• Journal of The Korean Society of Integrative Medicine
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• v.8 no.3
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• pp.93-101
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• 2020

Purpose : Temporomandibular joint disorder (TMJD) is often accompanied by pain and limited range of motion of the jaw joint, which affect patients' quality of life and result in hypertrophy or hyperactivity of the muscles around the jaw joint. In this study, we compared the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and the jaw range of motion in individuals with and without TMJD. Correlation comparison was performed on the results of the TMJD group. Methods : This study included 40 patients; 20 patients were assigned to an experimental group (TMJD group) and 20 to a control group (non-TMJD group). Ultrasonography, myotonometry, and measurements performed with digital Vernier calipers were used to determine the changes in muscle thickness, muscle tone, and maximum jaw opening, respectively. The independent t-test was used for intergroup comparison of data, and Pearson correlation coefficients were used to compare correlations in the TMJD group results. Results : We observed a significant intergroup difference in the masseter and SCM thickness during the relaxed and clenched phases (p<.05). A significant intergroup difference was also observed in maximum jaw opening (p<.05). With regard to muscle tone, we observed a significant intergroup difference in frequency (p=.011) and stiffness (p=.011) of the masseter, as well as in the frequency (p=.009) and stiffness (p=.026) of the SCM. We observed a moderate negative correlation (r=-.524) between maximum jaw opening and the frequency of the masseter. Additionally, we observed a moderately negative correlation between jaw opening and muscle stiffness (r=-.321). Conclusion : Planning exercise programs to treat patients with TMJD who present with pain should focus on efforts to reduce muscle thickness and achieve muscle relaxation (to reduce muscle tension) for improved jaw range of motion.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.52 no.9
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• pp.560-567
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• 2003

EMG recordings of the electrical activity of muscle have proved to be a valuable tool in studying muscle function and reflex activity. SP(silent period) is elicited by a electrical stimulation on the chin during isometric contraction of jaw muscle. This paper proposes a model of the inhibitory reflex mechanism of jaw muscle after electrical stimulation. The SPs of jaw muscle after a electrical stimulation to the chin were divided into SP1 and SP2. SP1 is produced by the activation of periodontal receptors. The activation of nociceptors contributes to the SP2. As a result, the EMG signal generated by a proposed a model of inhibitory reflex mechanism is similar to real both EMG signal including SP1 and SP2. The present study have shown differences of SP1 and SP2 induced by inhibitory reflex mechanism.

• Journal of Oral Medicine and Pain
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• v.48 no.4
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• pp.159-168
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• 2023

Purpose: Coordinated activity between the jaw and neck muscles is important in oral motor tasks such as chewing. This study examined coherence between the jaw and neck muscles during chewing in healthy adults. Methods: A total of 12 healthy adults underwent electromyography (EMG) of the jaw and neck muscles during right-sided chewing at a frequency of 1 Hz. Surface electrodes were placed over the temporalis (TA), masseter (MS), anterior digastric (DA), and sternocleidomastoid (SM) muscles on the right side. EMG signals were processed for coherence and phase analysis using advanced signal processing techniques. Results: The MS and TA muscle pair exhibited high synchronization when chewing (median coherence=0.992). Contrarily, the coherence values between the MS and DA, as well as the MS and SM muscle pairs, were relatively low (median coherence=0.848 and 0.957, respectively). Phase analysis revealed minimal temporal differences between the MS and TA muscle pair and the MS and SM muscle pair, whereas substantial phase shifts were observed between the MS and DA muscle pair. Conclusions: During chewing in healthy adults, the TA muscle works synergistically whereas the DA muscle antagonistically with the MS muscle, and the SM muscle supports the activity of the MS muscle. The observed synchrony and coordination provide insights into the intricate interplay among these muscles during oral motor tasks.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.2
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• pp.171-178
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• 2007

Botulinum toxin type A (BTX-A) has a local effect at the neuromuscular junction by blocking acetylcholine release and thus causing paralysis and atrophy of the affected muscles. In dentistry, Botulinum toxin type A(BTX-A) is used for the treatment of masseteric hypertrophy, temporomandibular disorder, and severe bruxism related neurologic disorder. We hypothesized that the muscle atrophy after BTX-A injection into masseter muscle in growing rats, could affect the jaw growth. The purpose of this study was to determine the effects of the BTX-A injected into the masseter muscle on the jaw growth in rats. Rats were divided into four groups(group 1; control group, group 2; saline injection group, group 3; BTX-A injection group, group 4; baseline control group). Group 4 was sacrificed at the beginning of the experiment to provide baseline values of jaw measurements. The weight, length and width of jaw in those groups were measured every weeks. This study reported that the mandibular body length, condylar length, coronoid process length, anterior region height, coronoid process height and condylar height of the jaw in BTX-A injection group were shorter than those of the control and saline injection groups(P<0.05). In conclusion, BTX-A injected into the masseter muscle may affect the undergrowth of the jaw in rats.

• The Korean Journal of Pain
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• v.37 no.2
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• pp.164-177
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• 2024

Background: Neck and jaw pain is common and is associated with jaw functional limitations, postural stability, muscular endurance, and proprioception. This study aimed to investigate the effect of jaw and neck pain on cranio-cervico-mandibular functions and postural stability in patients with temporomandibular joint disorders (TMJDs). Methods: Fifty-two patients with TMJDs were included and assessed using Fonseca's Questionnaire and the Helkimo Clinical Dysfunction Index. An isometric strength test was performed for the TMJ depressor and cervical muscles. The TMJ position sense (TMJPS) test and cervical joint position error test (CJPET) were employed for proprioception. Total sway degree was obtained for the assessment of postural stability. Deep neck flexor endurance (DNFE) was assessed using the craniocervical flexion test. The mandibular function impairment questionnaire (MFIQ) was employed to assess mandibular function, and the craniovertebral angle (CVA) was measured for forward head posture. Results: Jaw and neck pain negatively affected CVA (R² = 0.130), TMJPS (R² = 0.286), DNFE (R² = 0.355), TMJ depressor (R² = 0.145), cervical flexor (R² = 0.144), and extensor (R² = 0.148) muscle strength. Jaw and neck pain also positively affected CJPET for flexion (R² = 0.116) and extension (R² = 0.146), as well as total sway degree (R² = 0.128) and MFIQ (R² = 0.230). Conclusions: Patients with painful TMJDs, could have impaired muscle strength and proprioception of the TMJ and cervical region. The jaw and neck pain could also affect postural stability, and the endurance of deep neck flexors as well as mandibular functions in TMJDs.

• Journal of Oral Medicine and Pain
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• v.40 no.3
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• pp.115-123
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• 2015

Purpose: The aim of this study was to elucidate the coordination patterns of the sternocleidomastoid and posterior cervical muscles in response to symmetrical and asymmetrical jaw functions in normal adults. Methods: Twenty-seven healthy volunteers (8 females, 19 males; mean age, $30.4{\pm}2.5$ years) participated in this study. Surface electromyography (EMG) was used to record activities in the masseter, suprahyoid, sternocleidomastoid, and posterior cervical muscles at rest and during maximum tooth clenching, biting of a cotton roll with the anterior teeth, unilateral biting of a cotton roll with the posterior teeth, bilateral biting of cotton rolls with the posterior teeth, and jaw opening while seated. Normalized amplitude, activity indices, and asymmetry indices were compared between the muscles and the jaw tasks. Results: During symmetrical jaw functions (e.g., tooth clenching, biting with the anterior teeth, bilateral biting with the posterior teeth, jaw opening), the sternocleidomastoid and posterior cervical muscles showed elevated EMG amplitudes compared with the resting condition. The co-activation pattern of the sternocleidomastoid muscle was more pronounced than those of the posterior cervical muscles during these tasks. During asymmetrical jaw functions (e.g., unilateral biting with the posterior teeth), the ipsilateral sternocleidomastoid and masseter muscles showed higher contraction activity than did the contralateral muscles, but the contralateral posterior cervical muscles were more active than the ipsilateral muscles. Conclusions: The sternocleidomastoid and posterior cervical muscles were shown to be co-activated and coordinated anteroposteriorly or bilaterally according to symmetrical or asymmetrical jaw function. These results suggest an integrated neural control mechanism for the jaw and neck muscles, and provide further evidence supporting the intimate functional coupling between the trigeminal and cervical neuromuscular systems.

• Physical Therapy Korea
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• v.26 no.1
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• pp.28-36
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• 2019

Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.63-71
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• 2021

PURPOSE: The purpose of this study was to investigate the effects of trigger finger on pain, muscle strength and function in carpal tunnel syndrome (CTS) patients. METHODS: A total of 60 subjects (30 carpal tunnel syndrome with trigger finger and 30 carpal tunnel syndrome without trigger finger) were assessment for pain, muscle strength (power grip, key pinch , tip to tip pinch, three jaw pinch) and function. The effect sizes of the two groups were compared, and the correlation between the trigger finger and each variable was analyzed. RESULTS: The results showed that there were significantly difference in the pain, muscle strength excluding three jaw pinch and function (p < .05). The results also showed correlation between trigger finger and pain (r = .552), muscle strength excluding three jaw pinch (power grip r = -.296, key pinch r = -.260, tip to tip pinch r = -.285), and function (r = .375). The function of carpal tunnel syndrome patients was related to pain (r = .550) and power grips (r = -.324) of muscle strength. CONCLUSION: In carpal tunnel syndrome patients with trigger finger compared to carpal tunnel syndrome, muscle weakness, pain increase, and function reduction were shown. In addition, trigger finger are correlated with muscle strength, pain and function, and muscle weakness and increased pain affect the daily living of carpal tunnel syndrome patients with triggers finger. Therefore, physical therapy interventions of carpal tunnel syndrome patients with trigger finger should be combined with treatment for muscle strength enhancement as well as pain reduction.

• Annals of Clinical Neurophysiology
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• v.8 no.2
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• pp.171-173
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• 2006

Marcus Gunn jaw winking phenomenon has been thought to result from a congenitally abnormal innervation of the levator palpaebrae muscle by a branch of the trigeminal nerve. A 22-year old man presented with bilateral eyelid elevation on the chewing or eating since infancy. Neurological examination showed bilateral Marcus Gunn Jaw wingking phenomenon in this patient. We referred this patient to the department of ophthalmology and plastic surgery for levator resection or orbicularis oculi muscle flap. We report bilateral Marcus Gunn jaw winking phenomenon, although unilateral disorder is the most common form of trigemino-oculomotor synkinesis. Neurologists should be aware of this phenomenon for decision of proper management and take detailed neurologic examination for elucidating the association of other cranial nerves.

• The korean journal of orthodontics
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• v.27 no.1
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• pp.35-44
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• 1997

mastication is basically regulated by central pattern regulalor(CPG) of brain system, target organ output from CPG is modulated by oral sensory feedback, anterior cross bite pattern infuluence the feedback mechanism and change muscle activity and jaw movement. The purpose of this study was to investigate differnce anterior cross bite group from normal group, the selected sample groups were 30 normal patient, 30 anterior cross bite patient. EMG and EGN of Biopak system were used for this study The following results were obtained 1 In resting slate of mandible, anterior cross-bite showed the higher muscle activities in all the muscle.(exception:left digastric muscle) than normal group. 2. In clenching state, No significant difference in muscle activities of normal group and anterior cross bite group was noticed 3. In swallowing state Normal group showed the higher muscle activities in left and right masseter muscle, right posterior temporal muscle. 4. In maximum opening and closing velocity, normal group showed the higher value than anterior cross-bite. 5. In the mean value of the maximum opening,the maximum anterior posterior movemenl from centric-occlusion, the lateral deviation from centric occclusion, normal group showed the higher value than anterior cross-bite group.