NeBULA: A Standardized Protocol for the Benchmarking of Robotic-based Upper Limb Neurorehabilitation.

The use of robotic technologies in neurorehabilitation is growing, because they allow highly repeatable exercise protocols and patient-tailored therapies. However, there is a lack of objective methods for assessing these technologies, which makes it difficult to determine their value in rehabilitation settings. While there exist many outcome measurements for motor assessment from a clinical standpoint (such as the Fugl-Meyer scale), the evaluation of performance and clinical benefits of technology for rehabilitation still lacks a standardized approach from a technical standpoint.In this work, we describe NeBULA (Neuromechanical Biomarkers for Upper Limb Assessment), a benchmarking platform for evaluating robotic technology for upper limb neurorehabilitation. By utilizing standardized neuromechanical biomarkers, NeBULA aims at providing a groundwork for assessing and comparing neurorehabilitation robots. We describe its implementation and preliminary results assessing a novel upper limb exoskeleton.Clinical Relevance- Standardized evaluation of neurorehabilitation robots can lead to better patient outcomes, optimizing resources by identifying the most effective technology and by boosting their use in clinical practice. This would provide quantitative and objective information to complement clinical motor evaluation - preventing suboptimal treatments and ensuring that patients receive personalized care. It can also facilitate the transfer of technologyto clinics, identifying the most promising ones for further investment and research.

The Hannes hand prosthesis replicates the key biological properties of the human hand.

Replacing the human hand with artificial devices of equal capability and effectiveness is a long-standing challenge. Even the most advanced hand prostheses, which have several active degrees of freedom controlled by the electrical signals of the stump's residual muscles, do not achieve the complexity, dexterity, and adaptability of the human hand. Thus, prosthesis abandonment rate remains high due to poor embodiment. Here, we report a prosthetic hand called Hannes that incorporates key biomimetic properties that make this prosthesis uniquely similar to a human hand. By means of an holistic design approach and through extensive codevelopment work involving researchers, patients, orthopaedists, and industrial designers, our proposed device simultaneously achieves accurate anthropomorphism, biomimetic performance, and human-like grasping behavior that outperform what is required in the execution of activities of daily living (ADLs). To evaluate the effectiveness and usability of Hannes, pilot trials on amputees were performed. Tests and questionnaires were used before and after a period of about 2 weeks, in which amputees could autonomously use Hannes domestically to perform ADLs. Last, experiments were conducted to validate Hannes's high performance and the human likeness of its grasping behavior. Although Hannes's speed is still lower than that achieved by the human hand, our experiments showed improved performance compared with existing research or commercial devices.

A Glial-Silicon Nanowire Electrode Junction Enabling Differentiation and Noninvasive Recording of Slow Oscillations from Primary Astrocytes.

The correct human brain function is dependent on the activity of non-neuronal cells called astrocytes. The bioelectrical properties of astrocytes in vitro do not closely resemble those displayed in vivo and the former are incapable of generating action potential; thus, reliable approaches in vitro for noninvasive electrophysiological recording of astrocytes remain challenging for biomedical engineering. Here it is found that primary astrocytes grown on a device formed by a forest of randomly oriented gold coated-silicon nanowires, resembling the complex structural and functional phenotype expressed by astrocytes in vivo. The device enables noninvasive extracellular recording of the slow-frequency oscillations generated by differentiated astrocytes, while flat electrodes failed on recording signals from undifferentiated cells. Pathophysiological concentrations of extracellular potassium, occurring during epilepsy and spreading depression, modulate the power of slow oscillations generated by astrocytes. A reliable approach to study the role of astrocytes function in brain physiology and pathologies is presented.

Neuroengineering Tools For Studying The Effect Of Intracortical Microstimulation In Rodent Models.

Intracortical microstimulation can be successfully used to manipulate neuronal activity and connectivity, thus representing a potentially powerful tool to steer neuroplasticity occurring after brain injury. Activity-dependent stimulation (ADS), in which the spikes recorded from a single neuron are used to trigger stimulation at another cortical location, is able to potentiate cortical connections between distant brain areas. Here, we developed an experimental procedure and a computational pipeline aimed at investigating the ability of ADS to induce changes in intra-cortical activity of healthy anesthetized rats.

Masticatory muscle activity evaluation by electromyography in subjects with zygomatic implants.

BACKGROUND: Zygomatic implants are an alternative treatment in the rehabilitation of atrophic maxilla to promote stability in the stomatognathic system. The aim of this study was to compare the electromyographic (EMG) activity of masseter and temporalis muscles in controls and in individuals with complete implant-supported dentures anchored in the zygomatic bone. MATERIALS AND METHODS: Fifty-four volunteers of both genders (mean age 52.5 years) were selected and distributed into two groups: Individuals with zygomatic implant (ZIG; n=27) and fully dentate patients (CG; n=27). MyoSystem-BR1 was used to assess masseter and temporalis muscles EMG activity in different mandibular movements: protrusion, clenching, maximal voluntary contraction (MVC) with Parafilm M®, right and left laterality and chewing (peanuts and raisins). Data was processed, normalized (MVC) and analyzed using the SPSS 21.0. Student t-test (P ≤ 0.05) was used for group comparison. RESULTS: The results were statistically significant (P ≤ 0.05) for protrusion, clenching, right and left laterality and raisin chewing. For the mandibular posture conditions, the ZIG obtained higher EMG activity patterns when compared to CG. For the masticatory performance during chewing of peanuts and raisins, the ZIG showed higher EMG mean values when compared to CG. CONCLUSIONS: The zygomatic implant promoted an active response of the muscle fibers (hyperactivity) during both mandibular posture and chewing conditions, probably due to the absence of periodontal receptors, which play a significant role for preparing a bolus for swallowing.

Robot-assisted training to improve proprioception does benefit from added vibro-tactile feedback.

Proprioception is central for motor control and its role must also be taken into account when designing motor rehabilitation training protocols. This is particularly important when dealing with motor deficits due to proprioceptive impairment such as peripheral sensory neuropathy. In these cases substituting or augmenting diminished proprioceptive sensory information might be beneficial for improving motor function. However it still remains to be understood how proprioceptive senses can be improved by training, how this would translate into motor improvement and whether additional sensory modalities during motor training contribute to the sensorimotor training process. This preliminary study investigated how proprioceptive/haptic training can be augmented by providing additional sensory information in the form of vibro-tactile feedback. We tested the acuity of the wrist proprioceptive position sense before and after robotic training in two groups of healthy subjects, one trained only with haptic feedback and one with haptic and vibro-tactile feedback. We found that only the group receiving the multimodal feedback significantly improved proprioceptive acuity. This study demonstrates that non-proprioceptive position feedback derived from another somatosensory modality is easily interpretable for humans and can contribute to an increased precision of joint position. The clinical implications of this finding will be outlined.

Electromyographic analysis of masseter and temporal muscles, bite force, masticatory efficiency in medicated individuals with schizophrenia and mood disorders compared with healthy controls.

This study aimed to comparatively analyse the electromyographic activity of the masseter and temporal muscles at rest and during mandible postural clinical conditions (right and left laterality, protrusion and maximum voluntary contraction), right and left maximum molar bite forces and the masticatory efficiency of individuals with schizophrenia or mood disorders - all medicated (medicated groups) compared with control group (healthy volunteers) via electromyography. Individuals were distributed into three groups: Group I (Schizophrenia - 20 individuals), Group II (mood disorders - 20 individuals) and Group III (Control - 40 individuals). Basically, the results were only statistically significant for the clinical mandible conditions and bite force. The most unsatisfactory results were observed in the medicated groups in relation to the control group. The group with mood disorders obtained the most unsatisfactory results compared with the group with schizophrenia. It was suggested by these observations that the association of mood disorders and schizophrenia with medication has negatively affected the stomatognathic system in relation to controls when the electromyography and bite force were used for the analysis.

Implant-supported prosthesis following Brånemark protocol on electromyography of masticatory muscles.

This research evaluated the effects of Brånemark protocol on electromyography of the masseter and temporal muscles. The patients were divided into two groups: Group I: patients who wore an implant-supported prosthesis in the mandibular arch following Brånemark protocol, and maxillary removable complete dentures; Group II: dentate individuals (control). Electromyography was carried out at rest, right (RL) and left (LL) laterality, protrusion and maximum voluntary contraction (MVC). Data were compared by t-test. At rest, a higher electromyographic (EMG) activity was observed in Group I, and the values were significant in the right masseter and left temporal muscles. In RL, there were statistically significant differences for right masseter (P < 0·01), left masseter and temporal muscles and for the left temporal muscle in LL (P < 0·05). In protrusion, Group I presented a higher EMG activity, and there was a statistically significant difference for the right masseter muscle (RM) (P < 0·05). In MVC, the EMG values were higher in Group II (control), but significant just for the right temporal muscle (P < 0·05). In conclusion, individuals with mandibular fixed dentures supported according to the Brånemark protocol and maxillary removable complete dentures showed a higher activity of masticatory muscles during the mandibular postural clinical conditions examined; however, in the MVC, Group I presented lower values when compared to dentate group. Despite presenting different EMG values in all of the clinical conditions, both groups showed similar EMG patterns of muscle activation which demonstrates that the proposed treatment can be considered as a good option for oral rehabilitation.

Ageing and surface EMG activity patterns of masticatory muscles.

The purpose of this study was to evaluate the influence of age on the electromyographic activity of masticatory muscles. All volunteers were Brazilian, fully dentate (except for Group I - mixed dentition), Caucasian, aged 7-80, 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). Surface electromyographic records of masticatory muscles were obtained at rest and during maximal voluntary contraction, right and left laterality, maximal jaw protrusion and maximal clenching in the intercuspal position. Statistically significant differences (P < 0.05) were found in all clinical conditions among the different age groups. Considerably different patterns of muscle activation were found across ages, with greater electromyographic activity in children and youth, and decreasing from adults to aged people.

Correlation between bite force and electromyographic activity in dentate and partially edentulous individuals.

Dental absence interferes in the physiological functioning of the masticatory system, promoting occlusal and functional alterations. The purpose of this study was to verify maximal bite force and maximal bite force correlated with electromyographic activity in 14 partially edentulous and 14 dentate individuals. Bite force in right and left molar and incisor regions were registered using a dynamometer with capacity of up to 1000N, adapted for oral conditions and at the same time electromyography was performed using Myosystem-Br1 with electrodes positioned on right and left masseter and temporalis muscles, and one reference electrode on the frontal bone. The highest value out of three recordings was considered the individual's maximal bite force. Statistical analysis of the bite force data was performed by means of t-test and Pearson's bivariate correlation test was used for the analysis between bite and electromyographic activity using SPSS 12.0 software. Dentate individuals showed greater maximal bite force in the three regions. Correlations between electromyographic activity and bite force in the dentate group obtained positive coefficients for every muscle in the right molar region, for the left temporalis in the left molar region, and for every muscle in the incisive region. For the partially edentulous group, only the left temporalis muscle presented a positive correlation in the right molar region, there was positive correlation for the right masseter and right and left temporalis in the left molar region, and, in the incisive region, every muscle presented negative correlation. These data evidence the strong influence of dental loss over the maximal bite force and small correlation between bite force and electromyographic activity.

Anatomical variations of the mandibular nerve and its branches correlated to clinical situations.

AIM: The mandibular division of the trigeminal nerve is the largest of the three major divisions of the trigeminal nerve (fifth cranial nerve). In this way, many health professionals belonged to different fields are commonly evaluating patients suffering with orofacial pain and stomatognatic dysfunction associated to this structure. But, in the most cases, it is difficult to establish a correct diagnosis due to the anatomical complexity of the head and neck surfaces, especially when the focus is the trigeminal nerve. Thus, the objective of this research was to present the anatomical variations of the mandibular nerve and its branches correlated to more common clinical situations. METHODS: For this purpose, 20 human heads were anatomically dissected, so to study their structures, an external, medial and endocranial view. RESULTS: No significant variations related to ophthalmic and maxillary nerves were observed. Anatomical variations were observed in 20% of the total human heads dissected, all related to mandibular nerve and its branches: masseter, temporal, auriculotemporal and lingual. Variations in three to seven, on the number of the following nerves ramus, masseter and temporal were described. CONCLUSIONS: According to the present data using the described methodology, it was possible to conclude that anatomical variations are present in many subjects and they can explain many clinical situations that involve the stomatognathic structures.

Masticatory process in individuals with maxillary and mandibular osteoporosis: electromyographic analysis.

UNLABELLED: The masseter and temporal muscles of patients with maxillary and mandibular osteoporosis were submitted to electromyographic analysis and compared with a control group. In conclusion, individuals with osteoporosis did not show significantly lower masticatory cycle performance and efficiency compared to the control group during the proposal mastications. INTRODUCTION: This study aimed to examine electromyographically the masseter and temporal muscles of patients with maxillary and mandibular osteoporosis and compare these patients with control patients. METHODS: Sixty individuals of both genders with an average age of 53.0 +/- 5 years took part in the study, distributed in two groups with 30 individuals each: (1) individuals with osteoporosis; (2) control patients during the habitual and non-habitual mastication. The electromyographic apparel used was a Myosystem-BR1-DataHomins Technology Ltda., with five channels of acquisition and electrodes active differentials. Statistical analysis of the results was performed using SPSS version 15.0 (Chicago, IL, USA). RESULTS: The result of the Student's t test indicated no significant differences (p > 0.05) between the normalized values of the ensemble average obtained in masticatory cycles in both groups. CONCLUSION: Based on the results of this study, it was concluded that individuals with osteoporosis did not show significantly lower masticatory cycle performance and efficiency compared to control subjects during the habitual and non-habitual mastications. This result is very important because it demonstrates the functionality of the complex physiological process of mastication in individuals with osteoporosis at the bones that compose the face.

Evidence of muscle role over the cranio-facial skull development in Angle's Class III dental malocclusion under the clinical rest position.

OBJECTIVE: The purpose of this study was to investigate correlations between masseter muscle activity and cephalometric measures in Angle's class III dental malocclusion under the clinical rest position. METHODS: Eight volunteers, both sex, age 7-12, were submitted to an electromyographic analysis of the masseter muscle, subdivided in the upper, medium and lower regions, and to a cephalometric analysis of 15 angle and linear measurements. After normalization, the data was subjected to a statistical, non-parametric Spearman correlation test, by means of the SPSS 12.0 program. RESULTS: Statistically significant correlations were observed between the clinical rest condition before and after the execution of exercises (a serie of mandibular movements), and the cephalometric measurements angle SN GoGn, angle SNA, angle SNB, angle SND, upper incisive. NA angle, upper incisive-NA distance, lower incisive. NB angle, lower incisive-NB distance and angle IMPA, and the different regions of the masseter muscle. CONCLUSIONS: The significant statistical correlation found between the cephalometric analysis and the function of the masseter muscle indicate a strong influence of the musculature under a clinical rest condition over the cranial-facial development in the Angle's class III dental malocclusion. There is a selective activity of the different regions of the masseter muscle under the clinical rest condition in the Angle's class III dental malocclusion. There is a demand for research to complement these findings in other classes of dental malocclusion.

Effect of congenital blindness on EMG activity of the facial muscles.

The aim of this work was to analyze electromyographically the facial muscles: orbicularis oris (upper and lower fascicles), orbicularis oculi (right and left lateral portions) and frontal, in blind and clinically normal (control) individuals, in various clinical conditions. Electromyographic averages of all data collected were normalized by maximal voluntary contraction of the studied muscles and statistical analysis was performed by Student's t test, using "Statistical Package for the Social Sciences" software--SPSS 12.0 (Chicago, IL). It was found that electromyographic alterations occur in the facial musculature that influences facial expressions of individuals. Results for the orbicularis oris muscle demonstrated that myoelectric activity among blind and control subjects was greater for the control group at muscular rest, blowing, and in labial projection. Electromyographic analysis of the orbicularis oculi among blind and control subjects in three clinical conditions studied demonstrated that activity was greater for the control group at muscular rest, blinking, and forced blinking. For the frontal muscles were demonstrated that electromyographic activity was greater for blind individuals. These data suggest the influence of congenital blindness on muscular development, including alterations in electromyographic activity of skin musculature in individuals with visual impairment.

Electromyographic evaluation of the masseter and temporal muscles activity in volunteers submitted to acupuncture.

AIM: To assess the effect of acupuncture on the temporal and masseter muscles activity employing surface electromyography. METHODS: Thirty volunteers were evaluated according to three groups of acupuncture application: selected local points, selected points at distance and association of local and distant points. Bipolar surface electrodes were positioned bilaterally on the anterior portion of temporal muscle, as well as in the median region of masseter muscle. An electromyograph connected to a computer and a specific software registered the muscular activity before and after acupuncture, in the following experimental conditions: 1- Rest Position (RP); 2- Maximum Intercuspation Clenching (MIC); 3- Bilateral Molar Clenching with Cotton Rolls (BMCCR). The mean values obtained for the activities of the studied muscles were submitted to Analysis of Variance and Tukey complementary test. RESULTS: The electromyographic activity of the studied muscles was lower after the application of the methods of acupuncture in the Rest, and higher after the application of the acupuncture in the Maximum Intercuspation Clenching; the electromyographic activity of the temporal muscle was higher than the masseter muscle in the Rest and lower in the Bilateral molar clenching with cotton rolls; the electromyographic activity showed to be modified after the three used methods of acupuncture in the Maximum Intercuspation Clenching. In this clinical condition, the method of long-distance acupuncture was higher than the application of local needles and the associated method. CONCLUSION: Acupuncture provided alterations in the activity of the studied muscles, favoring conditions of rest and muscular tightness.

Electromyographical analysis of the masseter muscle in dentulous and partially toothless patients with temporomandibular joint disorders.

This study had as objective to analyze with computerized electromyography the masseter muscles bilaterally in twenty individuals with temporomandibular joint dysfunction (DTM), being: the group I consisting of ten individuals with complete dentition and group II constituted by ten individuals with posterior dental absences; comparing nine clinical activities: rest before and after exercises, maximum habitual intercuspation (MIH), right and left laterality, forced centric occlusion, protrusion, bilateral molar bite and chewing. It was utilized the Electromyography K6I-Myotronics, with eight canals and surface silver electrodes. By means of the results analysis, we verified significant differences between the groups (p < 0.01), being group I, presented greater electromyographic activity (32.98 microvolts), than the group II (22.31 microvolts), suggesting that this individuals presented low muscular activity. The interaction between the groups and the clinical activities was significant (p < 0.01), as well as between the groups, clinical activities and muscles (p < 0.05). To clarify which amongst the relative averages the clinical activities were different, calculated the critical value of Tukey, being that rest before and after exercises, MIH, right and left laterality, presented averages with similar distributions, with values below of the values of Tukey, as well as forced centric occlusion, protrusion, bilateral molar bite and chewing presented higher values than Tukey. Based on this research's data, we concluded that the electromyographical analysis of the masseter muscles in Individuals with TMD, dentulous and with dental absence showed that individuals with TMD, dentulous or not, presented elevated muscular activity in rest position and individuals with TMD, dentulous, presented higher electromyographical activity than the individuals with TMD and lacking posterior teeth.

Electromyographic analysis of the masseter and temporal muscles in oralized deaf individuals.

Deaf individuals show a number of difficulties related to the functionality of the stomatognathic system, mainly by reason of the little or no use of facial musculature during speech either due to the use of sign language or to the difficulty that these individuals have in articulating words. The stomatognathic system muscles play important roles in functions such as mastication, deglutition, and phonation. This study aimed to assess, by means of computerized bilateral electromyography (EMG), masseter and temporal muscles of 12 oralized deaf individuals in clinical activities that involve part of this masticatory musculature and compare this system's functionality with that of 12 normal listening individuals, performing the same activities. An 8-channel K6-I EMG Light Channel Surface Electromyography device was used (Myo-Tronics Co.Seattle, WA, USA), in addition to disposable double electrodes covered with silver chloride (Duotrodes; Myo-tronics Co., Seattle, WA) containing a conductor gel (Myogel- Myo-tronics Co., Seatlle, WA). The averaged rectified EMG values were normalized with reference to the EMG amplitude induced by a maximum bite force. The statistical analysis confirmed that there were any significant differences between the groups, clinical activities, and muscles, and also effects of interaction among them. The analysis made use of Variance Analysis (ANOVA). Significant differences (p < 0.01) for both muscles were found among the clinical conditions, with deaf individuals showing greater electromyographic activity for both muscles for the clinical activity protrusion. Deaf individuals showed a lower muscular activity for clinical activities that demanded a greater masseter and temporal muscular activity such as mastication, mouth opening and closing, and dental compression. Greater electromyographic values were found for both deaf individuals and healthy controls during clinical activities of mastication and dental compression. Based on the obtained data, we concluded that deaf individuals showed a lower activity of the masticatory musculature than healthy individuals; the differences were significant at the level of p < 0.01 between the performed clinical activities; and all deaf individuals and healthy controls showed greater electromyographic values for mastication and dental compression.

Electromyographic analysis of upper and lower fascicles of the orbicularis oris muscle in deaf individuals, in mandibular rest position, compared to hearers.

This study had the aim to analyze electromyographically, the upper and lower fascicles of the orbicularis oris muscle in bilingual, oralist deaf individuals, comparing them with clinically healthy volunteers in mandibular rest position. This was performed in 50 patients of both sexes with an average age of 18.5 years, divided into 4 groups. 1. Ten deaf bilingual, nasal-breathing patients; 2. Ten deaf bilingual, buccal-breathing patients; 3. Ten deaf oralist, nasal-breathing patients; 4. Twenty healthy volunteers, nasal-breathing patients. An electromyograph K6-I EMG Light Channel Surface Electromyography (Myo-tronics Co. Seattle, WA, EUA) of eight channels was used. The electrodes applied were duotrodes, silver-chloride surface, disposable. Statistical analysis was performed using the SPSS software version 10.0 (Chicago, IL). Continuos data with normal distribution were analyzed by univariate analysis of variance (ANOVA). The level of significance was set at alpha= 0.01. Comparing the EMG activity of the orbicularis oris muscle made it possible to verify that, during clinical mandibular rest position, all four groups presented various levels of electromyographic (EMG) activity with statistically significant differences (F = 8.81, p < 0.01). Based this study's data, it was possible to conclude that the electromyography analysis of the orbicularis oris muscle in deaf individuals showed that deaf individuals presented higher levels of EMG activity of the orbicularis oris muscle than normal controls during mandibular rest position.

Changes in masticatory muscles activity associated with Eagle's syndrome.

AIM: This study had the goal of analyzing masseter and temporalis muscles of individuals with Eagle's Syndrome, establishing comparisons with healthy control individuals by means of electromyography, due to the importance of the masticatory musculature upon the various functions of the stomatognathic system and the effects of Eagle's syndrome on this system's functioning. METHOD: Ten women with Eagle's syndrome and ten healthy controls volunteered to participate in the study. A Myosystem I system, Prosecon Ltda (Uberlândia/MG, Brazil) with 12 channels was used Active differential electrodes were placed on the belly of both masseters and on the anterior temporalis. Firstly, rest position was registered and then the patients were instructed to clench their teeth with maximum strength for four seconds to register the Clenching at Usual Maximum Intercuspation. Next, the clinical conditions of chewing, mandible laterality, and water swallowing were performed. RESULTS: The normalized data of muscle activity during the different clinical conditions and at rest position were compared by Student's t test, considering two groups: controls and syndrome bearers. The masticatory muscles of every syndrome bearers showed hyperactivity during the analyzed clinical conditions; except for chewing, in which the right masseter did not show greater electromyographic activity. CONCLUSION: It is concluded that individuals with the syndrome showed muscular hyperactivity when compared to healthy individuals, due to the interference of the elongated styloid process, which leads to dysfunctions of the stomatognathic system in the syndrome bearers, with signs and symptoms related to craniofacial pain, dysphagia, otalgy, temporomandibular dysfunctions, and headache.

The effect of the Schwartz-Jampel syndrome on masticatory and facial musculatures--an electromyographic analysis.

This study had the goal to perform an electromyography evaluation of the orbicularis oris, orbicularis oculi, masseter, and temporal muscles of two siblings with Schwartz-Jampel syndrome (SJS), in different clinical activities, comparing them to healthy controls (C). The Schwartz-Jampel syndrome is a rare genetic disorder (71 cases reported in worldwide literature), in which myotonia may be observed in the facial muscles, determining a standard facie that shows an appearance of someone who is sad and weeping For the electromyography (EMG), a Myotronics--K61 electromyographer, was used, with superficial and disposable silver chloride electrodes. By means of the analysis of the obtained results, we observed significant statistical differences for the masseter muscle and for orbicularis oculi muscles (p < 0.01) among the studied groups, in which the individuals with SJS presented greater muscular activity than the normal ones, used as healthy controls. The statistical difference between the two groups was not significant for the temporal muscle, as well as for the orbicularis oris muscle, although the EMG averages were much greater in patients who were bringers of the syndrome. This high muscular activity may be related to the facial osseous alterations, evidenced in both patients with SJS, such as the mandibular migrognathia, with an atrophy of the mandibular cortex and a consequent approximation between the inferior dental root apices and the mandible base, as well as the presence of hypoplastic condyles in terms of size and height.