Voluntary Bite Research Articles

Laboratory Validation of a Novel Indigenously Developed Bite Force Measuring Device.

It is critical to measure the maximum voluntary bite force of patients receiving restorative dentistry. A new device known as "BYTE" has been developed indigenously to measure bite force in humans. The purpose of this study is to evaluate the BYTE device's consistency and accuracy in a lab setting. Testing and calibration were done in the laboratory. The calibration machine with load cell pressed the biting part of the device with various forces from 3 N to 444 N in 3 N increments for two to three seconds each. The recorded force value in Newton by the device was noted down. At numerous standard loads, the minimum accuracy error is 0.333 N, while the maximum is 1.667 N. It marginally underestimates the load with an average accuracy error of 0.833 N. The calibration report showed that the BYTE device is precise and reliableand can be used to measure maximum bite force.

Unravelling the Complexities of Bite Force Determinants in Paediatric Patients: A Literature Review.

The amount of maximum voluntary bite force (MVBF)is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex processes. Bite force (BF) measurements can yield valuable information on the activity and function of the jaw muscles. The accuracy of biting force measurements depends on several variables, including age, gender, malocclusion, dental caries, dental prosthesesand temporomandibular joint (TMJ). This information is essential for evaluating the development and function of the masticatory system, identifying potential abnormalities or impairmentsand guiding appropriate treatment interventions for paediatric patients. The aim of this article is to review the literature on the factors affecting bite force and the importance of these factors in assessing dental development and guiding interventions for paediatric patients with bite force-related issues. Additionally, establishing normative values for bite force in different age groups can aid in monitoring growth and detecting any deviations from expected patterns. Measuring bite force in paediatric patients is significant in comprehensive oral health assessment and management.

The reliability and validity of the juvenile idiopathic arthritis magnetic resonance scoring system for temporomandibular joints

In children with juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) can be involved. To prevent TMJ damage due to inflammation, early recognition is important, for which contrast-enhanced magnetic resonance imaging (MRI) is the gold standard. In this study, the interobserver reliability and construct validity of the Juvenile Idiopathic Arthritis Magnetic Resonance Scoring System for Temporomandibular Joints (JAMRIS-TMJ) was assessed. Two radiologists independently examined 38 MRIs using the JAMRIS-TMJ scoring system. Inter-observer reliability was assessed by Cohen's (weighted) kappa (κ), 95% confidence intervals (CIs) and absolute agreement (%). Construct validity was assessed by correlation between the JAMRIS-TMJ items and TMJ involvement, active maximum interincisal mouth opening (AMIO), and anterior maximum voluntary bite force (AMVBF). The interobserver reliability for the JAMRIS-TMJ items varied from poor to good (κ = 0.18–0.61). Joint enhancement had the highest reliability (κ = 0.61). Correlations were found between TMJ involvement, AMIO, and the JAMRIS-TMJ items, although variation between radiologists and TMJ side existed. No correlation was found between AMVBF and the JAMRIS-TMJ items for both radiologists. The strongest correlations were found between most of the JAMRIS-TMJ items and AMIO. Our findings support the utility of AMIO as a clinical measure of TMJ status in children with JIA.

Natural History of Mandibular Function in Spinal Muscular Atrophy Types 2 and 3.

Hereditary proximal spinal muscular atrophy (SMA) is characterized by abnormal alpha motor neuron function in brainstem and spinal cord. Bulbar dysfunction, including limited mouth opening, is present in the majority of patients with SMA but it is unknown if and how these problems change during disease course. In this prospective, observational, longitudinal natural history study we aimed to study bulbar dysfunction in patients with SMA types 2 and 3. We included 44 patients with SMA types 2 and 3 (mean age was 33.6 (95% CI 28.4;38.9) and re-examined them after on average 4 years. None were treated with SMN-modulating treatments before or during the course of this study. Longitudinal assessments included a questionnaire on mandibular and bulbar function, the Mandibular Function Impairment Questionnaire (MFIQ), and a clinical examination of masticatory performance, maximum voluntary bite force, and mandibular movements including the active maximal mouth opening. We found significant higher MFIQ scores and a significant decrease of all mandibular movements in patients with SMA type 2 (p < 0.001), but not in SMA type 3. Masticatory performance and maximum voluntary bite force did not change significantly. Mean reduction of active maximal mouth opening at follow-up was 3.5 mm in SMA type 2 (95% CI: 2.3; 4.7, p < 0.001). SMA type 2 was an independent predictor for a more severe reduction of the mouth opening (β= -2.0 mm (95% CI: -3.8; -0.1, p = 0.043)). Bulbar functions such as mandibular mobility and active maximum mouth opening decrease significantly over the course of four years in patients with SMA type 2.

Changes in masticatory performance and bite force after treatment with mandibular overdentures retained by four titanium-zirconium mini implants: One-year randomised clinical trial.

This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium-zirconium mini implants. Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two-colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue-VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre-treatment) and the 3-, 6- and 12-month after implant loading. Descriptive statistics, independent t-test, and linear mixed-effect model (LMM) regression were used for data analysis. Seventy-four participants were assessed and 73 completed the 1-year follow-up. Statistically significant improvements in functional parameters were observed in all follow-up periods compared to baseline (p < .001). The flapless protocol was associated with higher improvement in MP at the 3-month follow-up (p = .004), while less resorbed ridges were associated with better MP (p = .038) and higher MBF (p < .001). The mandibular overdenture protocol using four titanium-zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre-treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. ClinicalTrials.Gov ID NCT04760457.

A Preliminary Report of Maximum Voluntary Bite Force of Young Indian Population

ABSTRACT Introduction: The measurement of bite force is increasingly gaining importance in dentistry. This preliminary report evaluates the maximum voluntary bite force (MVBF) of young healthy individuals with normal occlusion and correlates the effect of age and gender with the maximum bite force (MBF) Materials and Methods: 405 participants in the age group of 18 to 40 years were selected from the outpatient department meeting inclusion and exclusion criteria. MVBF was measured with the help of a digital device called “Byte” at incisors, right first molar, and left first molar region. Results: There was a strong correlation between age with bite force. Bite force increased with age. Males had more bite force than females. The posterior region had higher bite force than the anterior region Conclusion: Measurement of bite force is very important for every patient undergoing restorative treatment. The “Byte” device was found to be very efficient.

Psychological Stress as a Determinant of Increased Maximum Voluntary Bite Force - A Clinical Observational Study.

Background Psychological stress is a known risk factor and modulator for several oral diseases. It is among the critical etiological factors of bruxism and several other disorders. The quantum of bite force is one of the prime determinants of wear resistance and the clinical performance of restorations. Thus, the present study aims to investigate the relationship between the maximum voluntary bite force (MVBF) and the amount of perceived stress experienced by an individual. Materials and methods Patients (n=111) fulfilling the exclusion and inclusion criteria were divided into high, medium, and low-stress groups based on their stress scores deduced from the Perceived Stress Scale questionnaire (PSS). Bite force measurement was recorded in Newtons (N) for each subject using a portable customized bite recording FlexiForce sensor (B 201). The data were analyzed using Kruskal-Wallis and independent samples t-test. Results Among the females, the bite force in the medium and high-stress groups was greater compared to the low-stress level group. On the other hand, there was no difference in bite force between any of the stress level groups among male participants. Conclusion The results show that higher MVBF is associated with higher perceived stress scores in adult females. Practical Implications Psychological counseling can be included in the dental treatment plan of individuals with a high-stress score to counteract their stress-related higher occlusal forces, parafunctional jaw movements, and risky oral health behaviors, thereby potentially reducing the incidence of adverse outcomes such as temporomandibular joint dysfunction and restoration failure by careful choice of restorative materials.

Clinically Established Temporomandibular Involvement in Adults With Juvenile Idiopathic Arthritis.

To study clinical variables defining temporomandibular function in adults with juvenile idiopathic arthritis (JIA) and healthy controls. In this cross-sectional study, the temporomandibular joint (TMJ) screening protocol, mandibular range of motion (MROM), and anterior maximum voluntary bite force (AMVBF) were compared between adults with JIA and healthy controls. Unadjusted and adjusted models with corrections for sex and disease duration were constructed for active maximum interincisal mouth opening (AMIO) and AMVBF. A total of 100 adults with JIA and 59 healthy adults were included in this study. In adults with JIA, 56% had clinically established TMJ involvement. AMIO was the MROM variable most reduced by TMJ involvement; AMIO was 8.8 mm (95% CI -11.40 to -6.12; P < 0.001) less in adults with JIA with TMJ involvement compared to JIA without TMJ involvement. No differences of AMIO were found between healthy adults and adults with JIA without TMJ involvement (-2.52, 95% CI -5.13 to 0.10; P = 0.06). Male sex was associated with a higher AMIO, and disease duration was associated with a decreased AMIO. Collinearity between the subtype prebiologic era and disease duration was found. AMVBF did not differ between adults with JIA and healthy adults. The high prevalence of clinically established TMJ involvement in adults with JIA indicates the need for awareness of TMJ problems in adults with JIA. TMJ involvement negatively influenced AMIO and should therefore be part of the TMJ screening in adults with JIA. AMVBF seems to have less utility for TMJ screening in adult populations.

Measurement of voluntary bite forces in large carnivores using a semi-automated reward-driven system.

Bite force is a key performance trait of the feeding system, but maximal in vivo bite force has been measured in few large mammals. The alternative, modelling of bite force from anatomy, cannot be validated without in vivo measurements. To overcome existing limitations of ethics, safety, and animal well-being, we here propose a semi-automated method to obtain voluntary maximum bite forces from large mammals using bite plates that automatically dispense a food reward if an incrementally increasing threshold force value is reached. We validated our method using two Malayan sun bears, two Andean spectacled bears and a lioness. We show that voluntary bite force measurement using positive reinforcement is a non-invasive and reliable method to record maximum voluntary bite force performance in large mammals. Our results further show that in vivo data are critical as modeling efforts from osteology have greatly underestimated bite forces in Andean bears.

Duration of bite force reduction following a single injection of botulinum toxin in the masseter muscle bilaterally: A one-year non-randomized trial.

Previous studies concerning the effect of botulinum toxin in masseter muscle have mainly reported effects observed through inspection of facial features or differences in pain levels. One systematic review of studies utilizing objective measurements reported that long-term muscular effect of botulinum neurotoxin injections into masseter muscle was inconclusive. To evaluate the duration of reduced maximal voluntary bite force (MVBF) after botulinum toxin intervention. The intervention group was comprised of individuals seeking aesthetic treatment for masseter reduction (n= 20), the reference group (n= 12) comprised of individuals with no intervention. Intervention through 25 units of Xeomin® (Merz Pharma GmbH & Co KGaA, Frankfurt am Main, Germany) botulinum neurotoxin type A injected into the masseter muscles bilaterally (totalling 50 units). A reference group did not receive any intervention. MVBF was measured in Newtons using a strain gauge meter at the incisors and first molars. MVBF was measured at baseline, at 4 weeks, 3 months, 6 months, and after 1 year. Both groups were similar in terms of bite force, sex and age at baseline. MVBF remained similar compared to baseline in the reference group. At 3 months, a significant reduction at all measurement points was observed in the intervention group; at 6 months, this reduction was no longer significant. A single intervention of 50 units of botulinum neurotoxin results in a reversible MVBF reduction of at least 3months, although a visually discernable reduction may be more long-lasting.

Reliability and measurement error of anterior maximum voluntary bite force in children with juvenile idiopathic arthritis and healthy children.

In children with juvenile idiopathic arthritis (JIA) the temporomandibular joint (TMJ) can be involved. As a consequence, the oral function can be impaired due to joint and/or muscle involvement of the masticatory system with a negative influence on the maximum bite force. The aim of this cross-sectional study was to establish the reliability of AMVBF in children with JIA and healthy children. Children with JIA and healthy children conducted three attempts of AMVBF. The reliability of AMVBF measurement was determined by the intra-class correlation coefficient (ICC) by age, standard error of measurement (SEM), smallest detectable change (SDC), and limits of agreement (LoA). A total of 298 children with JIA and 168 healthy children were examined. The AMVBF measurements showed an good to excellent reliability in children with JIA based on the ICCs corrected for age (0.782-0.979). In healthy children, the reliability was moderate to excellent (0.546-0.999). The SDC in our study indicated that values above 11.4N might be a clinical relevant change over time in children with JIA. The LoA showed a wide spread of variability in both children with JIA (-72.6-44.4N) and healthy children (-79.9-72.8N). The Bland-Altman plots indicated that the differences between the test and retest increased in value proportionally to the biteforce value.

Bite force of children and adolescents: a systematic review and meta-analysis.

This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force (MVBF). This systematic review included observational studies and experimental studies in children and adolescents (upto 19 years of age) which evaluated MVBF using a bite force measuring device. Studies on participants with systemic conditions were excluded. Databases such as PubMed, Embase, LILACS, and the Cochrane library were searched until September 2022, for which screening and quality assessment were performed. Newcastle-Ottawa, modified Newcastle-Ottawa and ROBINS-I tools were used to assess the Risk-of-bias. All observational studies reporting overall bite force values of participants were included for meta-analyses. A total of 8864 participants (3491 males and 3623 females) were included from 61 studies. Meta-analyses were conducted to evaluate mean average bite force value for each included dentition using R software v2.4-0. Estimation was done to derive an average BF value for variables such as age (dentition), gender, side, site, device and ethnicity. MVBF values were reported as mean average in the form of MLN with 95% CI (Confidence Interval). Using a random-effects model, 29 forest plots were generated. I2 values varied between 90% and 100%. Bite force ranged from 246.22 N (220.47; 274.98) to 311.72 N (255.99; 379.59) and 489.35 N (399.86; 598.87) in primary, mixed, and permanent dentitions, respectively. Six different sites for recording bite force and 11 different types of devices were reported with portable occlusal bite force gauge being the most common device. Outcomes of this review provide useful baseline reference values of bite force for clinicians and researchers.

Functioning of the Masticatory System in Patients with an Alloplastic Total Temporomandibular Joint Prostheses Compared with Healthy Individuals: A Pilot Study.

Most patients with temporomandibular joint (TMJ) issues are successfully treated with nonsurgical methods. However, when end-stage TMJ pathologies occur, invasive management can be required, such as a total TMJ replacement. This cross-sectional pilot study aimed to provide insight into the functioning of the masticatory system, pain, and patient satisfaction in patients treated with a total joint replacement (TJR). A cross-sectional pilot study was conducted to determine the postoperative clinical results of an alloplastic TJR TMJ. Masticatory performance and also insight into maximum voluntary bite force (MVBF), active and passive maximum mouth opening (aMMO/pMMO), pain, and patient satisfaction were measured. Masticatory performance, MVBF, and aMMO of patients with a TJR TMJ were compared with healthy individuals. Masticatory performance is equal between patients with a TJR TMJ and healthy individuals, but both MVBF and aMMO were significantly smaller in patients with a TJR TMJ. However, patients had almost no pain and were very satisfied with the TJR TMJ treatment. This study revealed that most patients with an alloplastic TJR TMJ were able to function without pain, showed good masticatory performance, and were highly satisfied with their alloplastic TJR TMJ. However, MVBF and aMMO were lower than in healthy individuals.

A Low-Cost Wireless Bite Force Measurement Device.

Assessing maximum voluntary bite force is important to characterize the functional state of the masticatory system. Due to several factors affecting the estimation of the maximum bite force, a unique solution combining desirable features such as reliability, accuracy, precision, usability, and comfort is not available. The aim of the present study was to develop a low-cost bite force measurement device allowing for subject-specific customization, comfortable bite force expression, and reliable force estimation over time. The device was realized using an inexpensive load cell, two 3D printed ergonomic forks hosting reusable subject-specific silicone molds, a read-out system based on a low-cost microcontroller, and a wireless link to a personal computer. A simple model was used to estimate bite force taking into account individual morphology and device placement in the mouth. Measurement reliability, accuracy, and precision were assessed on a calibration dataset. A validation procedure on healthy participants was performed to assess the repeatability of the measurements over multiple repetitions and sessions. A 2% precision and 2% accuracy were achieved on measurements of forces in the physiological range of adult bite forces. Multiple recordings on healthy participants demonstrated good repeatability (coefficient of variation 11%) with no significant effect of repetition and session. The novel device provides an affordable and reliable solution for assessing maximum bite force that can be easily used to perform clinical evaluations in single sessions or in longitudinal studies.

Growth curves for mandibular range of motion and maximum voluntary bite force in healthy children.

Mandibular range of motion and bite force are indispensable variables for the evaluation of mandibular function. There are a variety of medical and dental conditions that can negatively affect mandibular function. Values for mandibular range of motion (i.e., active and passive maximum interincisal mouth opening, protrusion, and laterotrusion) and anterior maximum voluntary bite force (AMVBF) in healthy children and adolescents can help in recognizing temporomandibular dysfunction. In this longitudinal study, 169 healthy children aged 6–18 years were included. They were examined at four time points over 1 year. Mixed model analysis was performed to produce growth curves of mandibular range of motion and AMVBF. Average active maximum interincisal mouth opening was significantly higher in boys with 50.0 mm compared to 47.8 mm in girls. Boys also had a significantly higher AMVBF than girls with an average of 169.0 N versus 140.0 N, respectively. Growth curves of active and passive maximum interincisal mouth opening showed an increase with age, albeit levelling off through puberty. The growth curves of AMVBF in girls reach a plateau phase at ages 12–14 years, after which the curve descends; in boys, the AMVBF tended to increase up to 18 years of age, although a slow‐down after 14 years of age was noted.

Oral diadochokinesis and associated oro-facial function in young and old German mother-tongue speakers: A cross-sectional study.

ObjectivesThe aims of this study were to compare oral diadochokinesis and to test associations with oro‐facial functional parameters in healthy young and old German speakers.BackgroundOral diadochokinesis is a key component in the concept of oro‐facial hypofunction and relates to tongue and lip motor function but may depend on the linguistic background.Materials and methodsHealthy German speakers with a minimum of 20 teeth were recruited to form a young (<60 years) and an older group (≥60 years). Oral diadochokinesis was assessed as the number of repetitions/s for the monosyllables /pa/, /ta/ and /ka/ to evaluate movement capacity of the lip, the anterior region of the tongue and the posterior region of the tongue, respectively. Maximum voluntary lip force, maximum voluntary bite force, masticatory performance, maximum voluntary tongue pressure, xerostomia and swallowing function were assessed with validated instruments. Results are presented as median (IQR).ResultsSixty participants formed the younger group (n = 35, 30.0 years [24.0‐49.0]) and the older group (n = 25, 64.0 years [62.0‐72.0]). Counts/s of /ta/ were different between age groups (younger group: 6.0 vs older group: 5.4) but not for syllables /pa/ (younger group: 6.0 vs older group: 5.8) and /ka/ (younger group: 5.6 vs older group: 5.0). The oral diadochokinesis with /pa/ was overall associated with maximum voluntary lip force; oral diadochokinesis performed with /ta/ was associated with tongue pressure, and oral diadochokinesis with /ka/ with swallowing function. Masticatory performance was not associated with oral diadochokinesis but with maximum voluntary bite force, xerostomia and with maximum voluntary tongue pressure.ConclusionsThe published thresholds for oral diadochokinesis should be reconsidered in non‐Japanese mother‐tongue speakers. However, they still play an important role in the overall concept of oro‐facial functional assessment.

Analysis of maximum bite force and chewing efficiency in unilateral temporomandibular joint ankylosis cases treated with buccal fat pad interpositional arthroplasty

There is limited knowledge about masticatory function after the release of temporomandibular joint (TMJ) ankylosis. In this study, masticatory function was evaluated by measuring maximum voluntary bite force (MVBF) and chewing efficiency in 30 unilateral TMJ ankylosis patients who were treated with buccal fat pad (BFP) interpositional arthroplasty. Eighteen subjects over 12 years of age were included in study Group A and 12 subjects below 12 years of age in study Group B. Patients in the study groups had completed a minimum follow up of one year after surgery. Control groups C (over 12 years of age, n = 18) and D (under 12 years of age, n = 12) consisted of age, sex, and weight-matched normal subjects. The mean MVBF was measured between occluding molar teeth with a strain gauge transducer. Chewing efficiency was measured with two different coloured chewing gum strips. These were chewed for 5, 10, 20, 30, and 50 strokes. Compared with normal subjects, the study groups (A and B) could generate 64.7% (p = 0.004*) and 89.8% (p = 0.121) of MVBF, respectively. Overall chewing efficiency was 88.7% in Group A and 92.9% in Group B (p = 0.014* and p = 0.138, respectively) when compared with normal subjects. The study has shown that BFP interpositional arthroplasty effectively restores masticatory function.

Maximum bite force in children with juvenile idiopathic arthritis with and without clinical established temporomandibular joint involvement and in healthy children: a cross-sectional study.

BackgroundIn children with juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) can be involved, resulting in dysfunction of the masticatory system. Bite force is one of the variables that reflects the function of the masticatory system. The aim of this study was to compare maximum bite force in children with JIA, with and without TMJ involvement and with healthy children.MethodsChildren with JIA and healthy children between the ages 6 and 18 were included in this cross‐sectional study. The clinical examination consisted of measuring the anterior maximum voluntary bite force (AMVBF), assessment of the TMJ screening protocol items and TMJ, masseter and temporal muscle palpation pain. Unadjusted linear regression analyses were performed to evaluate the explanatory factors for AMVBF. Two adjusted models were constructed with corrections for age and gender differences: model 1 to compare children with JIA and healthy children and model 2 to compare children with JIA with and without TMJ involvement.ResultsIn this cross‐sectional study, 298 children with JIA and 169 healthy children participated. AMVBF was 24 Newton (N) lower in children with JIA, when compared with healthy children (95%CI: −35.5–−12.4, p = .000). When children with JIA also had clinically established TMJ involvement, AMVBF was reduced 42 N (component JIA:−16.78, 95% CI −28.96–−4.59, p = .007 and component TMJ involvement:−25.36, 95% CI −40.08–−10.63, p = .001). Age and male gender increased AMVBF.ConclusionChildren with JIA had a reduction in the AMVBF compared with healthy children. In children with JIA and clinically established TMJ involvement, AMVBF was more reduced.

Evaluation of bite force recovery in patients with maxillofacial fracture

The aim of this study was to measure the maximum voluntary bite force and recovery time in patients treated for different types of the maxillofacial fracture.Patients aged between 18 and 60 years, who received surgical treatment for a single isolated fracture of the maxillofacial structure, were included in this study. Healthy individuals without any maxillofacial abnormality were selected as the control group. Bite force (in kg) was measured at the first incisor tooth, bilaterally, prior to surgery and 2 weeks, 6 weeks, 3 months, and 6 months after surgery.Of 120 patients, 89 (74.17%) were male and 31 (25.83%) were female. Mean patient age (±SD) was 31.21 (±11.64) years. Bite forces relating to fractures of the zygomaticomaxillary complex (ZMC) with involvement of the arch and zygomaticofrontal suture reached normal levels after 6 weeks (from 3.89 (±1.11) to 10.82 (±1.29); p = 0.296 and from 4.20 (±0.93) to 10.70 (±1.70); p = 0.192, respectively). Bite force returned to normal after 3 months in fractures of the symphysis (from 2.05 (±0.97) to 12.18 (±0.77); p = 0.222), body (from 2.21 (±1.26) to 11.9 (±0.73); p = 0.750), angle (from 2.45 (±1.24) to 11.89 (±0.76); p = 0.769), condyle (from 2.45 (±1.27) to 11.25 (±0.82); p = 0.968), and ZMC with and without infraorbital rim involvement (from 3.83 (±0.93) to 11.92 (±0.84); p = 0.724 and from 3.7 (±1.21) to 12.03 (±0.82); p = 0.482, respectively).Patients with ZMC fracture involving the arch and zygomaticofrontal suture require fewer follow-ups in comparison with those with other maxillofacial fractures. Measurement of maximal bite force can help to evaluate dentofacial deformities before and after surgical treatment.

Comparative Assessment of Maximum Voluntary Bite Force and Electromyography of Masseter Muscle Pre- and Post-oral Rehabilitation in Children between 3 and 14 Years of Age: An In Vivo Study

Comparative Assessment of Maximum Voluntary Bite Force and Electromyography of Masseter Muscle Pre- and Post-oral Rehabilitation in Children between 3 and 14 Years of Age: An In Vivo Study