Clinical/occlusal scores and jaw-muscle EMGs were recorded in 24 TMD symptomatic (group S) and 20 normal (group N) subjects to evaluate the significance of EMG parameters and their clinical associations. Results indicated: (1) integrated EMG activity (IEMG) was larger at the rest position (RP) in anterior temporalis (Ta) but smaller at maximal voluntary clenching (MVC) in masseter (Ma) and Ta, and the ratios of IEMG at 70%MVC to the corresponding bite force (70%BF) were greater in group S; (2) mean power frequency (MPF) were almost the same in both groups but its shift was more rapid in group S; (3) silent period duration (SPD) was longer in group S; (4) asymmetry indices for SPD and silent period latency (SPL) were larger in group S; (5) muscle pain was associated negatively with IEMG at MVC and 70%BF but positively with IEMGs at RP and 70%MVC, and impaired jaw movements were associated negatively with the above EMG values; (6) muscle pain was positively associated with SPD in Ma, while joint pain and sound showed positive and negative associations with SPD, respectively; (7) associations between occlusion and EMG parameters were found more in group N. These findings verify: (1) jaw elevators in TMD may have hyper-tonic activities and a weak functional efficiency; (2) jaw muscles in TMD may become easily fatigued following a functional effort, and less relaxed following a muscle twitch; (3) the severity of pain could not be reflected in EMG activities, but impaired jaw movement may increase tonic activity and decrease functional effort; (4) TMD symptoms may alter the functional adaptation of jaw-muscle activities and occlusion.
In order to undertake a quantitative evaluation of balance occlusal load, the use of the Dental Prescale System was investigated. The method uses a test sheet that undergoes a colour-developing chemical reaction, for detecting contact area, and a computerized analysis system, for evaluating the balance of occlusal load. Twenty natural dentate subjects and 10 hemimaxillectomy patients participated in the study. Each subject bit a test sheet as hard as possible for 3 s. The balance of occlusal load was expressed as a percentage of the load on the side with the lesser occlusive load (%OLR). The %OLR ranged from 39.7% to 49.4% in the natural dentate subjects, and from 0% to 31.3% in the hemimaxillectomy patients at their resection site. The patients' low %OLRs were attributed to loss of sustaining structure and subjective occlusal adjustment by clinicians. Combining technical simplicity, relatively high reproducibility, and diverse analysis capability, this system is useful for quantitative evaluation of balance of occlusal load in clinical situations.
Many objective methods have been described to evaluate masticatory function. Recently, a new chewing gum system has been reported that utilizes a phloxine-sodium bicarbonate reaction and measures a chromatic coordinate as a functional indicator. A low-adhesive colour-developing chewing gum has been developed by selecting an appropriate gum base. This study examined the applicability of the system and reproducibility of results in subjects with different dental states. Tests were performed on 15 natural dentate subjects and 15 complete denture wearers after determination of germane test conditions through a pilot study. The colour was measured by a*, one of the coordinates in the L*a*b* colour system. All subjects could perform the test. The coefficient of variation ranged from 1.87% to 7.90%, averaging 5.15% in the natural dentate subjects and from 1.5% to 17.9%, averaging 9.75% in the complete denture wearers. The 95% confidence interval of a* was 28.76 +/- 1.76 in the natural dentate subjects and 10.05 +/- 2.58 in the complete denture wearers. The results indicated that this material can be useful for both complete denture wearers and subjects with a natural dentition with adequate reproducibility.
Disc displacement is accepted as one of major findings in temporomandibular disorders (TMD). However, the associations of disc positions with morphological and positional changes of temporomandibular joint (TMJ) components and lateral pterygoid (LP), TMD clinical symptoms, and occlusion have rarely been discussed quantitatively. In this study, the morphological and positional changes of TMJ components and LP were assessed by means of magnetic resonance imaging (MRI) and tomography of the TMJ in 41 TMD and nine control (CN) subjects. Disc positions in TMD subjects were divided into normal position (NP) and anterior displacement with and without reduction (ADR+ and ADR-, respectively). From MRI scans and tomograms, the morphological and positional changes of TMJ components and LP were measured and compared among CN, NP, ADR+ and ADR- groups. Correlations between these measurements and the scored clinical symptoms and occlusal factors were analysed in TMD subjects. The results indicated that: (1) TMJ osseous structures and LP showed no significant difference among CN and the three TMD groups, except for a posterior seat of condyle and shorter/steeper condylar movement during jaw opening; (2) disc length and inclination were significantly shorter and steeper, respectively, in ADR+ and ADR-; (3) disc positions were not specified by clinical symptoms and occlusal factors, except for the dominant TMJ sounds in ADR+; (4) an uncoordinated movement of the condyle/disc complex was found in ADR+ and/or ADR-; (5) TMJ osseous structures and the disc were weakly associated with clinical symptoms and occlusal factors. However, the LP showed negative associations with palpable pain for both the TMJ and jaw muscles and the static occlusal factors. These findings suggest that TMJ internal derangements are more related to the positional changes or spatial relationships of TMJ components but less to the individual morphologies of TMJ osseous structures, disc and LP, as well as specific clinical symptoms and occlusal factors, which might be in disagreement with a large body of previous statements.
Primary gastrointestinal cancer frequently spreads to the mesentery, omentum and other parts of the peritoneum and these deposits are generally considered to be induced by intraperitoneal seeding from the primary lesion. In this work, we examined the spread of gastrointestinal cancer from the viewpoint of lymphogenous metastasis using a rat model of mesenteric lymph vessel obstruction. With these models, we carried out mesenteric lymphangiography on the fourth and sixth postoperative days (five animals each) to examine morphological changes in the lymph vessels and lymph flow. In model animals with mesenteric lymph vessel obstruction, re-celiotomy, performed on the fourth postoperative day, revealed marked mesenteric edema and enlargement of the mesenteric lymph nodes, suggestive of lymph retention. We also carried out mesenteric lymphangiography and obtained images of extensive mesenteric lymph vessels and reflux of lymph distal to the obstruction point in all five animals. On the sixth postoperative day, we obtained lymphangiographic images of lymphatico-venous communication in the mesentery in all five animals. Thus in animals with lymph vessel obstruction, the lymph flow appeared to change to lymphatico-venous communication or reverse lateral flow. In clinical cases, it is conceivable that lymph retention and reflux of lymph induced by lymph vessel obstruction sometimes play a role in the mechanism of intraperitoneal cancer dissemination and hematogenous metastasis.
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