• Journal of Oral Medicine and Pain
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• v.16 no.1
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• pp.103-111
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• 1991

This study was performed to observe the effect of micro-wave diathermy and ultrasonic-wave diathermy on the craniomandibular disorder patients. 19 patients were classified into 12 acute and 7 chronic groups according to the duration of 6 months. They were treated with micro-wave diathermy and ultrasonic-wave diathermy for 2 weeks and pain, maximum comfortable opening, active range of motion were checked before and after therapy. Electromyographic activities of temporal and masseter muscles were also measured at physiologic rest position, clenching and mastication before and after therapy. The obtained results were as follows : 1. After treatment, pain were reduced and active range of motion and maximum comfortable opening were increased. 2. Temporoal and masseter muscle activities of post-treatment in rest position, clenching and mastication were lower than those of pre-treatment. 3. In rest position, temporal and masseter muscle activities of pre-treatment on affected sides were higher than those on unaffected sides, but there were no differences in muscle activities between affected ad unaffected sides on clenching and mastication in pre and post-treatment respectively. 4. There were no significant differences in active range of motion, pain and maximum comfortable opening between acute and chronic groups in pre and post-treatment but there were significant differences between pre-treatment and post-treatment in acute and chronic groups respectively. 5. Muscle activities of masseter and temporal muscles in acute and chronic patients were reduced in rest position after treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.5
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• pp.537-542
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• 2008

BSSRO is most frequently operated among orthognathic surgery techniques for repairment of maxillofacial deformities. In case of patients with maxillofacial asymmetry accompanying mandibular protrusion who are operated by BSSRO, this study considers the recovering time for masticatory force of each tooth and Masseteric EMG and the adequate time enabling normal occlusion. The patients who are operated with BSSRO under general anesthesia in Dankook Dental Hospital, Department of OMS are selected for this study. The control group is devided into 2. 26 patients with facial asymmetry accompanying mandibular protrusion are selected for group 1 and their maximum voluntary bite force and masseteric EMG are measured. Group 2 is formed by volunteers with healthy dentition who are measured maximum bite force and masseteric EMG on both sides of the mouth. At the week of 3rd, 5th, 7th, 9th and 11th, Mann-Whitney U test is carried on for statistical analysis and the result is as follows. 1. Patients with mandibular protrusion showed apparently low maximum bite force and masseteric EMG than patients with normal occlusion. 2. In comparison with control group 1, Occlusal force is regained in incisors and canines at the 9th week and in premolars and molars, 11th week and masseteric EMG is regained at 11th week. 3. Comparing to normal occlusal patients, no recovery could be found in experimental group in every parts of the mouth.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.171-183
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• 1995

This study was carried out to investigate the relationship between tensed mandibular positions, muscle tenderness and EMG activity, respectively, and between range of motion of the neck and sternocleidomastoid muscle tenderness. Under stressful conditions, most of people take several types of behavioral patterns. Two of them observed frequently are clenching of teeth and grasping of fist. Prolonged clenching or grasping should increase electromyographic activity of associated muscle, especially muscles of mastication and neck muscles and will cause hyperfunction, dysfunction and muscle pain. So it is necessary to relate EMG activity with muscle pain. The author performed routine clinical examination in 47 patients with Temporomandibular Disorders, especially for presence or absence of muscle tenderness. Mandibular rest position was used as a baseline reference position and two more position in which EMG activity was taken were rest postion with grasping of fist and teeth clenching position. BioEMG of Biopak system (Bioresearch Inc, USA) was used for measuring of integrated EMG in masseter, anterior temporalis, anterior belly of digastic muscle and sternocleidomastoid muscle. To measure of the range of neck motion. CROM(Cervical-Range-of Motion, USA) was used. The obtained results were as follows : 1. EMG activity of all muscles except in masseter was higher in grasping of fist than those in rest position and there were significant correlation in EMG activity between the two position except in anterior belly of digastric muscle. 2. When comparing EMG activity between tender and non-tender muscle, all examined muscles did not show any significant difference. From this data, we could conclude that EMG activity was generally not changed with tenderness, of couse, it might be dependent with degree of muscle tenderness. 3. Number of tender points in examined muscles was also not significantly different between in patients with masticatory muscle disorders and in patients with internal derangement. 4. Cervical posture and range of motion of the neck was not differed significantly between in patients with and in patients without tenderness of sternocleidomastoid muscle.

• Journal of Acupuncture Research
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• v.26 no.6
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• pp.111-119
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• 2009

Objectives : To assess the characteristics of electropyography(EMG) and heart rate variability(HRV) values in idiopathic facial palsy inpatients of different Sasang constitutions. Methods : Medical records of 103 idiopathic facial palsy inpatients who underwent facial EMG testing and HRV testing were retrospectively reviewed. All subjects had been consulted to the department of Sasang constitution for constitution differentiation. The Sasang constitutional and age distribution were initially analyzed, and axonal loss percentage values on EMG were correlated with Sasang constitution and sex. HRV results were also correlated with Sasang constitution and sex. Results : 1. 24.4 percent of idiopathic facial palsy inpatients were of the Soyang constitution, 52.4 percent were of the Taeum, and 23.3 percent were of the Soeum. Patients in their fifties were most common in all constitutions(27.8%). 2. Mean axonal loss values for the temporal, zygomatic, and buccal branches were all statistically significantly lower in the Taeum constitution compared with Soyang or Soeum(p<0.05). 3. Mean axonal loss values for the temporal, zygomatic, and buccal branches were all statistically significantly lower in men than women(p<0.05). 4. The mean LF/HF ratio was significantly lower in idiopathic facial palsy inpatients of the Soeum constitution compared with Soyang and Taeum(p<0.05), but there was no statistically significant difference in mean MHRT, SDNN, TP, VLF, LF, and HF of different constitutions. 5. The mean SDNN was significantly lower in women inpatients compared with men(p<0.05), but there was no statistically significant difference in mean MHRT, TP, VLF, LF, HF, and LF/HF ratio. Conclusions : The Sasang constitutional composition of idiopathic facial palsy inpatients closely adheres to the composition proposed in Dong-eui-su-se-bo-won, but the Taeum and Soeum proportion is slightly larger and the Soyang proportion slightly smaller. Axonal loss value on EMG was significantly lower in the Taeum constitution, and in men(p<0.05, <0.05). Mean LF/HF ratio was significantly lower in the Soeum constitution compared with Soyang and Taeum(p<0.05), and mean SDNN was significantly lower in women(p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.293-299
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• 2008

Bite force is created by the force of adjacent teeth accompanied with tension of masticatory muscle. The bite force value is greater in male than in female and ha maximum value at first molar. Masseter muscle is associated with bite force and during muscle contraction the electric signal is expressed in EMG form. The aim of the study is to assess recovery time for masseter muscle activity and according to each part of bite force after open reduction with internal fixation when mandibular angle fracture and subcondyle fracture occurred. And to determine the appropriate period for mandibular fracture patients to have normal masticatory activity. 30 patients with normal bite condition was selected for control group and from April, 2007 to September, 2007, 20 patients who visited our department of oral and maxillofacial surgery of Dankook University, were selected for the study and were diagnosed as mandibular angle fracture and subcondyle fracture. For control group, the bite force for incisors, canine, premolars and molars and activity of the masseter muscle was measured and compared for 1, 2, 3, 4, 6 and 8 weeks. That was divided as fracture side and normal side. Mann-Whitney U test was performed for significant difference and the following result was obtained. 1. The maximum voluntary bite force for incisors, canine, premolars and molars portion were 0.113 kN, 0.182kN, 0.295kN and 0.486kN and the masseter muscle activity was 0.192 volts in the control group. 2. The maximum bite force at fracture side was recovered by 4th weeks for incisors, 6th weeks for canine and premolars and 8th weeks for molars and the masseter muscle activity was recovered by 6th weeks in the experimental group. 2. The maximum bite force at normal side was recovered by 4th weeks for incisors, 6th weeks for canine, premolars and molars and the masseter muscle activity was recovered by 3rd weeks in the experimental group. 3. The method for internal fixation by 2.0mm miniplates at both superior and inferior border had no complications according for twenty patients and had a satisfactory recovery. According to the result, patient with mandibular angle fracture and subcondyle fracture, 8 weeks was required for bite force recovery. Therefore, patients with open reduction and internal fixation under general anesthesis, it can be assumed that 8 weeks was needed after operation in order to have normal bite force and masseter muscle recovery.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.121-130
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• 1993

Mandibular rest position is very essential position because in that position, masticatory muscularture can be reciprocally coordinative and unstrained. So obtaining a good ability to establish and maintain rest position in non-functioning state is mandatory for treatment of patient with craniomandibular disorders. In general, many types of mandibulr movement exercise start from rest position and use the sense of muscle relearning, that is, muscle smoothness and relaxation, throughout the exercise period. In this study, 44 normal subjects for control group and 37 patients with craniomandibular disorders for experimental group participated and they were classified into 3 subgroups, respectively. One method to guide mandibular rest position was used for one subgroup, so theree methods were used for this study, 1)self-guided rest position without any education, 2) guided by Rocabado's tongue rest position, 3) guided through swallowing after Dawson's centric relation. To record electromyographic activity, Bioelectric processor EM2 (Myotronics, U.S.A.) was used. The numbers of sessions from start to stable resting electromyographic level and muscle activities in stable state were recorded and two recordings which were first and second, 3 days after first recording, were done, The data were processed with SPSS/PC+package. The obtained results were as follows : 1. Mean number of sessions in second recording were fewer than those in first recording in both groups. In comparison among 3 subgroups, mean number of sessions of subgroup guided through Dawson's method were fewer than those of other groups though it is not statistically significant. 2. There was a difference of mean number of sessions between control and experimental group in first recording, but in second recording there was no difference in any cases. 3. Mean value of muscle activity were generally not different without regard to group and method if once come to stable resting position level. Mean value of muscle activity of guided subgroups showed a tendency of decreasing in second recording than in first recording. However, in self-guided subgroup there was a inconsistent pattern. 4. The amounts of change in session number from first to second recording in control group were fewer than those in experimental group.

• Journal of Acupuncture Research
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• v.31 no.2
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• pp.51-63
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• 2014

Background or Objectives : The purpose of this study is to measure surface Electromyography(sEMG) of facial muscles in normal person and to find method for standardizing of sEMG's value. Methods : We measured 3points on face, frontalis muscle($GB_{14}$), zygomaticus muscle($SI_{18}$), orbicularis oris muscle($LI_{19}$) of 40 normal person by sEMG. 40 normal person consist with two groups, each 20 male, 20 female. Average age of subject was $26.50{\pm}4.79$. SEMG instrument QEMG-4 XL was used. After training exercise of facial muscles, sEMG's root mean square value was measured once. Results : 1. In whole experimental group, frontalis muscle's both side average was $78.36{\pm}40.87$, zygomaticus muscle's both side average was $84.70{\pm}49.81$, orbicularis oris's both side average was $104.83{\pm}38.81$. 2. Left side of Frontalis muscle, both side of zygomaticus muscle are high marked in male than female in statistically. 3. In whole experimental group, average of ratio comparing smaller value with bigger value in difference between left side and right side was $19.60{\pm}12.88$ %. 4. Average of asymmetry index(AI) was $11.46{\pm}8.36$ %. orbicularis oris muscle's average of AI had least difference was $8.95{\pm}7.50$ %. zygomaticus muscle's average of AI had most difference was $13.95{\pm}8.90$ %. Conclusions : The result of this study could provide useful information of field of sEMG is used in oriental medicine treatment of facial muscles. To assess efficacy of treatment in facial muscles, we need to standardize facial muscle's sEMG values by using AI, ratio comparing values and etc.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.115-123
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• 2013

Objectives : This study was performed to confirm the usefulness of EMG and early-performed ENoG as predicting factor for facial palsy by clinical outcome. Methods : We gathered patients who visited the Facial Palsy Center in Kyung Hee University Hospital at Gangdong between January 2010 and September 2012. We used inclusion/exclusion criteria and reviewed 231 patients' medical records including gender, age, HB grade and EMG & ENoG axonal loss. We compared the relation between EMG axonal loss and improvement degree at 4 & 6 weeks after treatment, and between ENoG axonal loss at 3-5 & 6-8 days after onset and EMG axnoal loss using regression analysis. Results : Each analysis had statistical significance, but EMG & improvement degree at 6 weeks after treatment showed statistically higher correlation than that at 4 weeks after treatment, and ENoG at 6~8 days after onset & EMG showed statistically higher correlation than that at 3~5 day after onset. Conclusions : We could get the evidence of the validity of EMG and early-performed ENoG as predicting factor for facial palsy based on collaborative treatment between Korean and western medicine.

• Journal of Acupuncture Research
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• v.30 no.5
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• pp.155-167
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• 2013

Objectives : This research was conducted to investigate the factors that affect the level of facial nerve damage. Methods : From October 2009 to September 2013, the total number of 581 patients of Bell's palsy and Ramsay-Hunt syndrome visited Facial Palsy Center in Kyung Hee University Hospital at Gangdong for Traditional Korean and Western combined medical treatment. Of these, 453 patients of peripheral facial nerve palsy were selected for the research. After reviewing the medical records that have details of age, gender, diagnosis(Bell's palsy and Ramsay-Hunt syndrome), onset, underlying diseases(DM, HTN), and HbAlc value, the analysis on the influence factors on the level of facial nerve damage was drew out. Results : The axonal loss rate of oris branch and nasal branch were significantly higher than the axonal loss rate of frontal branch and oculi branch. In addition, the frequency of becoming a major damaged branch was also high in the oris branch nasal branch. The factors by month, weather, smoking, and alcohol did not influence EMG axonal loss rate. Male rather than female and patient with Rasmay-Hut syndrome rather than Bell's palsy had a higher axonal loss rate in all branches. Of those, front of branch of male was remarkably higher than female. Patient with DM as P/H had high axonal loss rate in all branches. Patient with HTN as P/H had high axonal loss rate in all branches except for oris branches. Patients with DM and HTN group had significantly higher value from the average of axonal loss rate than patients who are only with HTN and without DM/HTN. DM alone group had significantly higher value than patients who are without DM/HTN. However, HTN alone was not significantly high. By analysing HbAlc of the patients who were hospitalised regardless DM, axonal loss rate was high in the order of DM group, preDM group, normal group. Nevertheless, only DM group showed higher axonal rate statistically than normal group. Considering DM and HbA1c value, the patients can be divided into 4 different groups of hkDM, lkDM, hfDM and nDM. By analysing those groups, the average damaged value of the groups with diagnosis followed by treatment(lkDM, hkDM) were higher than the average rate of hfDM and statistically higher than the rate of the nDM. Conclusions : The influential factors of increasing the level of EMG damage are male(only for the frontal branch), age above sixties, HTN, DM, and HbAlc value above 6.5. Besides, the negligible factors are month, season, diagnosis, alcohol, and smoking. Further research including clinical prognosis should be conducted.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.53-67
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• 2013

This study was aimed to evaluate the masticatory efficiency after botulinum toxin type A (BTX-A) injection during 12 weeks using objective and subjective test. Also, we compared the difference of masticatory efficiency between group that injected into the masseter muscle only (M-group) and group that injected into the masseter and temporalis muscle (M-T group). The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as the subjective indicators. It was concluded that masticatory efficiency was significantly lowered after a BTX-A injection into the masticatory muscle, but it gradually recovered in a predictable pattern by the 12 weeks. The disturbance of subjective masticatory efficiency was lasted longer than objective masticatory efficiency. The masticatory efficiency was lower in M-T group than M group. It was statistically significant in the VAS and FIA at 4 weeks, but the MAI showed no significancy. After 4weeks, there was rapid recovery of muscle function in M-T group, and the difference between two groups was not significant. It could be concluded that there will be no serious disturbance of mastication compared to injection is done only into the masseter muscle, even if injection is done into the masseter and temporalis muscle in dose of this study. According to the food properties, it was confirmed that people feel more discomfort on taking hard and tough foods after BTX-A injection and not only hard foods, but also intake of soft and runny foods were influenced by botulinum toxin injection.