Tongue and jaw movement assessed by 3D motion capture during gum chewing.

Introduction: The tongue plays an important role in mastication, swallowing, and articulation, but it cannot be directly observed because of its location inside the oral cavity. This study aimed to clarify detailed 3D tongue movements during chewing using electromagnetic articulography (EMA). Materials and Methods: The participants were 10 healthy, young volunteers (average age 26.8 ± 2.1 years; 5 males, 5 females). Tongue and jaw movement during gum chewing was measured and recorded using EMA. Four EMA sensors were attached to the anterior, posterior, left, and right surfaces of the tongue, and one sensor was also attached to the mandibular left incisor. The tongue motion during the chewing cycle was spatially and sequentially analyzed based on the motion trajectories of the tongue and mandible. Results and Discussion: The tongue moved downward and to the masticatory side in a manner similar to the movement of the jaw. The anterior tongue marker moved downward to a greater extent than the other tongue markers. However, the tongue moved forward as the jaw moved backward. The anterior marker reached the most anterior position during the jaw-opening phase and the posterior markers reached the most anterior position during the jaw-closing phase. Just before maximum jaw-opening, all markers on the tongue reached the bottom lowest position. During the jaw-closing phase, the tongue reached the dominant farthest position in the masticatory side. All the markers reached the most posterior position during the occlusal phase. Conclusion: These findings demonstrate the sequence of tongue motion patterns during gum chewing.

Modelling of dynamic mastication physics of cheese/casein gels as function of milk-fat distribution and intensity of thermo-mechanical treatment.

Pasta filata-style cheese products are among the world's most famous cheese varieties. Thermo-mechanical processing of cheese curd results in stringy, fibrous, and anisotropic structures with pleasing texture attributes. A recent area of research focuses on improving yield during the manufacturing of pasta filata-type cheese products by homogenizing the milk. This process reduces the size of fat droplets, leading to better retention of milk fat during curd plasticization. As this sometimes results in texture deficits, this study aims to investigate the impact of thermo-mechanical processing on curd from homogenized and non-homogenized milk. The hypothesis is that increased thermo-mechanical processing, leading to more anisotropic structural elements, may offset texture deficits caused by homogenization. To assess textural and structural changes due to homogenization and thermo-mechanical processing, mechanical tests including rheology and texture analysis were conducted, along with confocal-laser-scanning microscopy. Additionally, sensory evaluation involving panelists consuming the samples and recording mastication properties such as muscle activity and jaw movement was carried out. Dynamic data modeling was used to derive connections between structure and texture. Results showed that homogenization alone did not yield significant differences between the samples, but plasticization and texturization properties differed significantly. Non-homogenized samples developed a distinct fibrous structure, and muscle activities and jaw movements increased significantly (p < 0.01) with longer thermo-mechanical processing.

Clinical profile in relation to age and gender of patients with temporomandibular disorders: a retrospective study.

BACKGROUND: The present study is to evaluate the clinical characteristics of patients with temporomandibular disorders (TMD). METHODS: A total of 3362 TMD patients were included. Each participant had complete medical records according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The clinical characteristics including symptoms and signs in relation to age and gender were analyzed. RESULTS: The mean age of the patients seeking care was 29.89 ± 13.73Y, and 68.6% of patients were aged 16-35 years. The female-to-male ratio of patients was 2.2: 1, and the average age of males was significantly lower than that of females. The prevalence of clicking symptoms decreased with age, while the prevalence of pain symptoms and limitations in jaw movement increased with age. Females were more likely to have limitations in jaw movement than males. Among the patients with pain, the average visual analogue scale (VAS) was 2.96 ± 1.23. The average VAS score of acute TMD patients (≤ 3 months) was significantly higher than that of chronic TMD patients (> 3 months). CONCLUSIONS: The majority of TMD patients seeking care were young people. The number and average age of female patients was higher than the males. Female patients were more likely to have limitations in jaw movement than males.

Comparison of the effects of submucosal hyaluronidase and dexamethasone on postoperative edema, pain, trismus, and infection following impacted third molar surgery.

BACKGROUND: Limiting postoperative edema, pain, trismus, and infection is crucial for smooth healing. This prospective, controlled clinical trial investigated and compared the effectiveness of dexamethasone and hyaluronidase in relieving these complications. METHODS: In groups Ia and IIa, 8 mg of dexamethasone and 150 IU of hyaluronidase were administered following the removal of impacted teeth, respectively. The contralateral sides (groups Ib and IIb) were determined as control groups. Edema, pain, trismus, and infection were clinically evaluated on the 1st, 2nd, 3rd, and 7th postoperative days. RESULTS: 60 patients were enrolled in the study. Hyaluronidase provided significantly more edema relief than dexamethasone on the 1st, 2nd, 3rd, and 7th postoperative days (P = 0.031, 0.002, 0.000, and 0.009, respectively). No statistical difference was found between dexamethasone and hyaluronidase in VAS and rescue analgesic intake amount values for all time points. Hyaluronidase was more effective in reducing trismus than dexamethasone on the 2nd and 3rd postoperative days (P = 0.029, 0.024, respectively). Neither of the agents significantly increased the postoperative infection rate. CONCLUSIONS: Hyaluronidase can be selected when postoperative excessive edema and trismus are anticipated. Dexamethasone may be a cost-effective option if postoperative pain control is merely targeted. TRIAL REGISTRATION: This trial was registered in the Clinical Trials Protocol Registration and Results System (ClinicalTrials.gov identifier number: NCT05466604) on 20/07/2022.

Accuracy of a new photometric jaw tracking system in the frontal plane at different recording distances: An in-vitro study.

OBJECTIVES: To evaluate the accuracy of a new photometric jaw tracking system (JTS) in recording linear vertical movements in the frontal plane at different distances. METHODS: A mandibular plaster cast of a patient was placed on a simulation machine capable of linear movements along two spatial axes. Cyclops JTS (Itaka) was adapted to the plaster cast, while the head frame was attached to the simulation machine. The latter performed five linear movements from 20 to 40 mm in the y-axis; each movement was repeated five times at five different recording distance (380 to 420 mm). The recorded movements were measured and compared with those obtained with a laser Doppler vibrometer (LDV) for accuracy analysis. Data were statistically processed (α = 0.05). RESULTS: No statistically significant differences were found between Cyclops and LDV measurements on the y- and z-axes (p = 0.5). Changes in linear vertical motion and distance positions did not affect the accuracy, which remained relatively constant with similar trends and values less than 1 % for each parameter variation. The best condition observed was linear vertical movement of 30 mm at 420 mm (0.010 ± 0.023 mm). CONCLUSIONS: Cyclops has proven to be an accurate JTS in recording linear vertical movements in the frontal plane at different recording distances. For optimal recordings, the scanner should be placed as close as possible to the markers; excessive vertical movements decreased the accuracy. However, this study has limitations and requires in-vivo confirmations. CLINICAL SIGNIFICANCE: The tested JTS proved accurate in recording linear vertical movements in the frontal plane. However, given the limitations of the study, further investigation under real conditions is needed to support prosthetic and gnathological rehabilitations.

The effects of lumbar stabilization exercises with and without jaw movements in non-specific low back pain (A randomized controlled trial).

Objective: This study aimed to investigate the added effect of jaw clenching on the efficacy of lumbar stabilization exercises to manage chronic non-specific low back pain. Methods: This randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation (SIPM&R) Karachi from April 2021 to April 2023. Eighty patients with chronic non-specific low back pain participated in this study. Forty patients each were randomly allocated to the lumbar stability exercise (LSE) group' and the lumbar stability exercise with teeth clenching (LSETC) group. Patients in both groups performed respective exercises twice weekly for 12 weeks. The Numeric Pain Rating Scale (NPRS), Roland Morris Disability Questionnaire (RMDQ), and Pressure Biofeedback Unit (PBU) were used to assess pain, disability, and muscle endurance respectively. Data were collected at the baseline, after six weeks and 12 weeks of intervention. A p-value of <0.05 was considered statistically significant. Results: Both groups showed statistically significant improvements in pain, disability, and muscle endurance. Upon further stratification, participants aged 20-30 years in the LSETC group showed significantly higher scores than the LSE group for NPRS, RMDQ, and PBU after 12 weeks. Overall, the LSETC group showed relatively higher improvement in mean scores for NPRS, RMDQ, and PBU than the LSE group. Conclusion: Lumbar stabilization exercises with and without jaw movement are effective for the treatment of chronic non-specific low back pain. The addition of teeth clenching enhanced the effectiveness of lumbar stability exercises, especially in young adults. Trial Registration: Clinicaltrials.gov (NCT04801212), Prospectively registered on March 16, 2021.

Investigation of the precision of a novel jaw tracking system in recording mandibular movements: A preliminary clinical study.

OBJECTIVES: This preliminary study aimed to clinically assess the precision of a novel optical jaw tracking system (JTS) in registering mandibular movements (MMs) of protrusion and mediotrusion. METHODS: Twenty healthy participants underwent recordings using Cyclops JTS (Itaka Way Med) for functional MMs of protrusion and laterotrusion by two trained clinicians. Each subject performed five registrations at different times according to a standardized pattern within one-month period. The angulations of protrusive and mediotrusive functional paths within the first 2 mm from the maximal intercuspal position (MIP) were calculated for each trace, using a data software for angle measurements. Descriptive statistics were used to assess the repeatability of the recordings for each participant and MM. Additionally, inferential statistics were carried out on standard deviation values obtained (α=0.05). RESULTS: The overall precision for all the patients was 7.07±3.37° for the protrusion angle, 5.24±2.24° for right laterotrusion and 5.14±3.06° for left laterotrusion angles. The protrusion angle ranged from 3.08° to 13.57°, while the right and left laterotrusion ranged from 1.82° to 9.42° and from 1.58° to 10.59°, respectively. No statistically significant differences were observed between different functional MM types and gender (p > 0.05). CONCLUSIONS: Recordings functional MMs of mediotrusion and protrusion using Cyclops JTS showed consistent repeatability, regardless of gender and functional MM type. The results revealed non-negligible variations that may be due to the patients' abilities to precisely reproduce jaw movements or to the operator's ability to consistently connect the kinesiograph. CLINICAL SIGNIFICANCE: Capturing functional MMs digitally and importing the data into dental CAD software is essential for virtual waxing in prosthetic rehabilitations to design a functionalized adapted occlusion. Establishing the repeatability of MM recordings by a JTS is a crucial step in better understanding this novel JTS in the market. This process could facilitate the interpretation of cusp angles, aid in CAD dynamic technical modeling, and enhance clinical data communication between clinicians and technicians in a modern workflow.

Analysis of mandibular jaw movements to assess ventilatory support management of children with obstructive sleep apnea syndrome treated with positive airway pressure therapies.

BACKGROUND: The polysomnography (PSG) is the gold-standard for obstructive sleep apnea (OSA) syndrome diagnosis and assessment under positive airway pressure (PAP) therapies in children. Recently, an innovative digital medicine solution, including a mandibular jaw movement (MJM) sensor coupled with automated analysis, has been validated as an alternative to PSG for pediatric application. OBJECTIVE: This study aimed to assess the reliability of MJM automated analysis for the assessment of residual apnea/hypopnea events during sleep in children with OSA treated with noninvasive ventilation (NIV) or continuous PAP (CPAP). METHODS: In this open-label prospective non-randomized multicentric trial, we included children aged from 5 to 18 years with a diagnosis of severe OSA. The children underwent in-laboratory PSG with simultaneous MJM monitoring and at-home recording with MJM monitoring 3 months later. Agreement between PSG and MJM analysis in measuring the residual apnea-hypopnea index (AHI) was evaluated by the Bland-Altman method. The treatment effect on residual AHI was estimated for both PSG and MJM analysis. RESULTS: Fifteen (60% males) children were included with a median age of 12 years [interquartile range 8-15]. Two (17%) were ventilated with NIV and 13 (83%) with CPAP. There was a good agreement between MJM-AHI and PSG-AHI with a median bias of -0.25 (95% CI: -3.40 to +2.04) events/h. The reduction in AHI under treatment was consistently significant across the three measurement methods: in-laboratory PSG and MJM recordings in the laboratory and at home. CONCLUSION: Automated analysis of MJM is a highly reliable alternative method to assess residual events in a small population treated with PAP therapies.

Oral processing, rheology, and mechanical response: Relations in a two-phase food model with anisotropic compounds.

Food-material poses a challenging matrix for objective material scientific description that matches the consumers' perception. With eyes on the emerging structured food materials from alternative protein sources, objectively describing perceived texture characteristics became a topic of interest to the food industry. This work made use of the well-known methodologies of jaw tracking and electromyography from the field of "food oral processing" and compared outcomes with mechanical responses to the deformation of model food systems to meat alternatives. To enable transferability to meat alternative products, an anisotropic structuring ingredient for alternative products, high-moisture texturized vegetable protein (HM-TVP), was embedded in an isotropic hydrocolloid gel. Data of the jaw movement and muscle activities exerted during mastication were modeled in a linear mixed model and set in relation to characteristic values obtained from small- and large-strain deformation. For improvement of the model fit, this work makes use of two new data-processing strategies in the field of oral processing: (i) Muscle activity data were set in relation to true forces and (ii) measured data were standardized and subjected to dimensional reduction. Based on that, model terms showed decreased p-values on various oral processing features. As a key outcome, it could be shown that an anisotropic structured phase induces more lateral jaw movement than isotropic samples, as was shown in meat model systems.

Evaluation of masticatory performance by motion capture analysis of jaw movement.

BACKGROUND: The assessment of masticatory performance (MP) is conducted in hospitals, but is difficult to perform in nursing facilities that lack specialists in dysphagia. To select the appropriate food textures in nursing practice, a simple method of evaluating the MP should be developed. OBJECTIVE: The purpose of this study was to investigate motion parameters that influence MP by motion capture analysis of maxillofacial movement on chewing gummy jelly in healthy adults. METHODS: The subjects were 50 healthy adults. The state of chewing gummy jelly was photographed using a high-speed camera. Simultaneously, we evaluated the amount of glucose extracted (AGE) obtained with gummy jelly as a reference value for MP. The subjects were divided into two groups: normal and low masticatory groups (NG and LG, respectively) based on the AGE. The cycle of mastication was classified into three phases: closing phase (CP), transition phase (TP) and opening phase (OP) through motion capture analysis of the video photographed. Parameters of jaw movement and their associations with the AGE were examined. RESULTS: The transition phase rate (TR) and opening phase rate (OR) were correlated with the AGE. Furthermore, the TR in the NG was significantly higher than in the LG, whereas the OR was significantly lower than in the LG. The age, TR and opening velocity were significant independent variables. CONCLUSION: Motion capture technology facilitated the analysis of jaw movement. The results suggested that MP can be evaluated by analysing the TP and OP rates.

Neuroendocrine Influencers and Associated Factors That Shape Jaw Movement and Growth in Temporomandibular Joint Disorder Management: A Systematic Review of Clinical and Radiographic Evidence.

OBJECTIVE: To investigate the influence of endogenous and exogenous neuroendocrine analogues on the range and motion of jaw movement, mandibular growth, and factors affecting condylar guidance in patients with temporomandibular joint disorders using clinical assessment and radiographic imaging. MATERIAL AND METHODS: Eligible articles were extracted from eleven databases in early 2023 and screened following PRISMA protocols. Certainty of evidence and potential biases were assessed using the GRADE approach. RESULTS: Nineteen articles were screened, with four deemed to be of high quality, eight of moderate quality, and the remaining seven of low to very low quality. Corticosteroids improve maximal incisal opening but not TMJ disorder symptoms. Higher doses worsen jaw movement and cause osseous deformity. Growth hormone affects occlusal development, and delayed treatment affects arch width. Sex hormone correlation with TMJ disorder is complex, with some studies showing a correlation between menstrual cycle phases and pain/limited mobility. CONCLUSIONS: The evaluation of neuroendocrine influencers in relation to jaw movement in patients with temporomandibular joint disorders involves the complex interplay of potentially confounding factors that each require careful consideration to ensure accurate diagnoses and evaluations.

The Impact of Technological Innovation on Dentistry.

Technology has revolutionized the way dentists are able to treat their patients. These technological advances have paved the way for the creation of virtual patient models utilizing these 3-dimensional intra-oral patient models, cone bean computer tomography (CBCT) radiograph scans, extraoral 3-dimensional scans, and jaw motion tracings to create a patient-specific model. These models are advantageous in planning surgical treatments by providing 3-dimensional views of vital anatomical structures to accurately identify the location, size, and shape of a structure or defect in order to plan accordingly. Virtual augmentation of either hard tissue (bone) and/or soft tissue (i.e., gingiva) can also be accomplished.Technology has allowed the capture of the dynamic motions of the jaw and combined them with the virtual patient to develop permanent restorations in harmony with the patient's orofacial complex. With the introduction of new technology in the realm of digital dentistry, patient care is being brought to a new and higher level. This creates a level of more optimal care that a dentist can deliver to patients.

A New Intraoral Six-Degrees-of-Freedom Jaw Movement Tracking Method Using Magnetic Fingerprints.

We proposed a novel jaw movement tracking method that can measure in six degrees of freedom. The magnetic field generated by a permanent magnet paired with a small, low-power-consumption Hall effect magnetic sensor is used to estimate the relative distance between two objects-in this instance, the lower and upper jaws. By installing a microelectromechanical system (MEMS) orientation sensor in the device, we developed a mouthpiece-type sensing device that can measure voluntary mandibular movements in three-dimensional orientation and position. An evaluation of individuals wearing this device demonstrated its ability to measure mandibular movement with an accuracy of approximately 3 mm. Using the movement recording feature with six degrees of freedom also enabled the evaluation of an individual's jaw movements over time in three dimensions. In this method, all sensors are built onto the mouthpiece and the sensing is completed in the oral cavity. It does not require the fixation of a large-scale device to the head or of a jig to the teeth, unlike existing mandibular movement tracking devices. These novel features are expected to increase the accessibility of routine measurements of natural jaw movement, unrestricted by an individual's physiological movement and posture.

Injectable platelet-rich fibrin as treatment for temporomandibular joint osteoarthritis: A randomized controlled clinical trial.

The purpose of this study was to assess the treatment outcomes of intraarticular injection of injectable platelet-rich fibrin (i-PRF) after arthrocentesis in patients with temporomandibular joint osteoarthritis (TMJ-OA). Patients were randomly assigned to one of two treatment groups: those who received intraarticular injection of i-PRF after arthrocentesis procedure - the i-PRF group; and those who underwent the arthrocentesis procedure alone - the control group. The primary outcome variable was pain, the level of which was measured preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. The secondary outcome variables included maximum mouth opening (MMO), and lateral and protrusive movements. Of the total of 36 patients, 18 were analyzed in the i-PRF group and 18 in the control group. There were significant differences between the groups in terms of pain levels and measurements of MMO, lateral movement, and protrusive movement over the 12 months of follow-up (p < 0.001). Significant increases in pain levels and decreases in measurements of MMO, lateral movement, and protrusive movement were observed in the control group from the 6th to 12th month postoperatively (p < 0.001). In contrast, no significant differences were found in both pain levels and measurements of MMO, lateral, and protrusive movements for the i-PRF group from the 2nd to the 12th month postoperatively. Within the limitations of the study it seems that intraarticular injection of i-PRF after arthrocentesis should be preferred whenever appropriate because when reducing pain intensity and improving functional jaw movement is the priority.

Digital Determination and Recording of Edentulous Maxillomandibular Relationship Using a Jaw Movement Tracking System.

PURPOSE: To establish a direct digital method for determining and recording edentulous maxillomandibular relationship using a custom-made jaw movement tracking system and evaluate its accuracy. MATERIALS AND METHODS: A novel jaw tracking system was used to record the trajectory of habitual opening-closing jaw movement, and mandibular rest position (MRP) in 10 edentulous patients. 3D surface scanning was performed on the conventional maxillomandibular impressions and facial structures of patients in MRP. The multisource data were registered using a custom-made recording tool. A plane parallel to the ala-tragus and horizontal lines was constructed 2 mm above the MRP, and its vertical position was used to determine the vertical relationship. The intersections of the trajectory passing through the plane were located, and their density distributions were analyzed. The coordinates of highest density, which presented the highest repeatability of jaw movement, were used to construct the digital maxillomandibular relationship (test group). The maxillomandibular relationship of the new complete dentures with artificial teeth in the intercuspal position was defined as the control group. The displacements of the anterior reference point and 3D deviations of the entire mandibular arch were measured and compared between the test and control groups using a Wilcoxon signed-ranks test and a one-sample t-test, respectively. RESULTS: With reference to the centric relationship position, the maximum displacements of the anterior reference points were in the horizontal anteroposterior direction for both groups, and there were no significant differences. Compared to the control group, the 3D deviations of the entire mandibular arch in the test group were significant (95% confidence interval: 0.76 mm to 1.35 mm, p < 0.001). CONCLUSIONS: By analyzing the individual trajectory features obtained by the in-house developed jaw tracking system, a digital method for determining and recording edentulous maxillomandibular relationships was established; however, the accuracy needs to be further improved.

Motor representation of rhythmic jaw movements in the amygdala of guinea pigs.

OBJECTIVE: The areas of the amygdala contributing to rhythmic jaw movements and the movement patterns induced remain unknown. Therefore, the present study investigated the areas of the amygdala contributing to rhythmic jaw movements using repetitive electrical microstimulation techniques. DESIGN: Experiments were performed on head-restrained guinea pigs under ketamine-xylazine anesthesia. EMG activities in the masseter and digastric muscles and jaw movements were recorded. Short- and long-train electrical microstimulations of the amygdala were performed and the patterns of jaw movements induced were analyzed quantitatively. RESULT: The short-train stimulation induced short-latency EMG responses in the masseter and/or digastric muscles. The stimulation sites inducing short-latency EMG responses were distributed within the ventral part of the amygdala, which covered the medial, basal, and cortical nuclei. The long-train stimulation induced tonic jaw opening and two types of rhythmic jaw movements: those with or without lateral jaw shifts, which were characterized by a larger jaw gape and ipsilateral jaw excursion, respectively. Rhythmic jaw movements with lateral jaw shifts were characterized by overlapping masseter and digastric EMG activities. However, rhythmic patterns did not differ between the two types of rhythmic jaw movements. The stimulation sites that induced rhythmic jaw movements were more localized to the cortical nucleus. CONCLUSIONS: The present results suggest that the ventral part of the amygdala is involved in the induction of rhythmic jaw movements in guinea pigs. The putative roles of the limbic system in the genesis of functional (e.g., chewing) and non-functional (e.g., bruxism) rhythmic oromotor movements warrant further study.

Masticatory movements and food textures in older patients with eating difficulties.

OBJECTIVES: To investigate whether masticatory movements in older patients with eating difficulties were associated with oral motor function, physical function, and appropriate food textures. BACKGROUND: There are few reports on the association between masticatory movements and food textures in older patients with eating difficulties. MATERIALS AND METHODS: This cross-sectional study involved outpatients at a clinic that specialised in eating and swallowing rehabilitation. Masticatory movements were evaluated as normal or abnormal masticatory path patterns. Oral and physical functions were assessed in terms of oral and physical status, muscle strength and motor skills. The appropriate food texture was determined based on fibreoptic endoscopic evaluation of swallowing and a video fluoroscopic swallowing study. The associations between food texture and masticatory organ, muscle strength and motor skills were analysed. RESULTS: A total of 126 outpatients (75 men and 51 women; mean age, 78.2 years; SD, 9.6 years) were included in the analysis. 68 participants (54.0%) showed abnormal masticatory movements. Masticatory movement was associated with masticatory performance (odds ratio [OR] = 0.99, 95% confidence interval [CI] = 0.98-0.99), oral diadochokinesis (OR = 0.55, CI = 0.35-0.86) and stepping test (OR = 0.92, CI = 0.86-0.97). Masticatory movement (OR = 2.94, CI = 1.23-7.01) and the number of natural teeth (OR = 0.94, CI = 0.89-0.99) were associated with normal food. CONCLUSION: Masticatory movements in older patients with eating difficulties may be associated with appropriate food textures whilst being influenced by individual differences in systemic motor control. Masticatory movements may be as important as teeth to enjoy eating.

Artificial Intelligence Analysis of Mandibular Movements Enables Accurate Detection of Phasic Sleep Bruxism in OSA Patients: A Pilot Study.

PURPOSE: Sleep bruxism (SBx) activity is classically identified by capturing masseter and/or temporalis masticatory muscles electromyographic activity (EMG-MMA) during in-laboratory polysomnography (PSG). We aimed to identify stereotypical mandibular jaw movements (MJM) in patients with SBx and to develop rhythmic masticatory muscles activities (RMMA) automatic detection using an artificial intelligence (AI) based approach. PATIENTS AND METHODS: This was a prospective, observational study of 67 suspected obstructive sleep apnea (OSA) patients in whom PSG with masseter EMG was performed with simultaneous MJM recordings. The system used to collect MJM consisted of a small hardware device attached on the chin that communicates to a cloud-based infrastructure. An extreme gradient boosting (XGB) multiclass classifier was trained on 79,650 10-second epochs of MJM data from the 39 subjects with a history of SBx targeting 3 labels: RMMA episodes (n=1072), micro-arousals (n=1311), and MJM occurring at the breathing frequency (n=77,267). RESULTS: Validated on unseen data from 28 patients, the model showed a very good epoch-by-epoch agreement (Kappa = 0.799) and balanced accuracy of 86.6% was found for the MJM events when using RMMA standards. The RMMA episodes were detected with a sensitivity of 84.3%. Class-wise receiver operating characteristic (ROC) curve analysis confirmed the well-balanced performance of the classifier for RMMA (ROC area under the curve: 0.98, 95% confidence interval [CI] 0.97-0.99). There was good agreement between the MJM analytic model and manual EMG signal scoring of RMMA (median bias -0.80 events/h, 95% CI -9.77 to 2.85). CONCLUSION: SBx can be reliably identified, quantified, and characterized with MJM when subjected to automated analysis supported by AI technology.

Classifying Ingestive Behavior of Dairy Cows via Automatic Sound Recognition.

Determining ingestive behaviors of dairy cows is critical to evaluate their productivity and health status. The objectives of this research were to (1) develop the relationship between forage species/heights and sound characteristics of three different ingestive behaviors (bites, chews, and chew-bites); (2) comparatively evaluate three deep learning models and optimization strategies for classifying the three behaviors; and (3) examine the ability of deep learning modeling for classifying the three ingestive behaviors under various forage characteristics. The results show that the amplitude and duration of the bite, chew, and chew-bite sounds were mostly larger for tall forages (tall fescue and alfalfa) compared to their counterparts. The long short-term memory network using a filtered dataset with balanced duration and imbalanced audio files offered better performance than its counterparts. The best classification performance was over 0.93, and the best and poorest performance difference was 0.4-0.5 under different forage species and heights. In conclusion, the deep learning technique could classify the dairy cow ingestive behaviors but was unable to differentiate between them under some forage characteristics using acoustic signals. Thus, while the developed tool is useful to support precision dairy cow management, it requires further improvement.

Influence of Simulated Loss of Posterior Occlusal Support on Three-dimensional Condylar Displacement.

The objective of this study was to verify whether loss of posterior occlusal support induced displacement of the mandibular condyles from a physiological point of view. Stabilization-type splints were fabricated for 12 healthy dentulous individuals. Each splint was designed to cover the bilateral maxillary teeth up to the second molars. To reproduce loss of posterior occlusal support, the extent of the splint was reduced one tooth at a time, bilaterally, starting from the back and moving forward sequentially. Tapping movement and lateral excursions were performed with each splint and a jaw movement tracking device with 6-degrees of freedom used to observe condylar displacement. Evaluation of 3-dimensional (3-D) displacement of the kinematic axis of the condyle during experimental jaw movement was performed under each occlusal condition with occlusal contact on all teeth, including the maxillary second molars. The habitual closing position was used as the reference. An increase was observed in 3-D displacement of the kinematic axis at the terminal point of the tapping movement with loss of occlusal support, and significant differences were observed in both condyles. An increase was also observed in 3-D displacement of the kinematic axis on the working side during lateral excursion with loss of occlusal support, and a statistically significant difference was observed in the left condyle. A small increase was observed in 3-D displacement of the kinematic axis on the non-working side during lateral excursion with loss of occlusal support. The results of this study suggest that loss of posterior occlusal support induces displacement of the mandibular condyles, suggesting that occlusal support in the molar region is an important factor in stabilization of the condylar position.