• Physical Therapy Korea
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• v.29 no.4
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• pp.255-261
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• 2022

Background: For the elderly, masticatory function is one of the most important oral functions and the masticatory ability is related to the wearing of dentures. Many older people wear dentures for their masticatory function, but a significant number of older people who use dentures have found that they feel uncomfortable when performing their daily activities, such as performing masticating functions or talking. Objects: The purpose of this study is to investigate how the forward head posture (FHP), respiratory function and thickness of masseter (MS), and sternocleidomastoid (SCM) are affected by the presence or absence of dentures in the elderly, and what kind of correlation there is between these variables. Methods: The study was conducted on 11 patients in the normal group and 13 in the denture group. The participant's cognitive ability was evaluated using Mini-Mental State Examination Korean (MMSE-K), and the FHP was evaluated by measuring the craniovertebral angle (CVA). The thickness of the MS and SCM muscles were measured using ultrasound, and respiration was measured with a spirometry. As for the statistical method, the correlation of each variable was investigated using Spearman's correlation coefficient. Results: In the normal group, there was a significant correlation between forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) (p < 0.001), and in the denture group, FVC and FEV1 (p < 0.001), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (p < 0.001), CVA and Lt. MS (p = 0.012). Conclusion: CVA and Lt. MS of the denture group have a high negative correlation, it is related that the thickness of MS may be thick when the elderly wearing dentures are FHP.

• Journal of Oral Medicine and Pain
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• v.45 no.4
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• pp.115-119
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• 2020

Infectious myositis, an infection of the skeletal muscles, is a rare condition and potentially life-threatening if not detected and treated in the early stages. This clinical entity may arise from various pathogens, such as bacteria, fungi, parasites, and viruses. A propagation of contiguous infection, penetrating trauma, vascular insufficiency, or hematogenous spreading of microorganisms can cause infectious myositis. Though several cases have been reported in large muscle groups in the lower extremities, there are only a few reports on infectious myositis of the masticatory muscles. We report three cases of infectious myositis presenting jaw pain and trismus. Unlike a common head and neck infection caused by the spreading of odontogenic origin, the early diagnosis of infectious myositis was difficult because no specific lesion suspected to be the infection source was observed in the physical examination and the plain radiographs. Advanced imaging modalities such as computed tomography and magnetic resonance imaging, and laboratory evaluation is useful for the early detection of infectious myositis.

• Journal of Oral Medicine and Pain
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• v.7 no.1
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• pp.47-58
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• 1982

The author has studied on the clinical features and symptomatology of 97 MPDS patients, who visited the Dept. of Dentistry, Kyungpook National University, from January to September in 1982. The results were as follow : In age and sex distribution of patients in this population, the third decades appeared to have the highest prevalence and the male to female ratio was almost 1 to 2.23. As to occupation, students and housewives were revealed to have the highest incidence of MPDS. The chief complaints of patients were pains, TMJ noises, and limitation of mouth opening in order of frequency, and the most prevalent site of symptom was that of preauricular area. In symptom sequence, the majority of initial symptoms were TMJ noise and pain but limitation of mandibular movement was progressively developed, regardless of nature of early symptoms. Chronic unfavorable oral habits were found to be the most possible predisposing factors in this study. The average maximum interincisal distance was $38.13\pm10.00mm$ in males and $30.73\pm8.75mm$ in females, and a deviation of mandible during mouth opening was observed in 60.8% of patients. In TMJ signs, tenderness of the TMJ to palpation was found in 60.8% of patients and TMJ noise was audible in 50.5% of patients with a stethoscope. The muscles of masticatory system were palpated according to usual methods, and a significant indidence of muscular tenderness was present, with the lateral pteygoid muscles being most frequently involved, followed by masseter, medical pterygoid and temporalis muscles.

• Journal of Oral Medicine and Pain
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• v.39 no.2
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• pp.55-62
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• 2014

Purpose: This study aims to evaluate the changes in soft tissue thickness of the masseteric region after injection of botulinum toxin type A (BTX-A). Methods: Twenty-four data acquired from medical records were classified into 4 groups: bruxer group that received masseter muscle injection only (M-B), bruxer group that received both masseter and temporalis muscle injections (MT-B), non-bruxer group that received masseter muscle injection only (M-NB) and non-bruxer group that received both masseter and temporalis muscle injections (MT-NB). Injection dose of BTX-A was 30 units for each masseter muscle and 20 units for each temporalis muscle. We measured the reduced thickness of the masseteric region before and after 12 weeks after injection using cone-beam computed tomography. Results: Among the patients that received both masseter and temporalis muscle injections, bruxer group showed a tendency to have more reduction in masseter muscle thickness than non-bruxer group. The difference in reduced thickness between M-B and MT-B tended to show greater than the difference between M-NB and MT-NB. Conclusions: In case of masseter hypertrothy patients with bruxism there was a tendency to show a difference in reduced thickness of soft tissue between the group that received both masseter and temporalis muscles injection and the group that received masseter muscle injection only hence a thorough inspection before the injection of BTX-A is condisered to be needed.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.265-277
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• 1996

The aim of this study was to investigate the electromyographic(EMG) activity of masticatory and cervical muscles according to chewing pattern in coronal plane during gum chewing. 70 patients with temporomandibular disorders and 30 dental students without any signs and symptoms of the disorders participated in this study. We measured the activity of masseter (MM), anterior temporalis(TA), sternocleidomastoideus(SCM) and trapezius muscle and recorded the chewing patterns using Biopak system synchronously. Chewing pattern was classified into S- or L-pattern by the midline opening path and short or long type by the lateral distance from midline. Obtained data were analyzed with SAS/STAT Program. The obtained results were as follows : 1. Generally, there was tended to be higher activity in the control group than in the patients group. 2. When comparing EMG activity according to preferred side, the muscle activity was tended to higher on the preferred chewing side than on the contralateral side. However, this difference is insignificant statistically 3. In unilateral affected patients, there was no difference in muscle activity between affected chewing side and unaffected chewing side except for the EMG of the temporalis anterior muscle. 4. Despite the varietal in each of the following variables, there mere no differences in EMG activity during gum chewing: chewing pattern in coronal plane and lateral distance of chewing. 5. The activity of SCM in chewing side was higher than that in contralateral side (p<0.001), but there was no difference in trapezius muscle. 6. In all of the control group, there was appeared L-chewing pattern than not involved the midline during preferred side chewing.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.293-304
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• 1996

The purpose of this study was to investigate the peak electromyographic activity(EMG) and time intervals in firing sequence of Anterior temporalis(TA) and Masseter(MM) on clenching, the number of tender points in the head and neck muscles, the occlusal contact state on clenching, and their relationship. 78 patients with Temporomandibular Disorders(TMDs) participated and were classified into articular or muscular group by clinical signs and symptoms. BioEMG$\textregistered$ of integrated masticatory function analyzer, Biopak$\textregistered$ system(Bioresearch Inc., USA), was used to measure EMG and related items, and T- Scan$\textregistered$(Tekscan, USA), computerized occlusal analyser, was used to record occlusal contact state on maximum voluntary clenching. EMG and occlusal contact were synchronously recorded and analysed with SAS Statistical program. The results of this study were as follows : 1. In total subjects, EMG of TA was lower than that of MM in articular group but in muscular group, vice versa, As a result, the ratio TA to MM was significantly different between the two groups. no significant differece. 3. The number and force of occlusal contact were more in articular group, but there was no significant difference in Total Left-Right statistics(TLR) between the two groups. 4. In unilaterally affected subjects for muscle function, no significant difference was observed between the affected side and the contralateral side in articular group, but in muscular group, the item of the number of tender points showed significant difference. However, for occlusal contact items, contact force in articular group shows significant difference between the two sides. 5. Rate of coincidence of the first firing side of TA with affected side or preferred chewing side was higher and not different between the two groups, but no significant correlation was showed between the first firing side and the first occlusal contact side.

• Imaging Science in Dentistry
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• v.44 no.4
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• pp.293-299
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• 2014

Purpose: This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. Materials and Methods: The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the $X^2$ test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results: Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p<0.05). However, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Conclusion: Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

• The Journal of Korean Academy of Prosthodontics
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• v.27 no.1
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• pp.103-121
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• 1989

The purpose of this study was to investigate the influence of balancing interference on the activity of masticatory muscles and condylar path. Eight dental students of Won Kwang University without any symptoms of temporomandibular disorder and occlusal interferences, were selected for this study, The balancing interference was provided by construction and cementation of cast metal crowns on the upper and lower first molars. For the measurement of muscle activity, bioelectric processor (EM2, Myotronic Res., Inc., U.S.A.) was used and for the condular path, computerized electronic pantograph (Pantronics, Denar Corp., U.S.A.) was used and the myographic recordings were taken bilaterally from the anterior temporal, masseter and digastric muscles on rest position and on functions. These experimental procedures were done before cementation of experimental crown, three days after cementation of experimental crown, one week after, two weeks after and then one week after removal of experimental crown. The results are as follows: 1. The PRI score was increased at three days after application of balancing interference, and decreased at two weeks after. 2. Three subjects showed mild symptom of temporomandibular disorder at three or four days after application of interference, but the symptom was subsided in one or two weeks after application of interference. 3. One week after application of balancing interference, the activity of ipsilateral anterior temporal muscle in four subjects was decreased on gum chewing at experimental site. 4. Three days after application of balancing interference, the activity of ipsilateral anterior temporal muscle in three subjects was increased on gum chewing at non-experimental site. 5. The influence of balancing interference on the activity of anterior temporal, masseter and gigastric muscle was not prominent.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.81-93
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• 2023

Purpose: The current case study focuses on identifying the effects of manual therapy and home self-therapeutic exercise including on mouth opening and pain relief in patients with continuous neck pain with myofascial temporomandibular disorders (TMDs) accompanied by headache induced by masticatory myalgia Subjects: The study participant was a 27-year-old woman who was treated a year ago for pain related to TMDs accompanied by a headache. Methods: Manual therapy of the cervical spine with upper cervical spine posterior-to-anterior mobilization (C1~C2), upper cervical spine flexion mobilization (C0~C2), upper cervical spine lateral flexion mobilization (C0~C1), upper cervical spine thrust manual therapy (C1~C2) and manual therapy of the temporomandibular joint and muscles with transverse medial accessory temporomandibular joint mobilization, manual therapies for the temporal, the masseter, and medial pterygoid muscles were performed twice a week for about 30 minutes for 4 weeks. This protocol included 3 sessions in total. The home self-therapeutic exercise was to be performed two to three times a day. Results: The values more improved MMO increased to 41.4 mm, left masseter muscle PPT to 2.9 kgf/cm², right masseter muscle PPT to 3.1 kgf/cm², KHIT-6 to 46 points, neck pain intensity (by NRS) to 2 points, headache frequency to per weeks, cervical kyphotic angle to -8.06%, and GCPS to grade 1 (low-intensity pain without pain-related disorder). Conclusion: Manual therapy and home self-therapeutic exercise can be helpful for mouth opening and pain relief in patients with myofascial TMDs accompanied by secondary headaches induced by masticatory myalgia.

• The korean journal of orthodontics
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• v.25 no.3 s.50
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• pp.355-373
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• 1995

Craniofacial region is a musculodentoskeletal system that consists of many anatomical structures ; cranioskeletal structures, dental arches, and formation and functions of masticatory muscles have close correlations. Growth and development of craniofacial region are influenced by not only hereditory factors, but also environmental factors such as craniofacial muscles and surrounding tissues. On the contrary, however, study on changes in functions or adaptations of craniofacial muscles following changes of craniofacial skeletal structures has been somewhat insufficient. The author's purpose was to observe correlations between masticatory muscular functions and change patterns according to cranial skeletal structures and occlusion patterns, for this, comparative study of muscle activity changes of preand post- orthognathic surgery states in skeletal Cl III malocclusion patients was peformed. The selected sample groups were 15 normal male patients, 15 skeletal Cl III pre-orthognatic surgery patients and 15 skeletal Cl III post-orthognatic surgery patients. For each sample groups, cephalometric x-ray taking, masticatory efficiency test and measurements of muscle activities in anterior temporal muscle, masseter and upper lip in rest, clenching, chewing and swallowing were carried out. The following results were obtained : 1. In resting state of mandible, pre-surgery malocclusion group showed higher m. activities in ant. temporalis, masseter and upper lip than post-surgery group. Post-surg. malocc. group showed significantly high m. activity only in upper lip compared to the normal group. 2. In clenching state, post-surg. malocc. group showed higher m. activities in ut. temporalis, masseter and upper lip than pre-surg. malocc. group. 3. In chewing state, post-surg. malocc. group showed higher m. activities in ant. temporalis and masseter than pre-surg. malocc. group, on the other hand, decreased upper lip activity was noticed. 4. In swallowing state, post-surg. malocc. group showed lower upper lip activity than pre-surg. malocc. group but higher than that of the normal group. No significant difference in m. activities of ant, temporalis and masseter was noticed among the three groups. 5. Masticatory efficiency was lower in pre-surg. malocc. group than normal group, masticatory efficiency showed an increase in post-surg. malocc. group compared to the pre-surg. malocc. group. However, both groups showed significant differences compared to the normal group.