Impact of obesity on the structures and functions of the stomatognathic system: A morphofunctional approach.

OBJECTIVE: The prevalence of obesity is increasing significantly worldwide, raising great concern among health professionals. This observational study evaluated the electromyographic activity and thickness of the masseter and temporalis muscles, in addition to the maximum molar bite force, in obese and eutrophic subjects. METHODS: Sixty subjects were divided into three groups: I (7-12 years), II (13-20 years), III (21-40 years) and sex: with 10 men and 10 women for each group. Electromyographic recordings of the masticatory muscles were obtained during mandibular tasks. The masticatory muscles thicknesses were obtained at rest and during dental clenching. The maximum molar bite forces were measured on the right and left sides. The difference in outcome measures between the groups and sex was analyzed using Mann-Whitney U test (p < 0.05) and analysis of covariance (ANCOVA). RESULTS: Electromyographic activity in the masseter and temporal muscles consistently displayed lower levels in obese subjects of both sexes across all three age groups during mandibular tasks. Additionally, greater thickness of the masticatory muscles was observed in obese subjects of both sexes across all three age groups. Obese women in Group II displayed higher values of molar bite force, both on the right and left sides, compared to eutrophic women. On the other hand, women in Group III exhibited higher values of molar bite force on the right side in comparison to eutrophic women. CONCLUSIONS: This study underscores the potential impact of obesity on the morphofunctional aspects of the stomatognathic system in subjects aged 7 to 40 years.

Effect of dry needling and instrumental myofascial release on masticatory, facial, and cervical muscles of patients with temporomandibular disorders of muscular origin.

Background: To evaluate the effectiveness of dry needling (DN) and instrumental myofascial release (IMR) therapies in the cervico-cranio-mandibular system through pain, bite force, and distribution of occlusal contacts in patients with muscular temporomandibular disorders. Material and Methods: Thirty patients were divided into treatment groups: DN (n=15) and IMR (n=15). Therapeutic efficacy regarding pain perception and tolerance of masticatory, facial, and cervical muscles, bite force, and distribution of occlusal contacts were analyzed in this observational longitudinal clinical study pre/post-intervention and pre/post one month of therapeutic intervention. The data were tabulated and statistically analyzed (repeated measures and Bonferroni post-hoc test, p<0.05). Results: There was a statistically significant difference in pain between the groups in the comparison of pre- and post-intervention with effect on time versus intervention in the head and neck. Pain perception and tolerance showed a statistical effect of time on the temporal, suboccipital, sternocleidomastoid, mental (right and left), right masseter, and left trapezius muscles. There was a statistically significant effect of the intervention on the mentalis, supraorbital, and infraorbital (right and left) muscles. There was a statistically significant effect of the interaction on the upper masseter (right and left), anterior temporal (left), suboccipital, sternocleidomastoid, and mentalis (left) muscles. There was an increase in post-intervention molar bite force in the groups, with a statistical effect on time versus intervention in the right and left regions. Contact of occlusal forces at the maxilla/mandible interface showed a difference between the mean times on teeth 26-36 after versus 1 month after the intervention. Conclusions: The two therapeutic techniques are viable for the treatment of muscular temporomandibular disorders; however, IMR proved to be more effective immediately after the intervention and after one month. Key words:Temporomandibular disorders, pain, masticatory muscles, facial muscles, cervical muscles, dry needling, instrumental myofascial release.

Orthodontic treatment of children with anterior open bite and posterior crossbite: An analysis of the stomatognathic system.

Dental malocclusions are deviations from normalities due to the inadequate growth and development of the dental arch which provides functional changes to the stomatognathic system. The aim of this longitudinal study was to evaluate the electromyographic activity (EMG) the masseter and temporalis muscles, strength of the orofacial tissues and occlusal force of children with anterior open bite (n = 15) and posterior crossbite (n = 20), 7 days after the removal of the orthodontic apparatus. A fixed horizontal palatal crib was used in the treatment of anterior open bite and the fixed appliances Hyrax or MacNamara was used in the treatment of posterior crossbite. EMG of the masticatory muscles was recorded using an electromyograph with wireless sensors during mandibular tasks. Habitual chewing was assessed using the integral of the linear envelope of the electromyographic signal in the masticatory cycles. The strength of the tongue and facial muscles was measured using the Iowa Oral Pressure Instrument. T-Scan was used to analyze the force of occlusal contact. Molar bite force was measured by digital dynamometer. Significant differences (p < 0.05) were found in the EMG data of the masseter and temporalis muscles in the static and dynamic mandibular tasks. There were no significant difference in strength of orofacial tissues, occlusal contact force and molar bite force 7 days after the removal of the orthodontic apparatus. The results of this study suggest that the orthodontic treatment of anterior open bite and posterior crossbite in children promoted functional alteration in the electromyographic activity of masseter and temporalis muscles.

Electromyographic analysis of the stomatognathic system of children with Molar-incisor hypomineralization.

INTRODUCTION: Molar-incisor hypomineralization (MIH) is a qualitative defect of dental enamel that affects one or more permanent first molars, with or without involvement of the incisor teeth. This condition leads to challenges to dental care and treatment planning. AIM: Based on the hypothesis that children who have MIH possibly present alterations in postural and masticatory activities and considering the absence of studies investigating these parameters, the present study evaluated the functionality of the stomatognathic system considering the mentioned aspects. MATERIALS: The comparison of individuals with (MIHG; n = 32) and without MIH (CG; n = 32) was evaluated by electromyographic activity of the masseter and temporal muscles (right and left), as well as evaluation of the masticatory cycles during habitual mastication. RESULTS: MIHG showed muscle hyperactivity in postural and dynamic conditions compared to the CG; higher electromyographic values for MIHG when compared to CG in the following postural conditions: at rest for the right temporal (p = 0.00) and left temporal muscles (p = 0.03); in the protrusion to the right temporal muscle (p = 0.02); in the right laterality for the right masseter (p = 0.00) and left temporal muscles (p = 0.01); in the left laterality for the right masseter (p = 0.03) and left temporal (p = 0.04) muscles. In dynamic conditions with consistent food, significance was observed for the left temporal (p = 0.01); and with soft food for the right (p = 0.01) and left temporal muscles (p = 0.04). CONCLUSIONS: Children with MIH seem to have impaired functionality of the stomatognathic system. Children with MIH have alterations in the stomatognathic system.

Amyotrophic Lateral Sclerosis: An Analysis of the Electromyographic Fatigue of the Masticatory Muscles.

Amyotrophic lateral sclerosis is a chronic degenerative disease that affects motor neurons, thereby promoting functional changes in the human body. The study evaluated the electromyographic fatigue threshold of the masseter and temporal muscles of subjects with amyotrophic lateral sclerosis. A total of eighteen subjects were divided into two groups: amyotrophic lateral sclerosis (n=9) and disease-free control (n=9). The groups were equally divided according to gender (7 males, 2 females). The fatigue threshold was analysed using median frequencies obtained during the 5-second window (initial [IP], mid [MP], and final [FP] periods) of electromyographic signalling of the masseter and temporal muscles bilaterally, with reduction in muscle force during maximal voluntary dental clenching. Significant difference (p<0.05) in the left temporal muscle: IP (p=0.05) and MP (p=0.05) periods was demonstrated. The amyotrophic lateral sclerosis group showed a decrease in median frequency of the electromyographic signal of the masseter and temporal muscles compared to the control group. Amyotrophic lateral sclerosis promotes functional impairment of the stomatognathic system, especially at the electromyographic fatigue threshold of the masticatory muscles.

Effect of intervertebral disc degeneration on the stomatognathic system function in adults.

OBJECTIVE: To analyze the electromyographic activity (EMG) and thermographic patterns of the masseter and temporalis muscles and pressure of the orofacial tissues in individuals with intervertebral disc degeneration (IDD). METHODS: This study had two distinct groups: with IDD (n = 16) and controls (n = 16). EMG at rest, protrusion, right and left laterality, and maximum voluntary contraction were evaluated. Tongue, orbicularis oris, and buccinator muscles pressures were measured by Iowa Oral Performance Instrument. The thermographic patterns were analyzed using infrared thermography. RESULTS: Comparisons between groups showed significant differences regarding at rest [right (p = 0.05) and left (p = 0.05) masseter and right temporal (p = 0.05)], orofacial tissue pressure [tongue (p = 0.001), orbicularis oris (p = 0.01), and buccinator (p = 0.0001)], but no significant differences for the thermographic patterns. CONCLUSION: IDD modifies the functionality of the craniomandibular complex, influencing the performance of the stomatognathic system.

Intervertebral Disc Degeneration: Functional Analysis of Bite Force and Masseter and Temporal Muscles Thickness.

Intervertebral disc degeneration is a pathological condition associated with the intervertebral disc and is related to functional alterations in the human body. This study aimed to evaluate the maximum molar bite force and masseter and temporal muscles thickness in individuals with intervertebral disc degeneration. Thirty-two individuals were divided into two groups: those with degeneration of intervertebral discs (n=16) and those without degeneration (n=16). The maximum molar bite force (on the right and left sides) was measured using a dynamometer. Masseter and temporal muscle thickness during mandibular task rest and dental clenching in maximum voluntary contraction were analysed using ultrasound. Significant differences in the left molar bite force (p=0.04) were observed between the groups (Student's t-test, p<0.05). The intervertebral disc degeneration group had a lower maximum molar bite force. No significant differences in muscle thickness were observed between the masseter and temporal muscles in either group. However, based on clinical observations, the group with intervertebral disc degeneration presented less masseter muscle thickness and greater temporal muscle thickness in both mandibular tasks. Degenerative disease of the intervertebral discs promoted morphofunctional changes in the stomatognathic system, especially in maximum molar bite force and masticatory muscle thickness. This study provides insight into the interaction between spinal pathology and the stomatognathic system, which is important for healthcare professionals who treat patients with functional degeneration.

Impact of chronic allergic rhinitis on bite force and electromyographic activity of masseter and temporalis muscles of adult women.

BACKGROUND: The aim of this study was to analyse the stomatognathic system of adult women with chronic allergic rhinitis by means of molar bite force and electromyographic activity of the masseter and temporalis muscles. MATERIAL AND METHODS: A total of 26 subjects were screened and divided into two distinct groups: chronic allergic rhinitis group (n = 13) and healthy control group (n = 13). Subjects were assessed by maximal molar bite force (right and left) and normalized electromyographic activity of mandibular tasks (rest, right and left laterality, protrusion and maximal voluntary contraction). Data were submitted to Student's t test (p< .05). RESULTS: There was significant difference in right (p = .03) and left (p = .04) maximal molar bite force with force reduction in the chronic allergic rhinitis group. There was significant difference in normalized electromyographic activity in maximal voluntary contraction in the right (p =.01) and left (p = .01) temporalis muscles, with increased electromyographic activity in the masticatory muscles for the chronic allergic rhinitis group. CONCLUSIONS: The results suggest that chronic allergic rhinitis in adult women promoted negative changes in the electromyographic activity of temporalis muscles in maximal voluntary contraction and maximal molar bite force. Key words:Rhinitis, occlusal force, electromyography, masticatory muscles.

Osteoarthrosis: Analyze of the Molar Bite Force, Thickness and Masticatory Efficiency.

Osteoarthrosis is a disorder of synovial joints, resulting from destruction of the cartilage and subchondral bone. The present study is aimed to investigate the molar bite force, thickness and efficiency of the masseter and temporalis muscles of subjects with osteoarthrosis. A total of forty-eight subjects participated in the study. They were distributed into two groups: with osteoarthrosis (n=24) and asymptomatic controls (n=24). Subjects were analyzed on the basis of maximal molar bite force (right and left side), thickness (mandibular rest and dental clenching in maximal voluntary contraction) and electromyographic activity of masticatory cycles through the linear envelope integral in habitual (raisins and peanuts) and non-habitual (Parafilm M) chewing of the masseter and temporalis muscles. All the data were analyzed statistically using t-test with a significance level of p≤0.05. There was no difference between groups in maximal molar bite force, muscle thickness and non-habitual chewing. Differences were found on the raisins (p=0.02) and peanuts (p=0.05) chewing for right temporal muscle, with reduced masticatory muscle efficiency in osteoarthrosis subjects. This study showed that osteoarthrosis induces negative changes in habitual chewing, highlighting the efficiency of the right temporalis muscles. The greater temporal muscle activity in subjects with osteoarthrosis may compromise chewing and consequently the nutritional status of adult subjects.

Low-level laser therapy enhances the number of osteocytes in calvaria bone defects of ovariectomized rats.

BACKGROUND: Osteoporosis can make bone repair difficult. Low-level laser therapy (LLLT) has been shown to be a promising tool for bone neoformation. This study aimed to analyze the effect of LLLT on calvaria bone defects of ovariectomized rats using stereology. METHODS: Fifty-four Wistar rats were subjected to bilateral ovariectomy, and bone defects were created in calvaria after 150 days. The animals were divided into nine groups (n =  6 per group), and 24 hours after the bone defects were created they received 3, 6 or 12 sessions of LLLT at 0, 20 or 30 J/cm2, using a 780-nm low-intensity GaAlAs laser. One-way ANOVA followed by Tukey's post hoc test was used for data processing. A difference of P < 0.05 was considered statistically significant. The parameters evaluated were osteocyte density (Nv ost), total osteocyte number (Nto ost), trabecular surface density (Sv t), and trabecular surface area (Sa t). RESULTS: Data obtained showed that Nto ost, Sv t, and Sa t in group G2 rats were significantly different from G1 (0 J/cm2) (P < 0.05). Compared to group G4, G5 presented higher values for the parameters Sv t and Sa t, and G6 presented significantly higher values for almost all the analyzed parameters (Nv ost, Nto ost, Sv t, and Sa t) (P < 0.05). Compared to group G7, G8 showed a higher value only for the parameter Sa t, and G9 showed significantly higher values for parameters Nv ost, Nto ost, Sv t, and Sa t. CONCLUSION: We conclude that LLLT stimulated bone neoformation and contributed to an increase in the total number of osteocytes, especially with a laser energy density of 30 J/cm2 given for 6 and 12 sessions.

Effect of Breast Cancer Treatment on the Stomatognathic System.

Breast cancer is the most common cancer affecting women in the world and provides functional changes in the human body. Evaluate women submitted to unilateral mastectomy, through electromyographic activity (mandibular rest, right and left laterality, protrusion, maximum voluntary contraction with and without Parafilm, habitual and non-habitual mastication) and thickness (rest and maximum voluntary contraction) of the right temporal muscle (RT), left temporal (LT), right masseter (RM) and left masseter (LM), also the molar bite force (right and left) and compare the data with healthy women. Material and Methods: 32 women were divided into two groups: unilateral mastectomy group (MG), average ± standard deviation 56.50±14.50 years (n=16) and without the disease group (CG), average ± standard deviation 56.56±14.15 years (n=16). The normalized electromyographic data, muscle thickness and maximal molar bite force were tabulated and submitted to statistical analysis (SPSS 21.0; student t test, p≤0.05). Significant statistical differences between MG and CG were found in right laterality, for RM (p=0.02); left laterality, for LT (p=0.01); chewing with peanuts, for RM (p=0.04); chewing with raisins, for LM (p=0.04) and right molar bite force (p=0.03). There was no statistically significant difference between MG and CG for muscle thickness. The results of this study suggest that women undergoing unilateral mastectomy may present functional changes, with emphasis on muscular hyperactivity, lower masticatory efficiency and lower maxillary bite force.

Alterations in the stomatognathic system due to amyotrophic lateral sclerosis.

OBJECTIVES: To compare the molar bite force, electromyographic activity, chewing efficiency and thickness of the masseter and temporalis muscles in individuals with amyotrophic lateral sclerosis (ALS) and healthy individuals. MATERIAL AND METHODS: Thirty individuals enrolled in the study were divided into the study group (with ALS, n=15) and control group (healthy individuals, n=15). Data regarding molar bite force (right and left), electromyographic activity (mandibular rest, right and left laterality, protrusion, and maximum voluntary contraction), chewing efficiency (habitual and non-habitual), and masticatory muscle thickness (rest and maximum voluntary contraction) were tabulated and subjected to statistical analysis (Student's t-test, p≤0.05). RESULTS: Comparisons between the groups demonstrated a statistically significant increase in the electromyographic activity of the right masseter (p=0.03) and left masseter (p=0.03) muscles during mandibular rest; left masseter (p=0.00), right temporalis (p=0.00), and left temporalis (p=0.03) muscles during protrusion; and right masseter (p=0.00), left masseter (p=0.00), and left temporalis (p=0.00) muscles during left laterality, in individuals with ALS as compared with healthy individuals. A statistically significant decrease was observed in the habitual chewing efficiency of the right masseter (p=0.00) and right temporalis (p=0.04) muscles in individuals with ALS. No statistically significant difference between the groups was found the masticatory muscle thickness and maximal molar bite force. CONCLUSIONS: ALS may lead to modifications in the activities of the stomatognathic system, including muscular hyperactivity and reduction in chewing efficiency; however, no change has been observed in the masticatory muscle thickness and molar bite force.

Analysis of the stomatognathic system of children according orthodontic treatment needs.

PURPOSE: The present study evaluated electromyographic activity (EMG), masticatory performance, and tongue strength in children without and with orthodontic treatment needs. PATIENTS AND METHODS: A total of 90 children were screened and divided into the following groups: Group I (no treatment needed; mean age: 8.00 ± 0.43 years; n = 26), Group II (few malocclusions, treatment needed; mean age: 8.89 ± 0.43 years; n = 28), and Group III (slight-to-borderline treatment needed; mean age: 8.44 ± 0.22 years; n = 36). Orthodontic treatment need was classified on the basis of IOTN-DHC (Index of Orthodontic Treatment Need - Dental Health Component). The electromyographic Trigno EMG Systems was used for muscle analysis and the Iowa Oral Pressure Instrument (IOPI) was used to measure tongue strength. Data were analyzed using normality tests and one-way analysis of variance with a Bonferroni post hoc test (p ≤ 0.05). RESULTS: EMG in almost all mandibular movements was higher in Group III with statistically significant differences compared to position at rest: right masseter (p = 0.03); protrusion: left temporal (p = 0.02); saliva swallowing: left temporal (p = 0.05) and water swallowing: orbicularis oris mouth, right upper segment (p = 0.05). Lower masticatory performance was found in Group III, but the difference compared to Group I and II was not significant. There were no significant differences between the groups in terms of tongue strength. CONCLUSIONS: Children with borderline orthodontic treatment needs show functional disorders of the stomatognathic system.

Radiation therapy alters microhardness and microstructure of enamel and dentin of permanent human teeth.

OBJECTIVES: To evaluate, in vitro, the effects of ionizing radiation on the mechanical and micro-morphological properties of enamel and dentin of permanent teeth. METHODS: Enamel and dentin microhardness (n=12 hemi-sections) was evaluated at three depths (superficial, middle and deep) prior to (control) and after every 10Gy radiation dose up to a cumulative dose of 60Gy by means of longitudinal microhardness. Data were analyzed using two-way analysis of variance and Tukey's test at a significance level of 5%. Enamel and dentin morphology was assessed by scanning electron microscopy (SEM) for semi-quantitative analysis (n=8 hemi-sections). Data were analyzed using Kruskal-Wallis and Dunn's or Fisher exact tests at a significance level of 5%. RESULTS: The application of ionizing radiation did not change the overall enamel microhardness, although an increase in superficial enamel microhardness was observed. The micro-morphological analysis of enamel revealed that irradiation did not influence rod structure but interprismatic structure became more evident. Dentin microhardness decreased after 10, 20, 30, 50 and 60Gy cumulative doses (p<0.05) compared with non-irradiated dentin, mainly in the middle portion of the tissue. The micro-morphological analysis revealed fissures in the dentin structure, obliterated dentinal tubules and fragmentation of collagen fibers after 30 and 60Gy cumulative doses. CONCLUSIONS: Although ionizing radiation did not affect the enamel microhardness of permanent teeth as a whole, an increase in superficial enamel microhardness was observed. Dentin microhardness decreased after almost all radiation doses compared with the control, with the greatest reduction of microhardness in the middle depth region. The morphological alterations on enamel and dentin structures increased with the increase of the radiation dose, with a more evident interprismatic portion, presence of fissures and obliterated dentinal tubules, and progressive fragmentation of the collagen fibers. CLINICAL SIGNIFICANCE: This study shows that irradiation affects microhardness and micro-morphology of enamel and dentin of permanent teeth. The effects of gamma irradiation on dental substrate might contribute to increased risk of radiation tooth decay associated with salivary changes, microbiota shift and high soft and carbohydrate-rich food intake.