The effect of clear aligner treatment on masticatory muscles (masseter, temporalis) activity in adults: a systematic review and meta-analysis.

BACKGROUND: The use of clear aligners is becoming more common for aesthetic orthodontic treatment, but there are still concerns about how they affect mastication biomechanics in the short and long term. The clear aligners treatment (CAT) mechanism changes the position of the mandible and maxilla, especially impacting the masseter muscle. Surface electromyography (sEMG) proves to be a useful method to evaluate masticatory muscle activity (MMA). OBJECTIVES: To analyze the effect of clear aligners treatment on alterations in masticatory muscles (masseter, temporalis) using surface electromyography. SEARCH METHODS: Five databases (PubMed, Web of Science, SCOPUS, Cochrane Library, and Google Scholar) were searched up to March 2024. SELECTION CRITERIA: Studies in which MMA was evaluated after the installation of orthodontic clear aligners. DATA COLLECTION AND ANALYSIS: Screening, data extraction, and quality assessments were performed by four investigators independently. The data, which evaluated temporalis and masseter muscle characteristics during CAT using surface electromyography, was extracted, and the quality of the studies was evaluated. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Six studies (two prospective cohort studies, three observational longitudinal studies, and one observational longitudinal case-control study) with low and moderate risk of bias were included in the qualitative synthesis. Six of these were also included in the meta-analysis. Our study investigated the dynamics of masseter and temporalis muscle activity during CAT. The results show that during maximal voluntary clenching, the masseter muscle demonstrated a significant initial increase (P < .05) followed by a subsequent non-significant decrease. It also showed that submaximal voluntary clenching consistently exhibited a significant reduction in muscle activity throughout the study period (P < .01). Assessment of muscle activity at the mandibular resting position revealed a variety of responses, with some participants showing a significant increase while others exhibited non-significant changes (P < .05, P > .05, respectively). However, the meta-analysis showed a non-significant difference in measuring masseter and temporalis muscles activity during CAT. CONCLUSIONS: Based on existing evidence, it is reasonable to conclude that CAT affected MMA. During maximal voluntary clenching, masseter muscle activity initially increased but later decreased, while temporalis muscle activity showed mixed results. Submaximal voluntary clenching revealed a consistent decrease in muscle activity over time. Mandibular resting position assessments showed both increases and no significant changes in muscle activity. However, the existing literature is insufficient to draw concrete conclusions; therefore, well-conducted further research is needed to confirm this statement. REGISTRATION: This systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42024522231).

Functional adaptation of the infant craniofacial system to mechanical loadings arising from masticatory forces.

The morphology and biomechanics of infant crania undergo significant changes between the pre- and post-weaning phases due to increasing loading of the masticatory system. The aims of this study were to characterize the changes in muscle forces, bite forces and the pattern of mechanical strain and stress arising from the aforementioned forces across crania in the first 48 months of life using imaging and finite element methods. A total of 51 head computed tomography scans of normal individuals were collected and analysed from a larger database of 217 individuals. The estimated mean muscle forces of temporalis, masseter and medial pterygoid increase from 30.9 to 87.0 N, 25.6 to 69.6 N and 23.1 to 58.9 N, respectively (0-48 months). Maximum bite force increases from 90.5 to 184.2 N (3-48 months). There is a change in the pattern of strain and stress from the calvaria to the face during postnatal development. Overall, this study highlights the changes in the mechanics of the craniofacial system during normal development. It further raises questions as to how and what level of changes in the mechanical forces during the development can alter the morphology of the craniofacial system.

Signal to noise ratio of masticatory muscle activity of functional and non-functional oral tasks.

BACKGROUND: Electromyographic activity (EMG) of masticatory muscles during wakefulness is understudied. It is unclear if single channel ambulatory EMG devices are sensitive enough to detect masticatory muscle activity (MMA) during wakefulness. OBJECTIVES: To compare the MMA of various oral tasks recorded with a single channel EMG device ((Grindcare4-datalogger Prototype device) (GC4-ß)) and a conventional EMG (cEMG) device. METHODS: EMG activity of 30 standardised oral tasks was recorded unilaterally from the masseter and anterior temporalis muscle in 24 healthy volunteers using GC4-ß and a cEMG device. To compare the EMG data, signal-to-noise ratios (SNR) were calculated as a way to normalise EMG activity across tasks. Analysis of variance was used to compare the SNR between the devices, muscles and oral tasks. RESULTS: SNR measured from GC4-ß was overall significantly higher than the cEMG device (p =.001). The SNR for maximum voluntary contraction (MVC) was significantly higher than all other tasks (p <.001). SNR for temporalis with GC4-ß was significantly higher for MVC, hard food, soft food, gum chewing (dominant side), rhythmic clenching and upper lip biting compared to the cEMG device (p <.021). The SNR for masseter with GC4-ß was significantly higher for hard food and gum chewing (dominant side), rhythmic clenching, rhythmic biting of an object and yawning compared to the cEMG device (p <.022). CONCLUSIONS: This study provides novel insight into the EMG patterns of numerous oral tasks enhancing knowledge of physiological differences between the masticatory muscles. Further, single channel EMG devices can effectively measure the EMG activity of various oral tasks during wakefulness.

Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study.

AIM: This longitudinal study aimed to evaluate the electromyographic activity of the masseter and temporal muscles in adult women who underwent buccal fat removal. MATERIALS AND METHODS: The sample consisted of 20 healthy adult women with no temporomandibular dysfunction and normal occlusion, who were assessed before, 30, and 60 days after the surgery. The electromyographic signal of the masseter and temporal muscles was captured through mandibular tasks including rest, protrusion, right and left laterality, and maximum voluntary contraction with and without parafilm. The results obtained were tabulated and the Shapiro-Wilk normality test was performed, which indicated a normal distribution. Statistical analysis was performed using the repeated measures test (p < 0.05). RESULTS: Significant differences were observed between time periods in maximum voluntary contraction for the left masseter muscle (p = 0.006) and in maximum voluntary contraction with parafilm for the right temporal (p = 0.03) and left temporal (p = 0.03) muscles. CONCLUSION: Bichectomy surgery did not modify the electromyographic activity of the masseter and temporal muscles during the rest task but may have influenced variations in the electromyographic signal during different mandibular tasks after 60 days of surgery, suggesting compensatory adaptations and functional recovery. CLINICAL SIGNIFICANCE: Understanding the impact of buccal fat removal surgery on the stomatognathic system function provides insights into postoperative functional recovery and potential compensatory adaptations, guiding clinical management and rehabilitation strategies for patients undergoing such procedures. How to cite this article: Cardoso AHDLS, Palinkas M, Bettiol NB, et al. Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study. J Contemp Dent Pract 2024;25(3):207-212.

Effects of age and diet consistency on the expression of myosin heavy-chain isoforms on jaw-closing and jaw-opening muscles in a rat model.

BACKGROUND: Skeletal craniofacial morphology can be influenced by changes in masticatory muscle function, which may also change the functional profile of the muscles. OBJECTIVES: To investigate the effects of age and functional demands on the expression of Myosin Heavy-Chain (MyHC) isoforms in representative jaw-closing and jaw-opening muscles, namely the masseter and digastric muscles respectively. METHODS: Eighty-four male Wistar rats were divided into four age groups, namely an immature (n = 12; 4-week-old), early adult (n = 24; 16-week-old), adult (n = 24; 26-week-old) and mature adult (n = 24; 38-week-old) group. The three adult groups were divided into two subgroups each based on diet consistency; a control group fed a standard (hard) diet, and an experimental group fed a soft diet. Rats were sacrificed, and masseter and digastric muscles dissected. Real-time quantitative polymerase chain reaction was used to compare the mRNA transcripts of the MyHC isoforms-Myh7 (MyHC-I), Myh2 (MyHC-IIa), Myh4 (MyHC-IIb) and Myh1 (MyHC-IIx)-of deep masseter and digastric muscles. RESULTS: In the masseter muscle, hypofunction increases Myh1 (26, 38 weeks; p < .0001) but decreases Myh4 (26 weeks; p = .046) and Myh2 (26 weeks; p < .0001) expression in adult rats. In the digastric muscle, hypofunction increases Myh1 expression in the mature adult rats (38 weeks; p < .0001), while Myh2 expression decreases in adult rats (26 weeks; p = .021) as does Myh4 (26 weeks; p = .001). Myh7 expression is increased in the digastric muscle of mature adult rats subjected to hypofunction (38 weeks; p = <.0001), while it is very weakly expressed in the masseter. CONCLUSION: In jaw-opening and jaw-closing muscles, differences in myosin expression between hard- and soft-diet-fed rats become evident in adulthood, suggesting that long-term alteration of jaw function is associated with changes in the expression of MyHC isoforms and potential fibre remodelling. This may give insight into the role of function on masticatory muscles and the resultant craniofacial morphology.

Decrypting the putative interrelation between sleep bruxism, masticatory muscle pain and sleep breathing disorders: Nosology and the role of hypoxia.

This commentary on sleep medicine explores whether the potential relationship between sleep bruxism (SB), masticatory muscle pain (MMP) and sleep breathing disorders (SBDs)contributes to improving the management of co-occurring conditions.The paper is divided into 2 sections: (1) reviewing the debate on SB nosology; and (2) based on the publications from the Martynowicz & Wieckiewicz research group, exploringthe role of intermittent hypoxia as a putative mechanism endotype that may link such co-occurrence among individuals for whom characteristics are not yet clear.

Comparison of masticatory muscle activity between young adults and elderly participants using a novel standardized bite device.

OBJECTIVES: Standardized bite training is required to prevent oral hypofunction in elderly individuals. We aimed to compare masticatory muscle activity between 24 young adults and 16 pre-elderly individuals during a biting task using a novel standardized bite device (BD). METHODS: The BD was made of silicone rubber and included a high-force or low-force plate spring or no plate spring (dummy). The compressive stiffness of the material in each BD was measured using a texture analyzer. All participants performed a biting task 50-times at a rate of 1/s each using the three types of BDs on the right first molar. Electromyographic (EMG) activity was recorded bilaterally from the masseter and temporalis muscles. The variability of each biting training session was calculated as the coefficient of variance (CV) from the EMG activity during each biting task for each muscle. Masticatory muscle fatigue was assessed using a numerical rating scale (NRS). RESULTS: Compressive stiffness was significantly different between each BD (P < 0.001). The CV and NRS scores were not significantly different between the groups. The EMG activities during each bite task in all muscles were not significantly different for any measurement item between the age groups. The EMG activities of high- and low-force BDs in the right temporalis (ipsilateral) muscle were significantly higher than those of the dummy BD (P < 0.001). CONCLUSIONS: Compressive stiffness of the BD affected EMG activity only in the ipsilateral temporalis muscle, but not in the masseter or contralateral temporalis muscles, without any age effect.

Cranial muscle architecture in wild boar: Does captivity drive ontogenetic trajectories?

The jaw system in mammals is complex and different muscle morphotypes have been documented. Pigs are an interesting group of animals as they are omnivorous and have a bunodont crushing dentition. Moreover, they have interacted with humans for over 10,000 years and grow nearly two orders of magnitude in size. Despite being a model system for studies on cranial form and function, data on the growth of the jaw adductor muscles are scant. Moreover, whether captivity impacts the growth and architecture of the jaw adductors remains unknown. Based on dissection data of the jaw adductors of 45 animals ranging from less than 1 kg to almost 100 kg, we show that muscle masses, muscle fiber lengths, and cross-sectional areas scale as predicted for geometrically similar systems or with slight negative allometry. Only the fiber length of the lateral pterygoid muscle grew with slight positive allometry. Animals raised in captivity in stalls or in an enclosure were overall very similar to wild animals. However, some muscles were larger in captive animals. Interestingly, variation in bite force in captive animals was well predicted by the variation in the size of the superficial masseter muscle relative to the overall jaw adductor mass.

Evaluating the muscle attachment hypothesis for sagittal cresting in Gorilla and Pongo.

Primate mandibular morphology is often associated with jaw functionality of the masticatory complex in the context of variation in diets. Recent research into the disparities between the diet and jaw functionality in male and female hominoids is inconclusive and suggests that sexual dimorphism in the mandible may be influenced by external factors such as temporalis and masseter muscle morphology, which in turn may be influenced by sexual selection. As the muscles associated with mastication (i.e., the type of chewing exhibited by primates and other mammals) encompass the mandible as well as the neurocranium, including the sagittal crest among some individuals, this study investigates sex-specific associations between regions of the mandibular ramus and neurocranium associated with mastication in a dentally mature sample of Gorilla and Pongo. A total of four cranial and mandibular variables were measured in two Gorilla taxa (Gorilla gorilla gorilla and Gorilla beringei graueri) and one Pongo taxon (Pongo pygmaeus pygmaeus) (n = 220). For all three taxa, we investigate (a) whether the degree of sexual dimorphism in cranial regions associated with sagittal cresting (sagittal crest size (SCS) and temporalis muscle attachment area (TMAA)) is proportional to the degree of mandibular ramus area (MRA) and coronoid process height (CPH) sexual dimorphism, (b) whether there are sex differences in scaling relationships between TMAA and MRA, and (c) whether there are sex differences in the strength of association between TMAA and CPH. We show that for G. g. gorilla, variables associated with sagittal cresting show higher sexual dimorphism values than our two mandibular ramus variables, which is not the case for G. b. graueri or for P. p. pygmaeus. All three taxa show similar sex-specific scaling relationships between TMAA and MRA, where for males this relationship does not diverge from isometry, and for females there is a negative allometric relationship. Our findings also show intraspecific sex differences in allometric slopes between MRA and TMAA for all three taxa. Only G. g. gorilla shows a significant association between TMAA and CPH, which is observed in both sexes. Although there are some statistical associations between the cranial and mandibular regions associated with mastication, our results show that among male gorillas and orangutans, patterns of variation in the sagittal crest, TMAA, mandibular ramus and the coronoid process cannot be explained by the muscle attachment hypothesis alone. These findings have implications surrounding the associations between social behaviour and the morphology of the craniofacial complex.

[Evaluation of the efficiency of the method of biological feedback in complex therapy of patients with hypertonus of the chewing muscles]. / Metod biologicheskoi obratnoi svyazi v kompleksnoi terapii patsientov s gipertonusom zhevatel'nykh myshts.

The aim the study. Evaluate the effectiveness of biofeedback therapy in the complex rehabilitation of masticatory muscle hypertonicity in patients with a high level of anxiety. MATERIAL AND METHODS: 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 Questionnaire¼, Beck Depression Inventory, Spielberger-Khanin Anxiety Scale, SF-16 Quality of Life Scale. RESULTS: 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. CONCLUSIONS: 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.

Three-dimensional Analysis of the Muscles Related to the So-Called "Pterygomandibular Raphe": An Anatomical and Histological Study.

The pterygomandibular raphe (PMR) is a tendinous bundle between the bucinator (BM) and the superior constrictor of pharynx (SC) and has been considered essential for swallowing. Despite its functional significance, previous studies reported that the PMR is not always present. Another study reported presence of the connecting fascia between the BM and deep temporalis tendon (dTT). Therefore, the present study analyzed the three-dimensional relationship between the BM, SC, and dTT. We examined 13 halves of 11 heads from adult Japanese and Caucasian cadavers: eight halves macroscopically and five halves histologically. There was no clear border between the BM and SC in any specimens macroscopically. The BM attachment varied depending on its levels. At the level of the superior part of the internal oblique line, the BM fused with the SC with no clear border. At the level of the midpart of the internal oblique line of the mandible, the BM attached to the dTT directly, and the SC attached to the dTT via collagen fibers and the BM. Based on these results, these muscles should be described as the BM/dTT/SC (BTS) complex. The three-dimensional relationship of the BTS complex might result in the so-called "pterygomandibular raphe." The BTS complex could be important as a muscle coordination center in chewing and swallowing.

Neuromuscular control of masticatory muscles in people with intellectual disability, middle-aged adults and older adults.

BACKGROUND: Motor control issues are common for people with intellectual disabilities (PWID), resulting in difficulties with basic activities of daily living, including eating. Mastication, which is crucial for digestion and overall health, is poorly understood in this population. PWID shows frailty similar to older people, highlighting the importance of comparing masticatory motor control with older adults. This study compared the neuromuscular control of the masticatory muscles in middle-aged, PWID and older adults. METHODS: A cross-sectional analytical design was used. During the mastication task of a carrot piece (2 cm in diameter and weighing 0.5 g), surface electromyography was used to record muscle activity patterns from the right and left masseter and temporalis muscles. Principal component analysis (PCA) was used to assess neuromuscular control. A z-score normalisation of the first component's variance from PCA to identify those individuals with altered neuromuscular control. A mixed ANOVA was performed to assess the interaction between principal components, groups and body composition. RESULTS: Thirty PWIDs (aged 35-55 years), middle-aged adults and 32 older adults were recruited. PWID and older adults showed decreased neuromuscular control of the masticatory muscles compared to middle-aged control adults (P < 0.05). PWID had the highest proportion of individuals with altered neuromuscular control of the masticatory muscle (53%) compared to older adults (19%) and middle-aged adults (0%) (P < 0.05). CONCLUSIONS: Our results indicate that PWID and older adults have reduced neuromuscular control compared to middle-aged adults. Notably, a significant proportion of the PWID showed altered masticatory muscle control compared to older adults. Further research is needed to explore the potential benefits of masticatory muscle training for PWID.

Symphyseal morphology and jaw muscle recruitment levels during mastication in musteloid carnivorans.

In studies of mammalian mastication, a possible relationship has been proposed between bilateral recruitment of jaw adductor muscle force during unilateral chewing and the degree of fusion of the mandibular symphysis. Specifically, species that have unfused, mobile mandibular symphyses tend to utilize lower levels of jaw adductor force on the balancing (nonchewing) than the working (chewing) side of the head, when compared to related species with fused symphyses. Here, we compare jaw adductor recruitment levels in two species of musteloid carnivoran: the carnivorous ferret (unfused symphysis), and the frugivorous kinkajou (fused symphysis). During forceful chewing, we observe that ferrets recruit far more working-side muscle force than kinkajous, regardless of food toughness and that high working-to-balancing side ratios are the result of increased working-side force, often coupled with reduced balancing-side force. We propose that in carnivorans, high working-to-balancing side force ratios coupled with an unfused mandibular symphysis are necessary to rotate the hemimandible for precise unilateral occlusion of the carnassial teeth and to sustain laterally oriented force on the jaw to engage the carnassial teeth during shearing of tough foods. In contrast, the kinkajou's flattened cheekteeth permit less precise occlusion and require medially-oriented forces for grinding, thus, a fused symphysis is mechanically beneficial.

Effects of orthodontic treatment on masticatory muscles activity: a meta-analysis.

Context: A comprehensive meta-analysis was carried out to investigate the impact of orthodontics on masticatory muscles.Methods: A thorough search of various databases, including CNKI, Wan Fang, VIP, CBM, MEDLINE, PubMed, Cochrane Library, EMBASE, Web of Science, and Google Scholar, was performed to identify relevant studies on patients undergoing orthodontics or functional corrections. Six case-control studies were finally included in this analysis, which specifically examined the effect of orthodontic treatment on masticatory muscle function.Results: The results revealed that the mean masticatory muscle voltage in patients treated with orthodontics was found to be higher after treatment compared to before treatment [odds ratio (OR)=1.57, 95% confidence interval (CI) (0.57, 2.57), p = 0.002], which could potentially have an impact on masticatory muscle function, particularly in individuals with Class II Division 1 malocclusion.Conclusion: These findings contribute to our understanding of the effects of orthodontic interventions on masticatory muscles, further highlighting the importance of orthodontics in optimising masticatory function.

Myopia & painful muscle form of temporomandibular disorders: connections between vision, masticatory and cervical muscles activity and sensitivity and sleep quality.

The main aim of this study is to evaluate the effects of painful muscle form of temporomandibular disorders and myopia on the connections between the visual organ, the bioelectrical activity and sensitivity of the masticatory and cervical muscles, and sleep quality. Subjects were divided into 4 groups (Myopia & TMDs, Myopia (Without TMDs), Emmetropic & TMDs and Emmetropic (Without TMDs)). The study was conducted in the following order of assessment: examination for temporomandibular disorders, assessment of the muscle activity by electromyograph, pressure pain thresholds examination, ophthalmic examination and completion of the Pittsburgh Sleep Quality Index. It was observed that the Myopia & TMDs group had higher muscle tenderness, higher resting and lower functional muscle bioelectrical activity. The visual organ is clinical related to the masticatory and cervical muscles. TMDs and myopia alter masticatory and cervical muscle activity. The thickness of the choroid in people with myopia is related to muscle tenderness. TMDs and myopia impair sleep quality. It is recommended to determine the number of people with refractive error and its magnitude in the sEMG study in order to be able to replicate the research methodology.

Predictors of the masticatory muscle activity during chewing in patients with myogenous temporomandibular disorder.

OBJECTIVES: The aim of the study was to identify predictors of the masticatory muscle activity during chewing (MMA) of the masseter and temporalis anterior (TA) muscles in patients with unilateral myogenous temporomandibular disorder (mTMD). MATERIALS AND METHODS: This observational and cross-sectional study included 109 patients diagnosed with unilateral mTMD. Surface electromyography was used to separately evaluate the MMA of the masseter and TA on the affected and unaffected sides. Also, pain intensity (with a visual analog scale), pressure pain threshold (with an algometer), active pain-free maximum mouth opening and temporomandibular joint lateral movements (with a ruler), cervical range of motions (with a goniometer), and TMD severity (with a Fonseca Anamnestic Index) were assessed. Various statistical methods were used to predict the MMA of the masseter and TA, including standard, forward, and best subsets multiple regression models. RESULTS: While there were significant correlations between the MMA of the masseter and TA and pain intensity, pressure pain threshold values, and TMD severity, they were not found with other variables. These parameters were also predictive factors for MMA of both muscles (p < 0.05). CONCLUSIONS: According to the present study, pain intensity, muscle and joint tenderness, and the severity of the disorder are predictive factors for MMA of the masseter and TA muscles in patients with mTMD. It is recommended that these parameters be considered when establishing clinical evaluation and treatment programs focusing on MMA in patients with mTMD. CLINICAL RELEVANCE: The pain intensity, masticatory muscles and TMJ tenderness, and disorder severity are predictors for MMA of the masseter and TA in patients with mTMD. Pain intensity has the most significant importance.

Correlation of masticatory muscle activity and occlusal function with craniofacial morphology: a prospective cohort study.

OBJECTIVES: Masticatory function, including masticatory muscle activity and occlusal function, can be affected by craniofacial morphology. This study aimed to investigate the relationship between craniofacial morphology and masticatory function in participants who had completed orthodontic treatment at least two years before and had stable occlusion. MATERIALS AND METHODS: Fourty-two healthy participants were prospectively enrolled and divided into three vertical cephalometric groups according to the mandibular plane angle. Masticatory muscle activity (MMA) in the masseter and anterior temporalis muscles was assessed using surface electromyography. The occlusal contact area (OCA) and occlusal force (OF), defined as occlusal function in this study, were evaluated using occlusal pressure mapping system. Masticatory muscle efficiency (MME) was calculated by dividing MMA by OF. The craniofacial morphology was analyzed using a lateral cephalogram. The masticatory function was compared using one-way analysis of variance. Pearson correlations were used to assess relationships between craniofacial morphology and masticatory function. RESULTS: The hypodivergent group had the lowest MMAand the highest MME in the masseter (167.32 ± 74.92 µV and 0.14 ± 0.06 µV/N, respectively) and anterior temporalis muscles (0.18 ± 0.08 µV/N, p < 0.05). MMA in the masseter showed a positive relationship with mandibular plane angle (r = 0.358), whereas OCA (r = -0.422) and OF (r = -0.383) demonstrated a negative relationship (p < 0.05). The anterior temporalis muscle activity negatively correlated with ramus height (r = -0.364, p < 0.05). CONCLUSIONS: Vertical craniofacial morphology was related to masticatory function. Hypodivergent individuals may have low MMA and high occlusal function, resulting in good masticatory muscle efficiency. CLINICAL RELEVANCE: Hypodivergent individuals require careful consideration in orthodontic diagnosis and prosthetic treatment planning.

Bilateral treatment of the masseter with botulinum toxin: Consequences for mastication, muscle force and the mandibular condyle.

BACKGROUND: Clinical use of botulinum neurotoxins (BoNTs) in masticatory muscles is usually bilateral, but most studies on the functional consequences of BoNT treatment have used unilaterally treated animals. OBJECTIVES: To test the hypothesis that bilateral BoNT treatment of the rabbit masseter hampers mastication and to assess its effects on bone density of the mandibular condyles. METHODS: Ten 5-month-old female rabbits received injections of BoNT into both masseter muscles and nine sham animals received saline. Body weight, incisor bite force during masseter tetany, and surface and fine-wire electromyography (EMG) of the masseter and medial pterygoid muscles were assessed at regular intervals. Half the sample was terminated after 4 weeks and the remainder after 12 weeks. Muscles were weighed and mandibular condyles were scanned with microCT to analyse bone density. RESULTS: BoNT rabbits lost weight and required a soft-food diet. Incisor occlusal force plummeted after BoNT injection and remained lower than the shams. The duration of masticatory cycles was increased in the BoNT rabbits for 5 weeks, with most of the increase due to the adductor burst. Masseteric EMG amplitude began to improve at Week 5, but remained low on the working side throughout the experiment. At the 12-week endpoint, masseter muscles were smaller in the BoNT rabbits. Medial pterygoid muscles did not compensate. Condylar bone density was reduced. CONCLUSION: Bilateral treatment of the rabbit masseter by BoNT severely affected chewing performance. Even after a 3-month recovery period, deficits remained in bite force, muscle size and condylar bone density.

Understanding the pathophysiology of sleep bruxism based on human and animal studies: A narrative review.

BACKGROUND: Sleep bruxism (SB) is a common sleep disorder that affects approximately 20% of children and 10% of adults. It may cause orodental problems, such as tooth wear, jaw pain, and temporal headaches. However, the pathophysiological mechanisms underlying SB remain largely unknown, and a definitive treatment has not yet been established. HIGHLIGHT: Human studies involving polysomnography have shown that rhythmic masticatory muscle activity (RMMA) is more frequent in otherwise healthy individuals with SB than in normal individuals. RMMA occurs during light non-rapid eye movement (non-REM) sleep in association with transient arousals and cyclic sleep processes. To further elucidate the neurophysiological mechanisms of SB, jaw motor activities have been investigated in naturally sleeping animals. These animals exhibit various contractions of masticatory muscles, including episodes of rhythmic and repetitive masticatory muscle bursts that occurred during non-REM sleep in association with cortical and cardiac activation, similar to those found in humans. Electrical microstimulation of corticobulbar tracts may also induce rhythmic masticatory muscle contractions during non-REM sleep, suggesting that the masticatory motor system is activated during non-REM sleep by excitatory inputs to the masticatory central pattern generator. CONCLUSION: This review article summarizes the pathophysiology of SB based on the findings from human and animal studies. Physiological factors contributing to RMMA in SB have been identified in human studies and may also be present in animal models. Further research is required to integrate the findings between human and animal studies to better understand the mechanisms underlying SB.

Response of masticatory muscles to treatment with orthodontic aligners: a preliminary prospective longitudinal study.

INTRODUCTION: The emergence of orthodontic aligners has provided an aesthetic and comfortable option for orthodontic treatment. However, the encapsulated design of the aligners can influence the masticatory muscles, and might compromise safe treatment. OBJECTIVE: This preliminary longitudinal study aimed to investigate whether the use of orthodontic aligners affects the biting force and myoelectric activity of the superficial masseter and anterior temporal muscles. METHODS: Ten subjects participated in the study and underwent treatment during an 8-month follow-up period. The root mean square (RMS), the median power frequency (MPF) of the surface electromyography (sEMG) signals, and the biting force (kgf) were recorded and normalized relative to the pretreatment condition. The data were analyzed by repeated-measure analysis of variance (ANOVA), with the significance level set at 5%. RESULTS: Both the superficial masseter and the anterior temporal muscles presented an increase in sEMG signal activity during the treatment, with a marked increase in the latter compared to the former (p<0.05). Moreover, a significant decrease in bite force was evidenced (p<0.05). CONCLUSIONS: This preliminary study observed that the orthodontic aligners affected the muscle recruitment pattern of masticatory muscles, and reduced biting performance during the 8-month follow-up period.