• Journal of Oral Medicine and Pain
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• v.45 no.4
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• pp.120-123
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• 2020

The causes of tongue pain and discomfort include systemic disease, malnutrition, mental illness, fungal infection, and neuropathy. Three postmenopausal women reported burning sensations and stiffness of the tongue for various periods, from one month to four years. There were no objective etiological factors to cause the tongue pain and discomfort. Muscular tenderness upon palpation of masticatory muscles, sternocleidomastoid, trapezius, and tongue were observed. Physical therapy approaches such as moist hot pack, ultrasound, and myomonitor were performed on three patients with tongue pain, just as for temporomandibular joint disease. Additional botulinum toxin injection therapy was applied to one patient who displayed a clenching habit. All three patients showed a marked improvement in their tongue symptoms after the muscle relaxation and botulinum toxin injection therapy.

• 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 Dental Anesthesia and Pain Medicine
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• v.21 no.3
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• pp.253-260
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• 2021

Therapeutic injections into the craniofacial region can be a complex procedure because of the nature of its anatomical structure. This technical note demonstrates a process for creating an extra-oral template to inject therapeutic substances into the temporomandibular joint and the lateral pterygoid muscle. The described process involves merging cone-beam computed tomography data and extra-oral facial scans obtained using a mobile device to establish a correlated data set for virtual planning. Virtual injection points were simulated using existing dental implant planning software to assist clinicians in precisely targeting specific anatomical structures. A template was designed and then 3D printed. The printed template showed adequate surface fit. This innovative process demonstrates a potential new clinical technique. However, further validation and in vivo trials are necessary to assess its full potential.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.282-286
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• 2021

Recent reports have described several cases of double muscle transfers to restore natural, symmetrical smiles in patients with long-standing facial paralysis. However, these complex procedures sometimes result in cheek bulkiness owing to the double muscle transfer. We present the case of a 67-year-old woman with long-standing facial paralysis, who underwent two-stage facial reanimation using two superficial subslips of the serratus anterior muscle innervated by the masseteric and contralateral facial nerves via a sural nerve graft. Each muscle subslip was transferred to the upper lip and oral commissures, which were oriented in different directions. Furthermore, a horizontal fascia lata graft was added at the lower lip to prevent deformities such as lower lip elongation and deviation. Voluntary contraction was noted at roughly 4 months, and a spontaneous smile without biting was noted 8 months postoperatively. At 18 months after surgery, the patient demonstrated a spontaneous symmetrical smile with adequate excursion of the lower lip, upper lip, and oral commissure, without cheek bulkiness. Dual-innervated muscle transfer using two multivector superficial subslips of the serratus anterior muscle may be a good option for long-standing facial paralysis, as it can achieve a symmetrical smile that can be performed voluntarily and spontaneously.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.1
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• pp.11-20
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• 1993

Bony ankylosis is an intraarticular condition where there is fusion of the bony surfaces of the joint : The condyle and the glenoid fossa. It occurs in both children and adults, unfortunately more frequently in the former, in whom early recognition and correction is particularly critical. Trauma is well proven to be the predominant cause of TMJ ankylosis. Infection, rheumatoid arthritis and neoplasm are another, significant cases of TMJ ankylosis. The necessity for using an interpositional material to prevent TMJ reankylosis has been widely discussed and many interpositional materials have been used, including temporal muscle and fascia, dermis, auricular cartilage, fascia lata, fat, Lyo-dura, Silastic and various metals. The temporal muscle and fascia have been widely used pedicled flap for head and neck reconstruction. The use of a temporal muscle and fascia for reconstruction of the TMJ, particularly in cases of ankylosis is a very reasonable option. Its principle advantages are its autogenous nature, resilience, and proximity to the joint, allowing for a pedicled transfer of vascularized tissue into the joint area. However, the viability of temporal muscle and fascia is a critical question. We treated 2 cases of TMJ ankylosis with temporal muscle and fascia transfer and one case with temporal fascia. We obtained satisfactory results as to functional aspects.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.261-266
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• 2013

Myofascial pain is a condition associated with regional pain and muscle tenderness characterized by the presence of myofascial trigger points. In this case report, a subject complaining of nighttime bruxism was clinically assessed, and a latent trigger point of the anterior temporalis muscle was identified with manual palpation. A surface electromyographic (SEMG) exam of the anterior temporalis muscle harboring the latent trigger point demonstrated several SEMG features, including post-contraction irritability, delayed relaxation following contraction and accelerated muscle fatigue. It was concluded that a SEMG exam may detect abnormal masticatory muscle function and, therefore, assist in the evaluation of myogenous temporomandibular disorders.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.46.1-46.6
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• 2015

Background: The purpose of this study was to evaluate the change of food intake after different dosages of botulinum toxin A (BTX) injection in the animal model. Additionally, the dimensional and histological change at 14 days after BTX injection was also evaluated. Methods: The comparative study was performed using the BTX injection model in rats (n = 5 for each group). Group 1 was the saline-injected group. Group 2 was the 5-unit BTX-injection group to each masseter muscle. Group 3 was the 10-unit BTX-injection group to each masseter muscle. Food intake rates and body weight were checked daily before and after BTX injection until 10 days. All animals were sacrificed at 14 days after BTX injection, and the specimens underwent hematoxylin and eosin stain and immunohistochemical staining for myosin type II (MYH2). Results: The recovery of food intake in groups 2 and 3 decreased significantly compared with group 1 from day 2 to day 7 and day 9 after injection (p < 0.05). The BTX-treated masseter muscles were significantly smaller than those in group 1 (p = 0.015). The immunohistochemical findings demonstrated that the expression of MYH2 was significantly higher in group 3 compared to groups 1 and 2 (p < 0.001). Conclusions: BTX injection to the masseter muscle in rats demonstrated short food-intake-rate reduction with recovery until 10 days after injection. The thickness of the masseter muscle and MYH2 expression were significantly changed according to the injected dose of BTX.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.313-320
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• 2020

Objectives: The aim of this study was to evaluate the relationship between masticatory muscle thickness and mandibular morphology in young Korean adults with normal occlusion and mandibular prognathism. Patients and Methods: Multidetector computed tomography (MDCT) was used to measure the masticatory muscle thickness on the right side in 100 Korean young adults (50 normal occlusion group, 50 mandibular prognathism group). Cephalometric analysis was done to measure mandibular morphology. Pearson correlation analysis was done to investigate the relationship between the masticatory muscle thickness and mandibular morphometry. Results: The four masticatory muscles showed positive correlation with intergonial width in all subjects. All muscles, except temporalis, positively correlated with height of the ramus and mandibular length. Positive correlation was also observed in all muscles, except medial pterygoid, with thickness of the ramus. In the normal occlusion group, all four masticatory muscles showed positive correlation with intergonial width and ramus thickness. Positive correlation was also observed in all muscles (except lateral pterygoid) with mandibular length. Masseter and lateral pterygoid positively correlated with height of the ramus. In the mandibular prognathism group, all masticatory muscles, except lateral pterygoid, showed positive correlation with intergonial width. The masseter muscle showed negative correlation with ANB. Conclusion: The results suggest a positive correlation of the thickness of masticatory muscles with both horizontal and vertical dimensions of the mandible. However, thickness of the masseter was found to decrease in patients with increasing severity of mandibular prognathism.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.259-266
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• 2005

The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

• Journal of Oral Medicine and Pain
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• v.15 no.1
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• pp.105-115
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• 1991

The purpose of the study was to evaluate the occlusal stability at the moment of dynamic occlusal tooth contact and to investigate the correlation between the occlusal stability and the masticatory muscle activities. It also evaluated the effect of short-term use of occlusal splints on the occlusal stability and the masticatory muscle activities in patients with temporomandibular disorders during maximum voluntary clenching by synchondronized with temporomandibular disorders during maximum voluntary clenching by synchronized use of the T-Scan system(Tekscan, Inc, USA) and K6-Diagnostic system(Myo-tronics Research, Inc, USA) The author measured its distance from retruded contact position(RCP) to intercuspal position(IP), average of contact intervals(ACI), total left-right statistics(TLR), average muscle activities of masseter and anterior temporal muscles during maximum voluntary clenching in 20 patients with temporomandibular disorders and 22 dental students as a control group. The data were compared between two groups and investigated for any correlations between the parameters. The results were as follows : 1. Both of the mean average of contact intervals and the mean absolute value of total left-right statistics during maximum voluntary clenching were increased in the patient group when compared with the control group. 2. Muscular disharmony of anterior temporal muscles of patient group is significantly greater than that of control group. However, muscular disharmony of masseter muscles of patient group is not significantly greater than that of control group. 3. There were significant correlations between muscular disharmony of anterior temporal muscles and average of contact intervals as well as total left-right statistics, and also between muscular disharmony of masseter muscles and total left-right statistics. 4. There were not any significant correlations between distance from RCP to IP and any other parameters. 5. There were a significant decrease in total left-right statistics and muscular disharmony of anterior temporal muscles during maximum voluntary clenching after a 1week use of occlusal splint in the patient group.