• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.45-55
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• 2005

As people prefer to use right or left hand, some have preferred chewing side while others do not. Totally, 82 volunteers composed of students and staffs from Dental Hospital College of Dentistry Yonsei University participated in this study for the investigation of influence of preferred chewing habit, that has lasted for more than a year, on electromyographic(EMG) activity of masticatory muscles and bite force. Among the 82 volunteers, 46 had preferred chewing habit while the other 36 did not. Prior to the investigation, those with factors that could affect the study, such as, general disease, irregular dentition and malocclusion, were screened and excluded by questionnaire and clinical examination. The results were as follows: 1. There was no significant difference in EMG activities between chewing side and non-chewing side of preferred chewing subjects at rest as well as maximal voluntary contraction(MCV)(p>0.05). 2. Asymmetrical coefficient of temporal and masseter muscle EMG activities between preferred chewing subjects and non-preferred chewing subjects at rest was not significantly different(p>0.05). 3. Asymmetrical coefficient of masseter EMG activity was significantly higher(p<0.05) than that of non-preferred chewing subjects at MCV, whereas that of anterior temporal muscle showed no difference(p<0.05). 4. In preferred chewing subjects, there was no significant difference in average bite force and occlusal contact area between chewing side and non-chewing side(p>0.05). 5. There was no significant difference in Asymmetrical coefficients of average bite force and occlusal contact area between preferred chewing subjects and non-preferred chewing subjects (p>0.05). Consequently, preferred chewing habit can be considered as physiological asymmetry with normal function rather than to have influence on EMG muscle activity of masticatory muscles, average bite force and occlusal contact area. Objective standardization to differentiate preferred chewing subjects and non-preferred chewing subjects should be established in the further study.

• 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 Oral Medicine and Pain
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• v.35 no.4
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• pp.275-281
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• 2010

The lateral pterygoid muscle is one of the masticatory muscles basic to jaw function. Because of its deep location in the masticatory system, digital palpation of the muscle is usually difficult to perform and unreliable. Therefore, diagnosis of the myalgic disorders involving the lateral pterygoid muscle is a perplexing problem for clinicians. Local anesthetic injection can be a more effective method to examine the lateral pterygoid muscle for the purpose of discriminating the source of pain. Furthermore, immediate elimination of muscle pain facilitates stretching of the muscle in the full range. We report two cases of lateral pterygoid myalgia that were diagnosed and managed successfully through the use of intramuscular local anesthetic injection.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.2
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• pp.175-182
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• 1990

This study was performed to investigate the influence of occlusal change on the masticatory muscle activity. 8 students without any symptom of T.M.J. dysfunction, any history of prosthodontic or orthodontic treatment on dental college of WonKwang Univ. were participated in this study. The activity of masseter and anterior temporal muscles were measured by bioelectric processor(EM2, Myotronics, Inc., U.S.A.) during voluntary maximal clenching on natural teeth, by splint with bilateral posterior surface contact, by splint with unilateral posterior surface contact, and by splint without unilateral posterior teeth contact. The obtained results were as follows ; 1. The loss of posterior contact on noe side resulted in change of the activity of anterior temporal and masseter muscle during clenching on ipsilateral side, but there was no change of muscle activity on contralateral side. 2. The activity of anterior temporal and masseter muscle during clenching were not affected by the pattern of occlusal contact. 3. There were no difference between the activity of anterior temporal and masseter miuscle during clenching by natural teeth and by occlusal splint.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.14.1-14.11
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• 2015

The aim of this article is to review temporomandibular joint symptoms as well as the effects of orthognathic surgery(OGS) on temporomandibular joint(TMJ). The causes of temporomandibular joint disease(TMD) are multifactorial, and the symptoms of TMD manifest as a limited range of motion of mandible, pain in masticatory muscles and TMJ, Joint noise (clicking, popping, or crepitus), myofascial pain, and other functional limitations. Treatment must be started based on the proper diagnosis, and almost symptoms could be subsided by reversible options. Minimally invasive options and open arthroplasty are also available following reversible treatment when indicated. TMD manifesting in a variety of symptoms, also can apply abnormal stress to mandibular condyles and affect its growth pattern of mandible. Thus, adaptive developmental changes on mandibular condyles and post-developmental degenerative changes of mandibular condyles can create alteration on facial skeleton and occlusion. The changes of facial skeleton in DFD patients following OGS have an impact on TMJ, masticatory musculature, and surrounding soft tissues, and the changes of TMJ symptoms. Maxillofacial surgeons must remind that any surgical procedures involving mandibular osteotomy can directly affect TMJ symptoms, thus pre-existing TMJ symptoms and diagnoses should be considered prior to treatment planning and OGS.

• Journal of Periodontal and Implant Science
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• v.45 no.1
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• pp.8-13
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• 2015

Purpose: The aim of this study was to evaluate the transfer of different occlusal forces in various skeletal malocclusions using finite element analysis (FEA). Methods: Three representative human cone-beam computed tomography (CBCT) images of three skeletal malocclusions were obtained from the Department of Orthodontics, Yonsei University Dental Hospital, Seoul, South Korea. The CBCT scans were read into the visualization software after separating bones and muscles by uploading the CBCT images into Mimics (Materialise). Two separate three-dimensional (3D) files were exported to visualize the solid morphology of skeletal outlines without considering the inner structures. Individual dental impressions were taken and stone models were scanned with a 3D scanner. These images were integrated and occlusal motions were simulated. Displacement and Von Mises stress were measured at the nodes of the FEA models. The displacement and stress distribution were analyzed. FEA was performed to obtain the 3D deformation of the mandibles under loads of 100, 150, 200, and 225 kg. Results: The distortion in all three skeletal malocclusions was comparable. Greater forces resulted in observing more distortion in FEA. Conclusions: Further studies are warranted to fully evaluate the impact of skeletal malocclusion on masticatory performance using information on muscle attachment and 3D temporomandibular joint movements.

• Journal of Oral Medicine and Pain
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• v.46 no.3
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• pp.93-97
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• 2021

The limited mouth opening, also known as trismus, can result from temporomandibular joint disorders, infection, neoplasm, trauma, and abnormal anatomic structure like coronoid hyperplasia. Head and neck cancer patients often complain of limited mouth opening, which is usually induced by myofibrotic contracture of masticatory muscle. But clinicians should consider any reasons such as infection or cancer growth and metastasis if trismus gets worse or pain develops. We report the case of the patient, who was diagnosed with myxofibrosarcoma on nasal cavity. He had suffered from trismus after concurrent chemoradiotherapy. However, pain had developed and trismus had worsened. He was diagnosed with infratemporal space abscess and myositis of masticatory muscles.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.245-257
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• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.

• Journal of Oral Medicine and Pain
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• v.26 no.1
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• pp.75-85
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• 2001

This study was performed to investigate the effect of mandibular midline shift and difference of mandibular height between both sides on the electromyo- graphic(EMG) activity of the masticatory muscles on clenching or gum chewing movement. For this study, 105 patients with temporomandibular disorders(TMD) were selected and panoramic radiograph were taken. Amount and side of the midline shift and height of the mandible from antegonial notch to the top of the condylar head were measured on panoramic view. $BioEMG^{(R)}$ (Bioresearch Inc., Milwaukee, USA) was used for recording of EMG activity(${\mu}V$) of the anterior temporalis and the superficial masseter on clenching or gum chewing movement. EMG activity on clenching during 533msec period were measured for activity of the starting point and the one second-after activity as the early EMG and the maximum EMG, respectively. EMG activity on gum chewing movement were measured for activity of the first and the second chewing stroke. The data collected were analysed by SPSS windows program, and the results of this study were as follows : 1. Height of the mandible was 8.06cm on right side and 8.03cm on left side, and showed no difference by age, but significantly differed by sex with higher in male subjects. 2. Mean value of the midline shift was 0.1mm with range of 0~5mm on both sides. The amount and side of the midline shift did not related with height difference of the mandible and/or the EMG activity of the masticatory muscles on clenching. 3. Prevalence of higher right side and higher left side of the mandible were almost same, and the EMG activity of higher side was not higher than that of the other side. 4. In the subjects with height difference of more than 5mm between both sides of the mandible, the early EMG activity on clenching were differed for the anterior temporalis, but the maximum activity were differed for the superficial masseter. 5. In the subjects with height difference of more than 5mm between both sides of the mandible, EMG activity of the anterior temporalis of the gum chewing side was not higher than that of the other side when chewing on the side of lower height, but in the subjects with height difference of less than 5mm, the EMG activity was higher than that of the other side.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.269-276
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• 2012

Many researches have been published about the numerous factors related to the chewing ability of implant prosthesis. Most respective studies have concluded that the chewing ability of implant prosthesis is mostly fine compared to other type of prosthesis. However, some patients are not satisfied with their chewing ability of implant prosthesis. Therefore the neurologic factor, one of the factors related to dissatisfaction of chewing ability was reviewed in this study to understand the mechanism of action of mastication. Data was searched using the keywords; 'implant chewing ability, masticatory ability' in Pubmed database and reviewed. Definitions of chewing ability, factors of chewing ability are reviewed and the neurologic factor, one of the factors influencing on chewing ability, is reviewed. Mechanoreceptor of Periodontal ligament(PDL) is providing the mastication information to brainstem. Due to the absence of mechanoreceptions of PDL in implant, masticatory ability is decreased especially when chewing hard food. Masticatory muscles and mechanoreceptor in TMD may compensate the lack of mechanoreceptor of PDL in implants. Furthermore sensitivity of nerve fiber around peri-implant tissues may support the mechanoreception and sensory reaction in the implant mastication. However, further studies should be conducted to prove the relationships between neurologic factors and mastication.