Alterations in masticatory cycle efficiency and bite force in individuals with periodontitis.

OBJECTIVES: The objective of this research was to evaluate the effect of periodontitis on masticatory cycle efficiency and maximum molar bite force. METHODS: Twenty-four individuals were divided into two groups: With periodontitis (Group I; mean age ± standard deviation (SD), 51.3 ± 2.8 years; n = 12) and without periodontitis (Group II; mean age ± SD, 48.9 ± 2.4 years; n = 12). Masticatory cycle efficiency was obtained from the value of the ensemble-averaged integrated linear envelope electromyographic signal of the masseter and temporalis muscles. Maximum bite force was recorded for the right and left molar regions. The data were tabulated and submitted to statistical analysis (P ≤ 0.05). RESULTS: There was a significant difference between the groups for the left masseter muscle when chewing raisins (P = 0.04), peanuts (P = 0.02), and biocapsules (P = 0.01). Multiple regression analysis demonstrated the influence of dental mobility on masticatory cycle efficiency for peanuts (P = 0.03) and biocapsules (P = 0.01). The maximum bite force for the left molar region was significantly different between the groups (P = 0.02). Dental mobility was a variable that had a greater effect on masticatory cycle efficiency. The periodontitis group had a reduced bite force. CONCLUSION: The present study findings indicate that the loss of periodontal supporting structures had a negative impact on masticatory cycle efficiency and molar bite force. This finding suggested that dental mobility should be considered when determining clinical treatments aimed at improving masticatory efficiency and bite force in individuals with the periodontal disease.

Influence of mandibular tori on stomatognathic system function.

OBJECTIVES: To verify the influence of prominent mandibular tori on the functioning of the stomatognathic system. METHODS: The participants included 40 individuals, divided into two groups: those with mandibular tori (GI group: 20 subjects) and those without mandibular tori (GII group: 20 subjects). The authors used the Myosystem-Br1 electromyography system to analyze electromyographic (EMG) activity. For muscle thickness, images of the masseter and temporalis muscles were captured using the NanoMaxx ultrasound. The maximal molar bite force was obtained by means of the Kratos digital dynamometer. RESULTS: The EMG activity was higher in the masseter muscles in the GI group, compared with the GII group, in all clinical conditions assessed except for the mandibular at rest. In dynamic conditions, this higher EMG activity was also observed in the temporalis muscles. The GI group presented significantly less temporalis muscle thickness than seen in the GII group. The maximal bite force was significantly higher in the GI group. CONCLUSIONS: Mandibular tori promoted morphological and functional changes in the stomatognathic system.

Poly(Vinylidene Fluoride-Trifluorethylene)/barium titanate membrane promotes de novo bone formation and may modulate gene expression in osteoporotic rat model.

Osteoporosis is a chronic disease that impairs proper bone remodeling. Guided bone regeneration is a surgical technique that improves bone defect in a particular region through new bone formation, using barrier materials (e.g. membranes) to protect the space adjacent to the bone defect. The polytetrafluorethylene membrane is widely used in guided bone regeneration, however, new membranes are being investigated. The purpose of this study was to evaluate the effect of P(VDFTrFE)/BT [poly(vinylidene fluoride-trifluoroethylene)/barium titanate] membrane on in vivo bone formation. Twenty-three Wistar rats were submitted to bilateral ovariectomy. Five animals were subjected to sham surgery. After 150 days, bone defects were created and filled with P(VDF-TrFE)/BT membrane or PTFE membrane (except for the sham and OVX groups). After 4 weeks, the animals were euthanized and calvaria samples were subjected to histomorphometric and computed microtomography analysis (microCT), besides real time polymerase chain reaction (real time PCR) to evaluate gene expression. The histomorphometric analysis showed that the animals that received the P(VDF-TrFE)/BT membrane presented morphometric parameters similar or even better compared to the animals that received the PTFE membrane. The comparison between groups showed that gene expression of RUNX2, BSP, OPN, OSX and RANKL were lower on P(VDF-TrFE)/BT membrane; the gene expression of ALP, OC, RANK and CTSK were similar and the gene expression of OPG, CALCR and MMP9 were higher when compared to PTFE. The results showed that the P(VDF-TrFE)/BT membrane favors bone formation, and therefore, may be considered a promising biomaterial to support bone repair in a situation of osteoporosis.

Impact of sleep bruxism on masseter and temporalis muscles and bite force.

OBJECTIVES: This study aimed to analyze the impact of sleep bruxism (SB) on electromyography (EMG) activity and the thickness of the masseter and temporal and maximal molar bite force. METHOD: Ninety individuals, aged between 18 and 45 years, were selected and divided into two groups: Group I (case group, 45 individuals with SB) and Group II (control group, 45 individuals without SB). A diagnosis of SB was made from polysomnography. RESULTS: The data obtained from EMG and the muscle thickness and the maximal molar bite force were tabulated (SPSS 21.0), normalized, and subjected to statistical analysis (p ≤ 0.05). Comparisons between the groups showed significant differences regarding the habitual chewing of hard food for the left temporalis muscle (p = 0.04) and the chewing of soft food for the right masseter muscle (p = 0.04), but no significant differences for the measurements of muscle thickness and maximal molar bite force. DISCUSSION: The present data suggest that SB negatively altered the masticatory muscles' functions. Based on the results of this research, it can be concluded that individuals with SB showed decreased EMG activity in the masticatory muscles.

Stomatognathic function in Duchenne muscular dystrophy: a case-control study.

AIM: This study aimed to analyse electromyographic activity, masticatory efficiency, muscle thickness, and bite force of individuals with Duchenne muscular dystrophy (DMD). METHOD: Forty males aged 4-15 years, 20 with DMD and 20 healthy age-, height-, and weight-matched controls, underwent electromyography and ultrasonography of temporalis, masseter, and sternocleidomastoid muscles during postural control of the jaw, mastication, and maximal molar bite force. RESULTS: The normalized electromyography signals showed higher activity in masseter and temporal muscles at rest, during protrusion, left and right laterality, and fatigue condition in the group with DMD than in the comparison group (p≤0.05). For masticatory efficiency of cycles, in analysis of non-habitual chewing of flavourless gum, and habitual chewing of peanuts and raisins, the group with DMD presented lower averages (p≤0.05). For the muscle thickness, the results showed that there was a lower muscle thickness in the group with DMD for all muscles during the rest and maximal voluntary contraction, except for masseter and sternocleidomastoid in the maximal voluntary contraction. In the maximal molar bite force, the group with DMD presented higher values for both sides than the comparison group (p≤0.05). INTERPRETATION: Patients with DMD show muscle changes related to the stomatognathic system, in their activity, bite force, and muscle thickness.

Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism.

OBJECTIVE: To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB. METHODS: The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed. RESULTS: Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of "probable SB" were associated with the worst sensitivity (16%, 18%, 22%, respectively). CONCLUSIONS: Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and--although they do not attain diagnostic values high enough to replace the current gold standard (PSG)--should be used as a screening tool to identify SB.

Low-level laser therapy improves bone formation: stereology findings for osteoporosis in rat model.

Low-level laser therapy (LLLT) benefits bone metabolism, but its use needs to be standardized. We evaluated the effects of LLLT on bone defects in calvaria of ovariectomized rats. Stereology was used to calculate tissue repair volume (V tr ), density of trabecular bone volume (Vv t ), total volume of newly formed trabecular bone (Vtot), and the area occupied by collagen fibers (A C ). Fifty-four Wistar rats were submitted to bilateral ovariectomy, and bone defects were created in calvaria after 150 days. The animals were divided into nine groups (n = 6), and 24 h after defects, the treatment started with a 780-nm low-intensity GaAlAs laser: G1, G2, and G3 received 3 sessions of 0, 20, and 30 J/cm(2) respectively; G4, G5, and G6 received 6 sessions of 0, 20, and 30 J/cm(2), respectively; and G7, G8, and G9 received 12 sessions of 0, 20, and 30 J/cm(2), respectively. A normal distribution was found for all of the data. The test used to verify the normality was the Kolmogorov-Smirnov (KS, p > 0.05). The 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. Groups G2 and G1 showed significance for V tr , Vv t , Vtot, and (A C ). Results were significant for (Vv t ) and (Vtot) between G3 and G1. There were no significant results between G5 and G4 as well as between G8 and G7. Groups G6 and G4 results showed statistical difference for V tr , Vv t , Vtot, and (A C ). Groups G9 and G7 showed significance for V tr , Vv t , Vtot, and (A C ). In conclusion, there was new bone formation in the groups that received 20 and 30 J/cm(2) when compared to control groups, but over time, the dose of 30 J/cm(2) showed better stereological parameters when compared to 20 J/cm(2).

The influence of maxillary and mandibular osteoporosis on maximal bite force and thickness of masticatory muscles.

The aim of this study was to examine the bite force and masseter and temporal muscle thickness in individuals with maxillary and mandibular osteoporosis. 72 individuals were distributed into two equal groups: (1) facial osteoporosis and (2) healthy controls. Bite force on the right and left molar regions was recorded with a dynamometer and the highest value out of three measurements was recorded as the maximal bite force. Muscle thickness was measured with a SonoSite Titan ultrasound scanner. Ultrasound images were obtained of the bilateral masseter and temporal muscles at rest and at maximal voluntary contraction. The means of the measurements in each clinical condition were analyzed with multivariate statistical analysis (SPSS 19.0). Student's t test indicated no significant difference for muscle thickness, but indicated significantly lower bite force values in the osteoporosis group (p>0.05). Lower bite force in individuals with facial bone loss demonstrates functional impact of osteoporosis on the complex physiological stomatognathic system.

The influence of maxillary and mandibular osteoporosis on maximal bite force and thickness of masticatory muscles

The aim of this study was to examine the bite force and masseter and temporal muscle thickness in individuals with maxillary and mandibular osteoporosis. 72 individuals were distributed into two equal groups: (1) facial osteoporosis and (2) healthy controls. Bite force on the right and left molar regions was recorded with a dynamometer and the highest value out of three measurements was recorded as the maximal bite force. Muscle thickness was measured with a SonoSite Titan ultrasound scanner. Ultrasound images were obtained of the bilateral masseter and temporal muscles at rest and at maximal voluntary contraction. The means of the measurements in each clinical condition were analyzed with multivariate statistical analysis (SPSS 19.0). Student's t test indicated no significant difference for muscle thickness, but indicated significantly lower bite force values in the osteoporosis group (p>0.05). Lower bite force in individuals with facial bone loss demonstrates functional impact of osteoporosis on the complex physiological stomatognathic system.

Este estudo teve como objetivo analisar a forca de mordida e a espessura dos musculos masseter e temporal em individuos com osteoporose maxilar e mandibular. 72 individuos distribuidos em dois grupos equivalentes: (1) osteoporose facial e (2) controles saudaveis. Forca de mordida nas regioes de molar direita e esquerda foi gravada com o dinamometro e o valor mais alto das tres medidas foi registrado como a forca de mordida maxima. A espessura muscular foi mensurada com ultrassom SonoSite Titan. As imagens de ultrassom foram obtidas dos musculos masseter e temporais bilateral em repouso e em contracao voluntaria maxima. As medias das medidas em cada condicao clinica foram analisadas com a analise estatistica multivariada (SPSS 19.0). Teste t de Student nao revelou diferencas significativas para a espessura musculos, mas indicou valores significativamente mais baixos de forca de mordida no grupo com osteoporose (p> 0,05). Forca de mordida menor em individuos com perda ossea facial demonstra um impacto funcional da osteoporose na fisiologia complexa do sistema estomatognatico.

Functional analysis of the stomatognathic system in individuals infected with human immunodeficiency virus.

PURPOSE: To understand the effects of HIV type 1 on the function of the masticatory muscles. METHODS: Sixty individuals were selected from both genders, aged between 22 and 57years (mean 36.77±9.33years), and divided into two groups: Group HIVG, 30 individuals with HIV subtype 1, and Group CG, 30 healthy individuals (control group). The individuals were submitted to assessments of their masticatory muscle activity, biting strength and thickness of the masticatory muscles by means of electromyography, maximal molar bite force and ultrasound imaging, respectively. The resultant data were statistically analyzed by t-tests (p<0.05). RESULTS: The HIVG normalized EMG data from a mandibular rest position, protrusion, right and left laterality movement of the jaw showed that HIVG presented a relative increase in EMG activity compared to the CG. The HIVG had a lower masticatory cycle ability while chewing Parafilm M®, Raisins and Peanuts when compared to CG. During rest conditions, the ultrasound images showed a greater average muscular thickness in the right and left temporal region compared to CG. Upon maximal voluntary contraction, an increased average thickness was seen in the temporalis muscles and left sternocleidomastoid muscle when compared to the CG. CONCLUSION: Based on the results of this research, it can be concluded that individuals with acquired immunodeficiency syndrome showed muscular changes related to the stomatognathic system, especially concerning EMG activity and muscle thickness.

Comparative effects of retinoic acid or glycolic acid vehiculated in different topical formulations.

Retinoids and hydroxy acids have been widely used due to their effects in the regulation of growth and in the differentiation of epithelial cells. However, besides their similar indication, they have different mechanisms of action and thus they may have different effects on the skin; in addition, since the topical formulation efficiency depends on vehicle characteristics, the ingredients of the formulation could alter their effects. Thus the objective of this study was to compare the effects of retinoic acid (RA) and glycolic acid (GA) treatment on the hairless mouse epidermis thickness and horny layer renewal when added in gel, gel cream, or cream formulations. For this, gel, gel cream, and cream formulations (with or without 6% GA or 0.05% RA) were applied in the dorsum of hairless mice, once a day for seven days. After that, the skin was analyzed by histopathologic, morphometric, and stereologic techniques. It was observed that the effects of RA occurred independently from the vehicle, while GA had better results when added in the gel cream and cream. Retinoic acid was more effective when compared to glycolic acid, mainly in the cell renewal and the exfoliation process because it decreased the horny layer thickness.

Analysis of Endodontist Posture Utilizing Cinemetry, Surface Electromyography and Ergonomic Checklists

The postural risk factors for dentists include the ease of vision in the workplace, cold, vibration and mechanical pressure in tissues, incorrect posture, functional fixity, cognitive requirements and work-related organizational and psychosocial factors. The objective was to analyze the posture of endodontists at the workplace. Eighteen right-handed endodontists aged 25 to 60 years (34±3) participated in the study. Electromyography, kinemetry, ergonomic scales (RULA and Couto's checklist) and biophotogrammetry were used to analyze the posture of endodontists during root canal treatment of the maxillary right first and second molars using rotary and manual instrumentation. The variations observed in the electromyographic activities during the performance of rotary and manual techniques suggest that the fibers of the longissimus region, anterior and medium deltoid, medium trapezium, biceps, triceps brachii, brachioradialis and short thumb abductor muscles underwent adaptations to provide more accurate functional movements. Computerized kinemetry and biophotogrammetry showed that, as far as posture is concerned, rotary technique was more demanding than the manual technique. In conclusion, the group of endodontists evaluated in this study exhibited posture disorders regardless of whether the rotary or manual technique was used.

Os fatores de risco posturais para cirurgiões dentistas incluem o acesso a visão no local de trabalho, frio, vibração, pressão mecânica nos tecidos, postura incorreta, alterações funcionais, requisitos cognitivos e fatores organizacionais e psicossociais relacionados com o trabalho. O objetivo é analisar a postura dos endodontistas no local de trabalho. Participaram dezoito endodontistas destros com idades entre as idades de 25 e 60 anos (34±3). Nesta pesquisa foi utilizado a eletromiografia, cinemetria, escalas de ergonomia (do RULA e Couto checklist) e biofotogrametria para analisar a postura dos endodontistas durante o preparo químico-mecânico do sistema de canais radiculares para primeiros e segundos molares superiores direitos, utilizando a instrumentação rotatória e manual. As variações observadas nas atividades eletromiográficas durante a execução das técnicas rotatórias e manuais sugerem que as fibras da região dos músculos longuíssimo, deltóide anterior e médio, trapézio médio, bíceps, tríceps braquial, braquiorradial e músculos abdutores curtos do polegar passaram por adaptações para promover movimentos funcionais mais precisos. A cinemetria e biofotogrametria computadorizada mostraram que a técnica rotatória foi mais exigente da postura corporal do que a técnica manual. Em conclusão, os endodontistas estudados apresentaram distúrbios de postura, independentemente da técnica utilizada, rotatória ou manual.

Analysis of endodontist posture utilizing cinemetry, surface electromyography and ergonomic checklists.

The postural risk factors for dentists include the ease of vision in the workplace, cold, vibration and mechanical pressure in tissues, incorrect posture, functional fixity, cognitive requirements and work-related organizational and psychosocial factors. The objective was to analyze the posture of endodontists at the workplace. Eighteen right-handed endodontists aged 25 to 60 years (34±3) participated in the study. Electromyography, kinemetry, ergonomic scales (RULA and Couto's checklist) and biophotogrammetry were used to analyze the posture of endodontists during root canal treatment of the maxillary right first and second molars using rotary and manual instrumentation. The variations observed in the electromyographic activities during the performance of rotary and manual techniques suggest that the fibers of the longissimus region, anterior and medium deltoid, medium trapezium, biceps, triceps brachii, brachioradialis and short thumb abductor muscles underwent adaptations to provide more accurate functional movements. Computerized kinemetry and biophotogrammetry showed that, as far as posture is concerned, rotary technique was more demanding than the manual technique. In conclusion, the group of endodontists evaluated in this study exhibited posture disorders regardless of whether the rotary or manual technique was used.

Changes in masticatory performance and quality of life in individuals with chronic periodontitis.

BACKGROUND: This study evaluates the effect of periodontitis on masticatory performance and quality of life index. METHODS: Patients (n = 24; 23 to 76 years of age) with periodontal conditions ranging from healthy to generalized disease categorized by the alveolar bone height-to-tooth length (AB/T) ratio were separated into the following two groups: control (AB/T >50%) and test (AB/T <50%). The masticatory performance was evaluated through continuous mastication of a special device called a biocapsule. The Brazilian Oral Health Impact Profile (OHIP-14Br) questionnaire was used to assess the oral health-related quality of life. The Student t test was applied for independent samples (P <0.05) to evaluate the masticatory performance, and the Mann-Whitney U test was used to determine quality of life (P <0.05). RESULTS: There was a statistically significant difference in masticatory efficiency between groups (P = 0.006). Statistically significant differences were also observed in the following parameters: 1) physical pain (P = 0.003); 2) psychologic discomfort (P = 0.008); 3) physical disability (P = 0.033); and 4) OHIP-14Br total score (P = 0.001). The control group achieved the best indicators. Both the masticatory performance and quality of life indicators showed significant correlation with the alveolar bone height. CONCLUSION: The loss of periodontal supporting structures has negative effects on the masticatory performance and quality of life.

Aging of masticatory efficiency in healthy subjects: electromyographic analysis--Part 2.

The masticatory process identifies the level of the individual's masticatory ability and provides important information for an adequate diagnosis of the masticatory function. The purpose of this cross-sectional study was to evaluate the influence of age on habitual and non-habitual mastication by means of the values of the ensemble average of masticatory cycles. All volunteers were Brazilian, Caucasian, fully dentate (except for Group I--mixed dentition), aged 7-80 years and divided into five groups: I (7-12 years), II (13-20 years), III (21- 40 years), IV (41-60 years) and V (61-80 years). Except for Group V, which comprised nine women and eight men, all groups were equally divided with respect to gender (20 M/20 F). All subjects were nasal breathers, had normal occlusion and no parafunctional habits or symptoms of temporomandibular dysfunction (RDC/TMD). The masticatory process was analyzed during habitual mastication of peanuts and raisins, and non-habitual mastication of ParafilmM, for 10 seconds each. The resulting electromyographic data were evaluated using SPSS 19.0 software for Windows. ANOVA (analysis of variance) followed by the Duncan test were used to compare the efficiency of the masticatory cycle between age groups. Multivariate analysis (General Linear Models) was used to analyze the effect of age groups and gender on the efficiency of themasticatory cycle, to compare groups (p < 0.05). The results showed that age is directly associated with the changes in masticatory process in healthy subjects.

Aging of masticatory efficiency in healthy subjects: electromyographic analysis--Part 2. / Aging of masticatory efficiency in healthy subjects: electromyographic analysis--Part 2.

The masticatory process identifies the level of the individuals masticatory ability and provides important information for an adequate diagnosis of the masticatory function. The purpose of this cross-sectional study was to evaluate the influence of age on habitual and non-habitual mastication by means of the values of the ensemble average of masticatory cycles. All volunteers were Brazilian, Caucasian, fully dentate (except for Group I--mixed dentition), aged 7-80 years and divided into five groups: I (7-12 years), II (13-20 years), III (21- 40 years), IV (41-60 years) and V (61-80 years). Except for Group V, which comprised nine women and eight men, all groups were equally divided with respect to gender (20 M/20 F). All subjects were nasal breathers, had normal occlusion and no parafunctional habits or symptoms of temporomandibular dysfunction (RDC/TMD). The masticatory process was analyzed during habitual mastication of peanuts and raisins, and non-habitual mastication of ParafilmM, for 10 seconds each. The resulting electromyographic data were evaluated using SPSS 19.0 software for Windows. ANOVA (analysis of variance) followed by the Duncan test were used to compare the efficiency of the masticatory cycle between age groups. Multivariate analysis (General Linear Models) was used to analyze the effect of age groups and gender on the efficiency of themasticatory cycle, to compare groups (p < 0.05). The results showed that age is directly associated with the changes in masticatory process in healthy subjects.

The effect of a Lucia jig for 30 minutes on neuromuscular re-programming, in normal subjects

The Lucia jig is a technique that promotes neuromuscular reprogramming of the masticatory system and allows the stabilization of the mandible without the interference of dental contacts, maintaining the mandible position in harmonic condition with the musculature in normal subjects or in patients with temporomandibular dysfunction (TMD). This study aimed to electromyographically analyze the activity (RMS) of the masseter and temporal muscles in normal subjects (control group) during the use of an anterior programming device, the Lucia jig, in place for 0, 5, 10, 20 and 30 minutes to demonstrate its effect on the stomatognathic system. Forty-two healthy dentate individuals (aged 21 to 40 years) with normal occlusion and without parafunctional habits or temporomandibular dysfunction (RDC/TMD) were evaluated on the basis of the electromyographic activity of the masseter and temporal muscles before placement of a neuromuscular re-programming device, the Lucia jig, on the upper central incisors. There were no statistically significant differences (p < 0.05) in the electromyographic activity of the masticatory muscles in the different time periods. The Lucia jig changed the electromyographic activity by promoting a neuromuscular reprogramming. In most of the time periods, it decreased the activation of the masticatory muscles, showing that this device has wide applicability in dentistry. The use of a Lucia jig over 0, 5, 10, 15, 20 and 30 minutes did not promote any statistically significant increase in muscle activity despite differences in the data, thus showing that this intra-oral device can be used in dentistry.