Premolar bite force was measured conventionally with a pressure transducer. During biting the tips of the buccal cusps made contact with the transducer. It was shown that the maximal bite force increased significantly if the eccentric load on the upper premolar was made centric and axial with respect to the transducer by covering the whole occlusal surface of the tooth with a plastic filling. Possible neurophysiological explanations of the difference in bite force are discussed. It is concluded that biting on a pressure transducer with an eccentric load cannot give a fair estimation of the true value of the maximal bite force during clenching in the position of intercuspidation.

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Differential diagnosis depends in cases with disk displacement on accurate identification of sound source. Mistakes may occur when clicking from one temporomandibular joint (TMJ) is heard on both sides of the head at auscultation and neither examiner nor patient, is sure about side. The hypothesis was that the head tissues affect spectral characteristics of TMJ sounds and that differences due to different positioning of sensors can be used in localization of source. The aim was to compare bilateral electronic recordings of unilateral TMJ sounds to obtain and compare attenuation, phase shift and time delay. Recordings were made from 12 subjects with unilateral clicking. Small electret condenser microphones, bandwidth 40-20 000 Hz, were placed at the openings of the auditory canals and the sounds were recorded at a sampling rate of 48 000 Hz. The head tissues acted as a filter causing a frequency dependent attenuation and phase shift. There was a time difference between the ipsi- and the contra lateral recordings, the latter always having a longer delay time (range 0.2-1.2 ms, group mean 0.68 ms, s.d. 0.292 ms). In conclusion, spectral analysis of bilateral electronic TMJ sound recordings is of diagnostic value when bilateral clicking is heard at auscultation and can help to avoid diagnosing a silent joint as clicking.

Temporomandibular joint (TMJ) sounds were recorded in 98 orthodontic retention patients, mean age 19 +/- 8.6 (s.d.) years, by interview, auscultation and electronic recording. Sounds were found by auscultation in 41% and by interview in 32% of the subjects, more often in females than in males (P < 0.05). A new method for time-frequency analysis, the reduced interference distribution (RID), was used to classify the electronic sound recordings into five subclasses, RID types 1-5, based upon location and number of their energy peaks. RID types 1-3 had a few energy peaks close in time. RID types 4-5, typical of subjects with crepitation, had multiple energy peaks occurring close in time for a period of 20-300 ms. RID type 1, found in 45% of the subjects, typical of patients with clicking, had its dominant energy peak located in a frequency range < 600 Hz and was significantly more common in the female than in the male subjects (P < 0.01). RID type 2, found in 68% of the subjects, with the dominant peak in the range 600-1200 Hz, and RID type 3, found in 38% of the subjects, with the peak in the frequency range > 1200 Hz, were found to have a similar gender distribution. RID type 4, found in 49% of the subjects, had the energy peaks distributed in the frequency range < 600 Hz. RID type 5, found in 43% of the subjects, more often in females than in males (P < 0.05), had the peaks distributed over the whole frequency range from about 30 Hz up to about 3000 Hz. In conclusion, a more detailed classification could be made of the TMJ sounds by displaying the RIDs than by auscultation. This suggests that RID classification methods may provide a means for differentiating sounds indicating different types of pathology.

The techniques and sites for EMG recordings from the digastric muscles are controversial. To re-evaluate old techniques for recording from the digastric muscles, especially the posterior bellies, the morphology of the muscles was studied by conventional dissections and by examination of specimens sectioned in the frontal and the horizontal planes. Based on these anatomical findings, recording sites and approaches to them were developed for the anterior and posterior bellies of the digastric muscles. EMG recordings from the two bellies of the muscle were obtained from five healthy subjects. The EMG recordings were ranked according to muscle activity level and the activity within single muscles and between muscles compared using the Wilcoxon signed rank test. The anterior and posterior bellies had synchronized activity in all mandibular movements but were silent or had negligible activity with the mandible in the rest position, when the head was rotated, and while clenching. Both bellies had marked to very marked activity during jaw opening, and moderate to marked activity during protrusion, retrusion and lateral movements. During swallowing the anterior and posterior bellies had patterns characterized by bursts of activity of high amplitude and short duration. The two bellies were not, however, always synchronously active.

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Background The objectives were to determine the percentage of children in Kindergarten through Grade 5 who reported TMD symptoms, to assess whether gender, race, and socioeconomic background mattered, and to explore the relationships between TMD and children’s oral health and oral health-related quality of life (OHRQoL). Methods Face-to-face interviews were conducted with 8,302 children in Kindergarten through Grade 5 (51% female/49% male; 53% African American/42% European American). Oral health screenings were conducted with 7,439 children. Results 23.6% of the children reported pain when chewing tough food and 18.8% when opening their mouth wide; 23.2% reported to hear a sound (clicking) when opening their mouth wide. Female students were more likely than male students and African American children were more likely than European American children to report TMD symptoms. The prevalence of TMD symptoms was not correlated with whether the children had a need for oral health care services, or whether they had an abscess or carious teeth with pulpal involvement. They were significantly associated with children’s OHRQoL. Conclusions Considerable percentages of 4–12 year old children reported TMD symptoms, with girls and African American children being more likely than their counterparts to be affected. Experiencing TMD symptoms is significantly associated with poorer OHRQoL. Practical Implications Dental practitioners need to be aware that substantial percentages of Kindergarten and elementary school age children experience TMD symptoms. Taking a dental history and conducting an oral exam should therefore include assessments of the signs and symptoms of TMD; treatment recommendations should be provided for affected children.

The aim of this study was to test the hypothesis that experimental and reversible changes of occlusion affect the levels of surface electromyographic (SEMG) activity in the anterior temporalis and masseter areas during unilateral maximal voluntary biting (MVB) in centric and eccentric position. Changes were achieved by letting 21 healthy subjects bite with and without a cotton roll between the teeth. The placement alternated between sides and between premolar and molar areas. The SEMG activity level was lower when biting in eccentric position without than with a cotton roll between teeth (P < 0.043). It was always lower with premolar than with molar support when biting with a cotton roll (P < 0.013). In the anterior temporalis areas, the SEMG activity was always lower on the balancing than on the working side (P < 0.001). Such a difference was also found in the masseter areas but only during molar-supported centric biting (P = 0.024). No differences were found when comparing the SEMG levels in masseter areas between centric and eccentric biting (P > 0.05). In the anterior temporalis area, the balancing side SEMG activity was lower in eccentric than in centric but only in molar-supported biting (P = 0.026). These results support that the masseter and anterior temporalis muscles have different roles in keeping the mandible in balance during unilateral supported MVB. Changes in occlusal stability achieved by biting with versus without a cotton roll were found to affect the SEMG activity levels.