочной перспективе. The prevalence of tooth wear among the Russian population is steadily increasing and, according to various authors, reaches 84%. Various clinical manifestations of the disease (pain and tension of the masticatory muscles, clicking and crepitus in the TMJ, lower jaw lock, reducing the interalveolar height and the lower third of the face), the complexity of diagnosis and a large percentage of unsuccessful treatment outcomes require the search for new therapeutic resources, among which digital technologies are becoming the most in demand. An extract from the medical history of patient K., 42 years old, whose orthodontic treatment led to the appearance of functional disorders of the masticatory organ, is presented. At the stage of the orthodontic treatment hypertension of masticatory muscles and clicking in the TMJ appeared, and at the end of the therapy diastema appeared in the area of 1.1 and 2.1 teeth as well as gingival recession in the area of 3.1 teeth. These symptoms caused the patient to start a new dental treatment, which was carried out using digital methods of functional diagnostics (obtaining the digital impressions, modeling and 3D printing of the gnathometer, determining of the lower jaw therapeutic position and checking the condyle position using computed tomography), which made it possible to achieve complete elimination of functional disorders of the masticatory organ. . Computer technologies allow to perform the competent diagnosis and treatment, as well as monitoring the position of the lower jaw at all stages of complex rehabilitation, which ultimately ensures a successful outcome of treatment in the long term.

ABSTRACT Research assessing the effects of mouthpieces on an individual’s aerobic, anaerobic, or muscular performance have attributed cited improvements to the participant’s ability to jaw clench. Jaw clenching research finds positive outcomes with the task of jaw clenching with targeted muscle groups in a controlled laboratory setting. Thus, the study’s goal was to determine if the addition of a mouthpiece would positively affect performance outcomes in a field-based whole-body muscle movement. Fourteen participants (8=F and 6=M) NCAA softball and baseball athletes completed 5 maximal bat swings with and without a mouthpiece in 4 conditions: no jaw clenching (NC), mouthpiece and jaw clenching (MP+C), mouthpiece only (MP), and jaw clenching only (C). Significant differences occurred in conditions, with the highest velocity noted in the combined condition of MP+C (71.9 mph) as compared to NC (67.9 mph), MP (68.6 mph), and C (70.9 mph). A repeated measures ANOVA demonstrated significant differences with bat swing velocity (F = 13.19, df 3, p < 0.0001). Pairwise comparisons revealed significant differences in MP+C with MP (p = 0.007); MP+C with NC (p = 0.001), and C with NC (p = 0.009). The results of this study provide evidence of jaw clenching’s positive effects on the dynamic, whole-body explosive activity of a bat swing.

Abstract Introduction Oral Appliance Therapy (OAT) is a management option for patients with Obstructive Sleep Apnea (OSA). A reported drawback to OAT is symptoms relating to Temporomandibular Joint Disorder (TMD), including post-procedure jaw pain. Some studies reported TMD in over 50% of patients prior to OAT. The aim of this study was to evaluate the prevalence of TMD and oral Parafunction Habits (PFH) in patients with OSA referred for OAT, and determine any relationship between patient characteristics, demographics, medical history, and degree of OAT advancement with post-procedure jaw pain. Methods A retrospective analysis was conducted, reviewing the electronic health records of 125 patients with OSA referred to the division of dental sleep medicine in Mayo Clinic Rochester, for OAT. Records reviewed included patient demographics, TMD-PFH symptoms and signs before and after initiation of OAT, self-reported history of, and signs of PFH, AHI pre-initiation of OAT, presence of fibromyalgia, SSRI use, and percent advancement of appliance at time of re-evaluation. Results The median age of patients reviewed was 58 (Interquartile Range (IQR) 20), median BMI 30.5 (IQR 7), median AHI 11.3 (IQR 9.5). 57% were male, 43% female. 20.8% patients had TMD history, 37.6% had TMD signs, 47.2% had PFH history (jaw clenching, lip biting, and/or thumb sucking). 96% had signs of PFH. 15.2% reported post-procedure jaw pain. There was a statistically significant relationship between both TMD history and TMD signs, with post-procedure jaw pain (p value 0.002 and 0.013 respectively), although after multi-variate analysis, only TMD history remained associated with post-procedure jaw pain (Odd’s Ratio 3.385, 95% Confidence Interval 1.081 – 10.601, p value = 0.036). Age, BMI, gender, PFH signs and history, SSRI use, fibromyalgia history, % advancement of OA had no statistical association with post-procedure jaw pain. Conclusion Having a history of TMD symptoms prior to OAT is a risk factor for post-OAT jaw pain. A thorough oral and maxillofacial history in patients being considered for OAT is important to identify patients with TMD history, to establish a clear path to initiate OAT and to closely monitor, reduce or potentially eliminate the reported side effect. Support (if any)

Jaw clenching improves dynamic reactive balance on an oscillating platform during forward acceleration and is associated with decreased mean sway speed of different body regions. It is suggested that jaw clenching as a concurrent muscle activity facilitates human motor excitability, increasing the neural drive to distal muscles. The underlying mechanism behind this phenomenon was studied based on leg and trunk muscle activity (iEMG) and co-contraction ratio (CCR). Forty-eight physically active and healthy adults were assigned to three groups, performing three oral motor tasks (jaw clenching, tongue pressing against the palate or habitual lower jaw position) during a dynamic one-legged stance reactive balance task on an oscillating platform. The iEMG and CCR of posture-relevant muscles and muscle pairs were analysed during platform forward acceleration. Tongue pressing caused an adjustment of co-contraction patterns of distal muscle groups based on changes in biomechanical coupling between the head and trunk during static balancing at the beginning of the experiment. Neither iEMG nor CCR measurement helped detect a general neuromuscular effect of jaw clenching on the dynamic reactive balance. The findings might indicate the existence of robust fixed patterns of rapid postural responses during the important initial phases of balance recovery.

Assessing multi-domain impact of IAQ and noise on productivity with portable air cleaners through physiological signals